首页 期刊 论文 学科刊群 资讯 加盟 关于
EN
image
Article(id=1240972420601934523, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240972413354176744, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202311072, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1699200000000, receivedDateStr=2023-11-06, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773800481224, onlineDateStr=2026-03-18, pubDate=1715270400000, pubDateStr=2024-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773800481224, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773800481223, creator=13701087609, updateTime=1773800481223, updator=13701087609, issue=Issue{id=1240972413354176744, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='9', pageStart='1537', pageEnd='1728', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773800479495, creator=13701087609, updateTime=1773800596829, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240972905568334240, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240972413354176744, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240972905568334241, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240972413354176744, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1568, endPage=1573, ext={EN=ArticleExt(id=1240972421012976347, articleId=1240972420601934523, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis on influencing factors of multimorbidity of two common chronic diseases, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the risk factors of two common chronic diseases in order to provide evidence for the prevention of common chronic diseases and government investment in disease management.

Methods

Four waves follow-up data of China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018 were used. In total 2 992 and 1 952 patients with hypertension and rheumatism or arthritis, stomach diseases and rheumatism or arthritis were included. Cox proportional hazard model and shared vulnerability model were used to analyze the influencing factors of multimorbidity.

Results

For people with hypertension and rheumatism or arthritis, living in rural areas (HR=1.367, 95%CI: 1.096-1.705), advanced age group (HR=1.342, 95%CI: 1.013-1.778), obesity (HR=2.424, 95%CI: 1.790-3.283), rheumatism or arthritis as first onset disease (HR=3.797, 95%CI: 3.059-4.713) and other chronic diseases more than 1 (HR=2.694, 95%CI: 2.042-3.555) were associated with a higher possibility of multimorbidity, while people with high education level (HR=0.766, 95%CI: 0.594-0.988) had a lower possibility of multimorbidity, and the shared vulnerability model outperformed Cox model. For people with stomach disease and rheumatism or hypertension: advanced age (HR=0.392, 95%CI: 0.240-0.640), highly educated (HR=0.667, 95%CI: 0.461-0.964),and overweight (HR=0.720, 95%CI: 0.540-0.96)) were associated with lower possibility to have multimorbidity, negative health self-assessment (HR=1.409, 95%CI: 1.038-1.912), being lean (HR=1.935, 95%CI: 1.198-3.126), and having more than 1 chronic diseases (HR=2.339, 95%CI: 1.644-3.328) were associated with higher possibility to have multimorbidity, and there was no significant difference between the two models in this population.

Conclusion

In the hierarchical survival data, the fitting effect of the shared fragile model is better than that of the traditional model. In the group of patients with hypertension and rheumatism or arthritis, there is an increased risk of rheumatism or arthritis in the older age group, obesity and the first onset of rheumatism or arthritis, and the incidence of stomach disease and rheumatism or arthritis is lower in the higher age group and overweight group. Therefore, the prevention measures of chronic multimorbidity should be taken based on different combinations of common diseases to identify high-risk groups respectively, carry out different intervention behaviors, accurately invest medical resources, and reduce the disease burden of the government.

, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Rui LI, Wei LEI, Wen-li BAI, Yin-zhen LI, Ya-zhou ZHANG, Mei ZHANG, Dong-sheng RUI, Kui WANG), CN=ArticleExt(id=1240972421440795391, articleId=1240972420601934523, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=两种常见慢性病共病的影响因素分析, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

了解两种常见慢性病的危险因素，以期为慢性病共病预防和政府的疾病投入提供依据。

方法

采用中国健康与养老追踪调查（China health and retirement longitudinal study，CHARLS）2011—2018年四次随访数据。纳入高血压和风湿病或关节炎、胃部疾病和风湿病或关节炎两种慢性病共病人群2 992和1 952例。采用Cox比例风险模型和共享脆弱模型分析共病发生影响因素。

结果

高血压和风湿病或关节炎人群：居住在农村（HR=1.367，95%CI：1.096～1.705）、高年龄组（HR=1.342，95%CI：1.013～1.778）、肥胖（HR=2.424，95%CI：1.790～3.283）、首发病是风湿病或关节炎（HR= 3.797，95%CI：3.059～4.713）、其他慢性病数量大于1（HR=2.694，95%CI：2.042～3.555）人群发生共病的可能性更高，高受教育水平（HR=0.766，95%CI：0.594～0.988）人群发生共病可能性较低，共享脆弱模型拟合程度优于Cox模型。胃部疾病和风湿病或高血压人群：高年龄组（HR=0.392，95%CI：0.240～0.640）、受教育水平高（HR=0.667，95%CI：0.461～0.964）、超重（HR=0.720，95%CI：0.540～0.96）人群中共病发生的可能性较低，健康自评消极（HR=1.409，95%CI：1.038～1.912）、偏瘦（HR=1.935，95%CI：1.198～3.126）、慢性病数量大于1人群（HR=2.339，95%CI：1.644～3.328）发生共病可能性更高，该人群中两模型结果无太大差异。

结论

层次生存数据中，共享脆弱模型拟合效果高于传统模型。高血压和风湿病或关节炎共病人群中高年龄组、肥胖、首发病是风湿病或关节炎人群发病风险升高，高年龄组、超重人群中胃部疾病和风湿病或关节炎共病发生可能性更低。因此慢性病共病的预防应针对不同共病组合，分别确定高危人群，进行不同的干预行为，准确进行医疗资源的投入，降低政府的疾病负担。

, correspAuthors=null, authorNote=null, correspAuthorsNote=
王奎，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=nGe8u1OpeMqlnNi0TMczyg==, magXml=T/eBizWntmP4gBqQueURfA==, pdfUrl=null, pdf=xrr+b3oRdnBXPh0hexx5Zw==, pdfFileSize=674320, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=XL/aBkipvFHcVRQ+hrBIzg==, mapNumber=null, authorCompany=null, fund=null, authors=

李瑞（1988—），男，硕士在读，研究方向：流行病与卫生统计学

, authorsList=李瑞, 雷伟, 摆文丽, 李寅臻, 张亚洲, 张眉, 芮东升, 王奎)}, authors=[Author(id=1240986260496503612, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1240986260651692869, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, authorId=1240986260496503612, language=EN, stringName=Rui LI, firstName=Rui, middleName=null, lastName=LI, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1240986261012403023, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, authorId=1240986260496503612, language=CN, stringName=李瑞, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=1.石河子大学医学院预防医学系，新疆 石河子 832000
2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000, bio={"content":"

李瑞（1988—），男，硕士在读，研究方向：流行病与卫生统计学

"}, bioImg=null, bioContent=

李瑞（1988—），男，硕士在读，研究方向：流行病与卫生统计学

, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1240986259259183913, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=1., ext=[AuthorCompanyExt(id=1240986259271766824, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas), AuthorCompanyExt(id=1240986259280155433, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.石河子大学医学院预防医学系，新疆 石河子 832000)]), AuthorCompany(id=1240986259955438385, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=2., ext=[AuthorCompanyExt(id=1240986259963826995, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259955438385, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000)])]), Author(id=1240986261104677717, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, orderNo=1, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1240986261322781534, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, authorId=1240986261104677717, language=EN, stringName=Wei LEI, firstName=Wei, middleName=null, lastName=LEI, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1240986261670908777, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, authorId=1240986261104677717, language=CN, stringName=雷伟, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=1.石河子大学医学院预防医学系，新疆 石河子 832000
2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1240986259259183913, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=1., ext=[AuthorCompanyExt(id=1240986259271766824, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas), AuthorCompanyExt(id=1240986259280155433, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.石河子大学医学院预防医学系，新疆 石河子 832000)]), AuthorCompany(id=1240986259955438385, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=2., ext=[AuthorCompanyExt(id=1240986259963826995, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259955438385, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000)])]), Author(id=1240986261821903735, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, orderNo=2, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1240986262006453120, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, authorId=1240986261821903735, language=EN, stringName=Wen-li BAI, firstName=Wen-li, middleName=null, lastName=BAI, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1240986262170030988, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, authorId=1240986261821903735, language=CN, stringName=摆文丽, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=1.石河子大学医学院预防医学系，新疆 石河子 832000
2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1240986259259183913, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=1., ext=[AuthorCompanyExt(id=1240986259271766824, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas), AuthorCompanyExt(id=1240986259280155433, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.石河子大学医学院预防医学系，新疆 石河子 832000)]), AuthorCompany(id=1240986259955438385, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=2., ext=[AuthorCompanyExt(id=1240986259963826995, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259955438385, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000)])]), Author(id=1240986262438466461, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, orderNo=3, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1240986262593655723, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, authorId=1240986262438466461, language=EN, stringName=Yin-zhen LI, firstName=Yin-zhen, middleName=null, lastName=LI, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1240986262727873463, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, authorId=1240986262438466461, language=CN, stringName=李寅臻, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=1.石河子大学医学院预防医学系，新疆 石河子 832000
2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1240986259259183913, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=1., ext=[AuthorCompanyExt(id=1240986259271766824, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas), AuthorCompanyExt(id=1240986259280155433, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.石河子大学医学院预防医学系，新疆 石河子 832000)]), AuthorCompany(id=1240986259955438385, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=2., ext=[AuthorCompanyExt(id=1240986259963826995, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259955438385, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000)])]), Author(id=1240986262992114626, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, orderNo=4, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1240986263168275409, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, authorId=1240986262992114626, language=EN, stringName=Ya-zhou ZHANG, firstName=Ya-zhou, middleName=null, lastName=ZHANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1240986263398962140, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, authorId=1240986262992114626, language=CN, stringName=张亚洲, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=1.石河子大学医学院预防医学系，新疆 石河子 832000
2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1240986259259183913, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=1., ext=[AuthorCompanyExt(id=1240986259271766824, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas), AuthorCompanyExt(id=1240986259280155433, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.石河子大学医学院预防医学系，新疆 石河子 832000)]), AuthorCompany(id=1240986259955438385, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=2., ext=[AuthorCompanyExt(id=1240986259963826995, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259955438385, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000)])]), Author(id=1240986263885501415, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, orderNo=5, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1240986264250405870, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, authorId=1240986263885501415, language=EN, stringName=Mei ZHANG, firstName=Mei, middleName=null, lastName=ZHANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1240986264359457786, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, authorId=1240986263885501415, language=CN, stringName=张眉, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=1.石河子大学医学院预防医学系，新疆 石河子 832000
2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1240986259259183913, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=1., ext=[AuthorCompanyExt(id=1240986259271766824, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas), AuthorCompanyExt(id=1240986259280155433, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.石河子大学医学院预防医学系，新疆 石河子 832000)]), AuthorCompany(id=1240986259955438385, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=2., ext=[AuthorCompanyExt(id=1240986259963826995, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259955438385, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000)])]), Author(id=1240986264472702978, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, orderNo=6, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1240986264674029587, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, authorId=1240986264472702978, language=EN, stringName=Dong-sheng RUI, firstName=Dong-sheng, middleName=null, lastName=RUI, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1240986264866967581, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, authorId=1240986264472702978, language=CN, stringName=芮东升, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=1.石河子大学医学院预防医学系，新疆 石河子 832000
2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1240986259259183913, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=1., ext=[AuthorCompanyExt(id=1240986259271766824, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas), AuthorCompanyExt(id=1240986259280155433, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.石河子大学医学院预防医学系，新疆 石河子 832000)]), AuthorCompany(id=1240986259955438385, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=2., ext=[AuthorCompanyExt(id=1240986259963826995, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259955438385, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000)])]), Author(id=1240986265085071400, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, orderNo=7, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=kwang_shzu@163.com, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1240986265236066357, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, authorId=1240986265085071400, language=EN, stringName=Kui WANG, firstName=Kui, middleName=null, lastName=WANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1240986265538056262, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, authorId=1240986265085071400, language=CN, stringName=王奎, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=1.石河子大学医学院预防医学系，新疆 石河子 832000
2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1240986259259183913, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=1., ext=[AuthorCompanyExt(id=1240986259271766824, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas), AuthorCompanyExt(id=1240986259280155433, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.石河子大学医学院预防医学系，新疆 石河子 832000)]), AuthorCompany(id=1240986259955438385, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=2., ext=[AuthorCompanyExt(id=1240986259963826995, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259955438385, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000)])])], keywords=[Keyword(id=1240986266032984159, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, language=EN, orderNo=1, keyword=Multimorbidity), Keyword(id=1240986266192367724, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, language=EN, orderNo=2, keyword=CHARLS data), Keyword(id=1240986266372722801, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, language=EN, orderNo=3, keyword=Influencing factor analysis), Keyword(id=1240986266670518396, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, language=EN, orderNo=4, keyword=Hierarchical data), Keyword(id=1240986266884427905, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, language=CN, orderNo=1, keyword=慢性病共病), Keyword(id=1240986267064782992, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, language=CN, orderNo=2, keyword=CHARLS数据), Keyword(id=1240986267329024153, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, language=CN, orderNo=3, keyword=影响因素分析), Keyword(id=1240986267454853284, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, language=CN, orderNo=4, keyword=层次结构数据)], refs=[Reference(id=1240986269975630078, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2021, volume=11, issue=2, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=Marthias T, Anindya K, Ng N, journalName=BMJ Open, refType=null, unstructuredReference=Marthias T, Anindya K, Ng N, et al. Impact of non-communicable disease multimorbidity on health service use, catastrophic health expenditure and productivity loss in Indonesia: a population-based panel data analysis study[J]. BMJ Open, 2021, 11(2): e041870., articleTitle=Impact of non-communicable disease multimorbidity on health service use, catastrophic health expenditure and productivity loss in Indonesia: a population-based panel data analysis study, refAbstract=null), Reference(id=1240986270147596549, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2022, volume=25, issue=10, pageStart=1186, pageEnd=1190, 1196, url=null, language=null, rfNumber=[2], rfOrder=1, authorNames=王浩, 张琳, 方晓雅, journalName=中国全科医学, refType=null, unstructuredReference=王浩，张琳，方晓雅，等.中国中老年人慢性病共病现状及其空间分布研究[J].中国全科医学，2022，25（10）：1186-1190, 1196., articleTitle=中国中老年人慢性病共病现状及其空间分布研究, refAbstract=null), Reference(id=1240986270319563019, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2022, volume=25, issue=10, pageStart=1186, pageEnd=1190, 1196, url=null, language=null, rfNumber=[2], rfOrder=2, authorNames=Wang H, Zhang L, Fang XY, journalName=Chinese General Practice, refType=null, unstructuredReference=Wang H, Zhang L, Fang XY, et al. Prevalence and spatial analysis of chronic comorbidity among Chinese middle-aged and elderly People[J].Chinese General Practice, 2022, 25(10): 1186-1190, 1196., articleTitle=Prevalence and spatial analysis of chronic comorbidity among Chinese middle-aged and elderly People, refAbstract=null), Reference(id=1240986270546055441, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[3], rfOrder=3, authorNames=World Health Organization, journalName=null, refType=null, unstructuredReference=World Health Organization. World health statistics 2022:monitoring health for the SDGs, sustainable development goals[EB/OL]. [2024-03-15]. https://www.who.int/., articleTitle=World health statistics 2022:monitoring health for the SDGs, sustainable development goals, refAbstract=null), Reference(id=1240986270663495961, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2021, volume=12, issue=1, pageStart=e03647, pageEnd=20, url=null, language=null, rfNumber=[4], rfOrder=4, authorNames=Ng WH, Tipih T, Makoah NA, journalName=mBio, refType=null, unstructuredReference=Ng WH, Tipih T, Makoah NA, et al. Comorbidities in SARS-CoV-2 patients: a systematic review and Meta-Analysis[J]. mBio, 2021, 12(1): e03647-20., articleTitle=Comorbidities in SARS-CoV-2 patients: a systematic review and Meta-Analysis, refAbstract=null), Reference(id=1240986271003234597, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2023, volume=26, issue=29, pageStart=3599, pageEnd=3607, url=null, language=null, rfNumber=[5], rfOrder=5, authorNames=何莉, 张逸凡, 沈雪纯, journalName=中国全科医学, refType=null, unstructuredReference=何莉，张逸凡，沈雪纯，等.中国大陆地区居民慢性病共病的流行趋势:一项Meta分析[J].中国全科医学，2023，26（29）：3599-3607., articleTitle=中国大陆地区居民慢性病共病的流行趋势:一项Meta分析, refAbstract=null), Reference(id=1240986271200366892, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2023, volume=26, issue=29, pageStart=3599, pageEnd=3607, url=null, language=null, rfNumber=[5], rfOrder=6, authorNames=He L, Zhang YF, Shen XC, journalName=Chinese General Practice, refType=null, unstructuredReference=He L, Zhang YF, Shen XC, et al. Prevalence trends of multimorbidity among residents in mainland China:a Meta-analysis[J]. Chinese General Practice, 2023, 26(29): 3599-3607., articleTitle=Prevalence trends of multimorbidity among residents in mainland China:a Meta-analysis, refAbstract=null), Reference(id=1240986271317807413, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2022, volume=12, issue=4, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[6], rfOrder=7, authorNames=Ho ISS, Azcoaga-Lorenzo A, Akbari A, journalName=BMJ Open, refType=null, unstructuredReference=Ho ISS, Azcoaga-Lorenzo A, Akbari A, et al. Variation in the estimated prevalence of multimorbidity: systematic review and meta-analysis of 193 international studies[J]. BMJ Open, 2022, 12(4): e057017., articleTitle=Variation in the estimated prevalence of multimorbidity: systematic review and meta-analysis of 193 international studies, refAbstract=null), Reference(id=1240986271426859324, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2023, volume=26, issue=21, pageStart=2574, pageEnd=2580, url=null, language=null, rfNumber=[7], rfOrder=8, authorNames=冯佳, 王洁, 余丹, journalName=中国全科医学, refType=null, unstructuredReference=冯佳，王洁，余丹，等.2010—2021年国内外老年多重慢病研究热点分析[J].中国全科医学，2023，26（21）：2574-2580., articleTitle=2010—2021年国内外老年多重慢病研究热点分析, refAbstract=null), Reference(id=1240986271619797313, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2023, volume=26, issue=21, pageStart=2574, pageEnd=2580, url=null, language=null, rfNumber=[7], rfOrder=9, authorNames=Feng J, Wang J, Yu D, journalName=Chinese General Practice, refType=null, unstructuredReference=Feng J, Wang J, Yu D, et al. Analysis of research hotspots of multiple chronic conditions in the elderly in 2010-2021[J]. Chinese General Practice, 2023, 26(21): 2574-2580., articleTitle=Analysis of research hotspots of multiple chronic conditions in the elderly in 2010-2021, refAbstract=null), Reference(id=1240986271884038469, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2022, volume=25, issue=19, pageStart=2371, pageEnd=2378, url=null, language=null, rfNumber=[8], rfOrder=10, authorNames=范潇茹, 陈莎, 施予宁, journalName=中国全科医学, refType=null, unstructuredReference=范潇茹，陈莎，施予宁，等.我国中老年人慢性病共病现状及其对卫生服务利用和医疗费用的影响研究[J].中国全科医学，2022，25（19）：2371-2378., articleTitle=我国中老年人慢性病共病现状及其对卫生服务利用和医疗费用的影响研究, refAbstract=null), Reference(id=1240986272580292940, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2022, volume=25, issue=19, pageStart=2371, pageEnd=2378, url=null, language=null, rfNumber=[8], rfOrder=11, authorNames=Fan XR, Chen S, Shi YN, journalName=Chinese General Practice, refType=null, unstructuredReference=Fan XR, Chen S, Shi YN, et al. Multimorbidity prevalence and its association with health service utilization and medical costs among middle-aged and older Chinese People[J]. Chinese General Practice, 2022, 25(19):2371-2378., articleTitle=Multimorbidity prevalence and its association with health service utilization and medical costs among middle-aged and older Chinese People, refAbstract=null), Reference(id=1240986273058443598, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2023, volume=42, issue=21, pageStart=3745, pageEnd=3763, url=null, language=null, rfNumber=[9], rfOrder=12, authorNames=Tawiah R, Bondell H, journalName=Medicine Statistics, refType=null, unstructuredReference=Tawiah R, Bondell H. Multilevel joint frailty model for hierarchically clustered binary and survival data[J]. Medicine Statistics, 2023, 42(21): 3745-3763., articleTitle=Multilevel joint frailty model for hierarchically clustered binary and survival data, refAbstract=null), Reference(id=1240986273272353110, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2021, volume=63, issue=7, pageStart=1493, pageEnd=1506, url=null, language=null, rfNumber=[10], rfOrder=13, authorNames=Kim SW, Schumacher M, Augustin NH, journalName=Biometrical Journal, refType=null, unstructuredReference=Kim SW, Schumacher M, Augustin NH. A shared frailty model for multivariate longitudinal data on adverse event of radiation therapy[J]. Biometrical Journal, 2021, 63(7): 1493-1506., articleTitle=A shared frailty model for multivariate longitudinal data on adverse event of radiation therapy, refAbstract=null), Reference(id=1240986273364627802, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2014, volume=43, issue=1, pageStart=61, pageEnd=68, url=null, language=null, rfNumber=[11], rfOrder=14, authorNames=Zhao YH, Hu YS, Smith JP, journalName=International Journal of Epidemiology, refType=null, unstructuredReference=Zhao YH, Hu YS, Smith JP, et al. Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS)[J]. International Journal of Epidemiology, 2014, 43(1): 61-68., articleTitle=Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS), refAbstract=null), Reference(id=1240986273490456929, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2022, volume=72, issue=1, pageStart=926, pageEnd=null, url=null, language=null, rfNumber=[12], rfOrder=15, authorNames=Liu Q, Charleston MA, Richards SA, journalName=Systematic Biology, refType=null, unstructuredReference=Liu Q, Charleston MA, Richards SA, et al. Performance of AIC and Bic in selecting partition models and mixture models[J]. Systematic Biology, 2022, 72(1): 926., articleTitle=Performance of AIC and Bic in selecting partition models and mixture models, refAbstract=null), Reference(id=1240986273704366441, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2022, volume=80, issue=1, pageStart=195, pageEnd=null, url=null, language=null, rfNumber=[13], rfOrder=16, authorNames=Tesema GA, Seifu BL, Tessema ZT, journalName=Archives of Public Health, refType=null, unstructuredReference=Tesema GA, Seifu BL, Tessema ZT, et al.Incidence of infant mortality and its predictors in East Africa using Gompertz gamma shared frailty model[J]. Archives of Public Health, 2022, 80(1): 195., articleTitle=Incidence of infant mortality and its predictors in East Africa using Gompertz gamma shared frailty model, refAbstract=null), Reference(id=1240986273935053169, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2023, volume=37, issue=8, pageStart=1492, pageEnd=1495, url=null, language=null, rfNumber=[14], rfOrder=17, authorNames=梁丽芬, 李静颖, 赵静, journalName=护理研究, refType=null, unstructuredReference=梁丽芬，李静颖，赵静，等.太原市晋源区慢性病老年人共病现状及影响因素[J].护理研究，2023，37（8）：1492-1495., articleTitle=太原市晋源区慢性病老年人共病现状及影响因素, refAbstract=null), Reference(id=1240986274010550646, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2023, volume=37, issue=8, pageStart=1492, pageEnd=1495, url=null, language=null, rfNumber=[14], rfOrder=18, authorNames=Liang LF, Li JY, Zhao J, journalName=Chinese Nursing Research, refType=null, unstructuredReference=Liang LF, Li JY, Zhao J, et al. Current situation and influencing factors on comorbidity among elderly People with chronic disease in Jinyuan district,Taiyuan city[J]. Chinese Nursing Research, 2023, 37(8): 1492-1495., articleTitle=Current situation and influencing factors on comorbidity among elderly People with chronic disease in Jinyuan district,Taiyuan city, refAbstract=null), Reference(id=1240986274111213944, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2021, volume=37, issue=4, pageStart=518, pageEnd=524, url=null, language=null, rfNumber=[15], rfOrder=19, authorNames=刘帅帅, 张露文, 陆翘楚, journalName=实用医学杂志, refType=null, unstructuredReference=刘帅帅，张露文，陆翘楚，等.中国中老年人多重慢性病现状调查与健康损失因素探究:基于CHARLS 2018数据[J].实用医学杂志，2021，37（4）：518-524., articleTitle=中国中老年人多重慢性病现状调查与健康损失因素探究:基于CHARLS 2018数据, refAbstract=null), Reference(id=1240986274367066491, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2021, volume=37, issue=4, pageStart=518, pageEnd=524, url=null, language=null, rfNumber=[15], rfOrder=20, authorNames=Liu SS, Zhang LW, Lu QC, journalName=The Journal of Practical Medicine, refType=null, unstructuredReference=Liu SS, Zhang LW, Lu QC, et al. The prevalence of multi-morbidity and related functional limitation among middle-aged and Senior population in China: nationally evidence from CHARLS 2018[J]. The Journal of Practical Medicine, 2021, 37(4): 518-524., articleTitle=The prevalence of multi-morbidity and related functional limitation among middle-aged and Senior population in China: nationally evidence from CHARLS 2018, refAbstract=null), Reference(id=1240986274597753218, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2022, volume=10, issue=4, pageStart=253, pageEnd=263, url=null, language=null, rfNumber=[16], rfOrder=21, authorNames=Kivimäki M, Strandberg T, Pentti J, journalName=Lancet Diabetes Endocrinol, refType=null, unstructuredReference=Kivimäki M, Strandberg T, Pentti J, et al. Body-mass index and risk of obesity-related complex multimorbidity: an observational multicohort study[J].Lancet Diabetes Endocrinol, 2022, 10(4): 253-263., articleTitle=Body-mass index and risk of obesity-related complex multimorbidity: an observational multicohort study, refAbstract=null), Reference(id=1240986274811662726, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2024, volume=73, issue=2, pageStart=243, pageEnd=252, url=null, language=null, rfNumber=[17], rfOrder=22, authorNames=Xie HL, Wei LS, Zhang HY, journalName=Inflammation Research, refType=null, unstructuredReference=Xie HL,Wei LS,Zhang HY,et al.Association of systemic inflammation with the obesity paradox in cancer: results from multi-cohort studies[J]. Inflammation Research, 2024, 73(2): 243-252., articleTitle=Association of systemic inflammation with the obesity paradox in cancer: results from multi-cohort studies, refAbstract=null), Reference(id=1240986274912326026, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2022, volume=30, issue=5, pageStart=381, pageEnd=384, url=null, language=null, rfNumber=[18], rfOrder=23, authorNames=李亚杰, 李剑波, 莘军龙, journalName=中国慢性病预防与控制, refType=null, unstructuredReference=李亚杰，李剑波，莘军龙，等.老年流动人口高血压和糖尿病患病现状及与自评健康的相关性研究[J].中国慢性病预防与控制，2022，30（5）：381-384., articleTitle=老年流动人口高血压和糖尿病患病现状及与自评健康的相关性研究, refAbstract=null), Reference(id=1240986275012989326, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, doi=null, pmid=null, pmcid=null, year=2022, volume=30, issue=5, pageStart=381, pageEnd=384, url=null, language=null, rfNumber=[18], rfOrder=24, authorNames=Li YJ, Li JB, Shen JL, journalName=Chinese Journal of Prevention and Control of Chronic Diseases, refType=null, unstructuredReference=Li YJ, Li JB, Shen JL, et al. Study on the prevalence of Hypertension and diabetes in the elderly floating population and their correlation with self rated health[J]. Chinese Journal of Prevention and Control of Chronic Diseases, 2022, 30(5): 381-384., articleTitle=Study on the prevalence of Hypertension and diabetes in the elderly floating population and their correlation with self rated health, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1240986259259183913, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=1., ext=[AuthorCompanyExt(id=1240986259271766824, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas), AuthorCompanyExt(id=1240986259280155433, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259259183913, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.石河子大学医学院预防医学系，新疆 石河子 832000)]), AuthorCompany(id=1240986259955438385, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, xref=2., ext=[AuthorCompanyExt(id=1240986259963826995, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, companyId=1240986259955438385, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000)])], figs=[ArticleFig(id=1240986268067221691, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, language=EN, label=Table 1, caption=

Univariate analysis of factors associated with the occurrence of two MMD ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量高血压和风湿病或关节炎胃部疾病和风湿病或关节炎
非共病组共病组HR Z值P值非共病组共病组HR Z值P值
居住类型
城市965(37.7)123(28.5)———626(37.0)83(31.9)———
农村1 595(62.3)309(71.5)1.453.484<0.0011 066(63.0)177(68.1)1.2211.5010.133
年龄(岁)
0～49751(29.3)101(23.4)———450(26.6)80(30.8)———
50～59862(33.7)163(37.7)1.3542.3950.017610(36.1)96(36.9)0.882-0.8300.407
60～69644(25.2)119(27.5)1.3222.0630.039432(25.5)59(22.7)0.773-1.4980.134
70～110303(11.8)49(11.3)1.1770.9360.349200(11.8)25(9.6)0.723-1.4160.157
性别
男1 270(49.6)195(45.1)———766(45.3)99(38.1)———
女1 290(50.4)237(54.9)1.1871.7720.076926(54.7)161(61.9)1.3182.1590.031
受教育水平
文盲1 050(41.0)219(50.7)———721(42.6)126(48.5)———
小学或私塾629(24.6)92(21.3)0.719-2.6500.008379(22.4)64(24.6)0.972-0.1870.8519
中学564(22.0)83(19.2)0.726-2.4870.013379(22.4)42(16.2)0.653-2.3900.017
高中及以上317(12.4)38(8.8)0.607-2.8400.005213(12.6)28(10.8)0.780-1.1860.236
婚姻状况
有配偶2 328(90.9)384(88.9)———1 516(89.6)223(85.8)———
无配偶232(9.1)48(11.1)1.2181.2870.198176(10.4)37(14.2)1.4031.9080.06
睡觉时间
睡眠充足1 124(43.9)161(37.3)———736(43.5)98(37.7)———
睡眠不足1 210(47.3)235(54.4)1.3352.8260.005815(48.2)136(52.3)1.2321.5710.116
睡眠过多226(8.8)36(8.3)1.1070.5500.582141(8.3)26(10.0)1.3571.3830.167
吸烟
不吸烟1 522(59.5)257(59.5)———1 068(63.1)174(66.9)———
吸烟1 038(40.5)175(40.5)0.995-0.0550.959624(36.9)86(33.1)0.855-1.1880.235
饮酒
不饮酒1 633(63.8)274(63.4)———1 138(67.3)176(67.7)———
饮酒较少202(7.9)28(6.5)0.837-0.8970.370128(7.6)20(7.7)1.0130.0580.953
饮酒较多725(28.3)130(30.1)1.0640.5860.558426(25.2)64(24.6)0.985-0.1020.919
健康自评
一般1 669(65.2)285(66.0)———1 115(65.9)157(60.4)———
积极557(21.8)68(15.7)0.731-2.3260.020337(19.9)39(15.0)0.830-1.0390.299
消极334(13)79(18.3)1.3332.2610.024240(14.2)64(24.6)1.7563.196<0.001
BMI
正常1 317(51.4)220(50.9)———879(52.0)143(55.0)———
偏瘦113(4.4)22(5.1)1.1630.6750.49959(3.5)20(7.7)1.9122.7160.006
超重916(35.8)131(30.3)0.876-1.2050.228600(35.5)77(29.6)0.809-1.4980.134
肥胖214(8.4)59(13.7)1.6073.2360.001154(9.1)20(7.7)0.818-0.8370.402
民族
汉族2 366(92.4)386(89.4)———1 561(92.3)232(89.2)———
其他194(7.6)46(10.6)1.4042.1770.030131(7.7)28(10.8)1.40371.6950.090
发生共病前其他慢病的数量
（种）
0963(37.6)109(25.2)———658(38.9)72(27.7)———
1794(31.0)323(26.2)1.2481.6530.098452(26.7)61(23.5)1.2171.1290.259
2445(17.4)97(22.5)1.8424.374<0.001279(16.5)52(20.0)1.6242.6640.008
>2358(14.0)113(26.2)2.5546.984<0.001303(17.9)75(28.8)2.09734.488<0.001
首发病是风湿病或关节炎
否1 555(60.7)125(28.9)———654(38.7)88(33.8)———
是1 005(39.3)307(71.1)3.49611.79<0.0011 038(61.3)172(66.2)1.2341.6040.109
), ArticleFig(id=1240986268616675520, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, language=CN, label=表1, caption=

两种共病发生影响因素的单因素分析［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量高血压和风湿病或关节炎胃部疾病和风湿病或关节炎
非共病组共病组HR Z值P值非共病组共病组HR Z值P值
居住类型
城市965(37.7)123(28.5)———626(37.0)83(31.9)———
农村1 595(62.3)309(71.5)1.453.484<0.0011 066(63.0)177(68.1)1.2211.5010.133
年龄(岁)
0～49751(29.3)101(23.4)———450(26.6)80(30.8)———
50～59862(33.7)163(37.7)1.3542.3950.017610(36.1)96(36.9)0.882-0.8300.407
60～69644(25.2)119(27.5)1.3222.0630.039432(25.5)59(22.7)0.773-1.4980.134
70～110303(11.8)49(11.3)1.1770.9360.349200(11.8)25(9.6)0.723-1.4160.157
性别
男1 270(49.6)195(45.1)———766(45.3)99(38.1)———
女1 290(50.4)237(54.9)1.1871.7720.076926(54.7)161(61.9)1.3182.1590.031
受教育水平
文盲1 050(41.0)219(50.7)———721(42.6)126(48.5)———
小学或私塾629(24.6)92(21.3)0.719-2.6500.008379(22.4)64(24.6)0.972-0.1870.8519
中学564(22.0)83(19.2)0.726-2.4870.013379(22.4)42(16.2)0.653-2.3900.017
高中及以上317(12.4)38(8.8)0.607-2.8400.005213(12.6)28(10.8)0.780-1.1860.236
婚姻状况
有配偶2 328(90.9)384(88.9)———1 516(89.6)223(85.8)———
无配偶232(9.1)48(11.1)1.2181.2870.198176(10.4)37(14.2)1.4031.9080.06
睡觉时间
睡眠充足1 124(43.9)161(37.3)———736(43.5)98(37.7)———
睡眠不足1 210(47.3)235(54.4)1.3352.8260.005815(48.2)136(52.3)1.2321.5710.116
睡眠过多226(8.8)36(8.3)1.1070.5500.582141(8.3)26(10.0)1.3571.3830.167
吸烟
不吸烟1 522(59.5)257(59.5)———1 068(63.1)174(66.9)———
吸烟1 038(40.5)175(40.5)0.995-0.0550.959624(36.9)86(33.1)0.855-1.1880.235
饮酒
不饮酒1 633(63.8)274(63.4)———1 138(67.3)176(67.7)———
饮酒较少202(7.9)28(6.5)0.837-0.8970.370128(7.6)20(7.7)1.0130.0580.953
饮酒较多725(28.3)130(30.1)1.0640.5860.558426(25.2)64(24.6)0.985-0.1020.919
健康自评
一般1 669(65.2)285(66.0)———1 115(65.9)157(60.4)———
积极557(21.8)68(15.7)0.731-2.3260.020337(19.9)39(15.0)0.830-1.0390.299
消极334(13)79(18.3)1.3332.2610.024240(14.2)64(24.6)1.7563.196<0.001
BMI
正常1 317(51.4)220(50.9)———879(52.0)143(55.0)———
偏瘦113(4.4)22(5.1)1.1630.6750.49959(3.5)20(7.7)1.9122.7160.006
超重916(35.8)131(30.3)0.876-1.2050.228600(35.5)77(29.6)0.809-1.4980.134
肥胖214(8.4)59(13.7)1.6073.2360.001154(9.1)20(7.7)0.818-0.8370.402
民族
汉族2 366(92.4)386(89.4)———1 561(92.3)232(89.2)———
其他194(7.6)46(10.6)1.4042.1770.030131(7.7)28(10.8)1.40371.6950.090
发生共病前其他慢病的数量
（种）
0963(37.6)109(25.2)———658(38.9)72(27.7)———
1794(31.0)323(26.2)1.2481.6530.098452(26.7)61(23.5)1.2171.1290.259
2445(17.4)97(22.5)1.8424.374<0.001279(16.5)52(20.0)1.6242.6640.008
>2358(14.0)113(26.2)2.5546.984<0.001303(17.9)75(28.8)2.09734.488<0.001
首发病是风湿病或关节炎
否1 555(60.7)125(28.9)———654(38.7)88(33.8)———
是1 005(39.3)307(71.1)3.49611.79<0.0011 038(61.3)172(66.2)1.2341.6040.109
), ArticleFig(id=1240986268767670473, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, language=EN, label=Table 2, caption=

Analysis of influencing factors for MMD of hypertension + rheumatism or arthritis

, figureFileSmall=null, figureFileBig=null, tableContent=
变量Cox比例风险模型共享脆弱模型
Z值HR值(95%CI)Z值HR值(95%CI)
居住类型(城市)
农村2.7781.367(1.096～1.705)7.8061.377(1.100～1.724)
年龄(岁，0～49)
50～592.2421.337(1.037～1.722)5.4641.355(1.050～1.747)
60～691.9251.317(0.995～1.742)4.2081.342(1.013～1.778)
70～1101.4421.309(0.908～1.889)2.4921.345(0.931～1.942)
性别(男)
女-0.2790.971(0.792～1.192)0.0610.975(0.794～1.196)
受教育水平(文盲)
小学或私塾-2.0100.771(0.599～0.994)4.2020.766(0.594～0.988)
中学-1.4510.816(0.621～1.074)1.7910.828(0.628～1.092)
高中及以上-1.9380.695(0.481～1.004)3.4630.702(0.484～1.019)
睡眠时间(睡眠充足)
睡眠不足1.4621.165(0.949～1.431)2.3201.174(0.955～1.442)
睡眠过多0.2011.038(0.721～1.494)0.0201.026(0.713～1.478)
健康自评(一般)
积极-0.8630.888(0.678～1.163)0.7190.890(0.679～1.166)
消极-1.0280.871(0.670～1.133)1.1230.867(0.666～1.129)
BMI(正常)
偏瘦-0.6370.865(0.554～1.351)0.6350.834(0.533～1.304)
超重1.0381.126(0.900～1.410)1.5741.157(0.921～1.452)
肥胖5.6572.370(1.758～3.196)32.7472.424(1.790～3.283)
民族(汉族)
其他1.3381.236(0.906～1.687)0.4631.118(0.810～1.544)
发生共病前其他慢病的数量(种，0)
11.6311.246(0.957～1.623)2.8631.257(0.964～1.637)
24.6501.932(1.464～2.551)21.8471.942(1.470～2.566)
>26.9702.672(2.027～3.522)49.0612.694(2.042～3.555)
首发病是风湿病或关节炎(否)
是12.2163.807(3.072～4.718)146.5163.797(3.059～4.713)
省份——12.5630.095
AIC6 5936 587
), ArticleFig(id=1240986269342290138, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, language=CN, label=表2, caption=

高血压和风湿病或关节炎共病的影响因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量Cox比例风险模型共享脆弱模型
Z值HR值(95%CI)Z值HR值(95%CI)
居住类型(城市)
农村2.7781.367(1.096～1.705)7.8061.377(1.100～1.724)
年龄(岁，0～49)
50～592.2421.337(1.037～1.722)5.4641.355(1.050～1.747)
60～691.9251.317(0.995～1.742)4.2081.342(1.013～1.778)
70～1101.4421.309(0.908～1.889)2.4921.345(0.931～1.942)
性别(男)
女-0.2790.971(0.792～1.192)0.0610.975(0.794～1.196)
受教育水平(文盲)
小学或私塾-2.0100.771(0.599～0.994)4.2020.766(0.594～0.988)
中学-1.4510.816(0.621～1.074)1.7910.828(0.628～1.092)
高中及以上-1.9380.695(0.481～1.004)3.4630.702(0.484～1.019)
睡眠时间(睡眠充足)
睡眠不足1.4621.165(0.949～1.431)2.3201.174(0.955～1.442)
睡眠过多0.2011.038(0.721～1.494)0.0201.026(0.713～1.478)
健康自评(一般)
积极-0.8630.888(0.678～1.163)0.7190.890(0.679～1.166)
消极-1.0280.871(0.670～1.133)1.1230.867(0.666～1.129)
BMI(正常)
偏瘦-0.6370.865(0.554～1.351)0.6350.834(0.533～1.304)
超重1.0381.126(0.900～1.410)1.5741.157(0.921～1.452)
肥胖5.6572.370(1.758～3.196)32.7472.424(1.790～3.283)
民族(汉族)
其他1.3381.236(0.906～1.687)0.4631.118(0.810～1.544)
发生共病前其他慢病的数量(种，0)
11.6311.246(0.957～1.623)2.8631.257(0.964～1.637)
24.6501.932(1.464～2.551)21.8471.942(1.470～2.566)
>26.9702.672(2.027～3.522)49.0612.694(2.042～3.555)
首发病是风湿病或关节炎(否)
是12.2163.807(3.072～4.718)146.5163.797(3.059～4.713)
省份——12.5630.095
AIC6 5936 587
), ArticleFig(id=1240986269468119266, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, language=EN, label=Table 3, caption=

Analysis of the influencing factors of MMD of gastric diseases+ rheumatism or arthritis

, figureFileSmall=null, figureFileBig=null, tableContent=
变量Cox比例风险模型共享脆弱模型
Z值HR值（95%CI）Z值HR值（95%CI）
年龄(岁，0～49)
50～59-1.8020.755（0.557～1.025）3.2370.756（0.557～1.025）
60～69-3.6230.512（0.357～0.736）13.0920.513（0.357～0.736）
70～110-3.7510.392（0.240～0.639）14.0460.392（0.240～0.640）
性别(男)
女1.1481.167（0.896～1.520）1.3211.168（0.897～1.520）
受教育水平(文盲)
小学或私塾0.0991.016（0.745～1.384）0.0101.016（0.746～1.385）
中学-2.1560.666（0.461～0.964）4.6360.667（0.461～0.964）
高中及以上-0.9580.811（0.528～1.245）0.9160.811（0.528～1.245）
婚姻状况(有配偶)
无配偶1.9441.441（0.997～2.084）3.7791.442（0.997～2.084）
健康自评(一般)
积极-0.5030.913（0.640～1.302）0.2500.913（0.640～1.303）
消极2.1951.408（1.037～1.912）4.8241.409（1.038～1.912）
BMI(正常)
偏瘦2.6991.935（1.198～3.125）7.2811.935（1.198～3.126）
超重-2.2320.720（0.540～0.961）4.9710.720（0.540～0.961）
肥胖-1.9310.624（0.386～1.007）3.7270.624（0.386～1.007）
民族(汉族)
其他0.9041.200（0.808～1.781）0.8101.199（0.807～1.782）
发生共病前其他慢病的数量(种，0)
11.4251.284（0.910～1.812）2.0341.285（0.910～1.813）
22.8891.718（1.190～2.480）8.3331.717（1.190～2.479）
>24.7212.339（1.644～3.328）22.2812.339（1.644～3.328）
省份——0.2660.351
AIC3 8553 855
), ArticleFig(id=1240986269581365485, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420601934523, language=CN, label=表3, caption=

胃部疾病和风湿病或关节炎共病的影响因素分析分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量Cox比例风险模型共享脆弱模型
Z值HR值（95%CI）Z值HR值（95%CI）
年龄(岁，0～49)
50～59-1.8020.755（0.557～1.025）3.2370.756（0.557～1.025）
60～69-3.6230.512（0.357～0.736）13.0920.513（0.357～0.736）
70～110-3.7510.392（0.240～0.639）14.0460.392（0.240～0.640）
性别(男)
女1.1481.167（0.896～1.520）1.3211.168（0.897～1.520）
受教育水平(文盲)
小学或私塾0.0991.016（0.745～1.384）0.0101.016（0.746～1.385）
中学-2.1560.666（0.461～0.964）4.6360.667（0.461～0.964）
高中及以上-0.9580.811（0.528～1.245）0.9160.811（0.528～1.245）
婚姻状况(有配偶)
无配偶1.9441.441（0.997～2.084）3.7791.442（0.997～2.084）
健康自评(一般)
积极-0.5030.913（0.640～1.302）0.2500.913（0.640～1.303）
消极2.1951.408（1.037～1.912）4.8241.409（1.038～1.912）
BMI(正常)
偏瘦2.6991.935（1.198～3.125）7.2811.935（1.198～3.126）
超重-2.2320.720（0.540～0.961）4.9710.720（0.540～0.961）
肥胖-1.9310.624（0.386～1.007）3.7270.624（0.386～1.007）
民族(汉族)
其他0.9041.200（0.808～1.781）0.8101.199（0.807～1.782）
发生共病前其他慢病的数量(种，0)
11.4251.284（0.910～1.812）2.0341.285（0.910～1.813）
22.8891.718（1.190～2.480）8.3331.717（1.190～2.479）
>24.7212.339（1.644～3.328）22.2812.339（1.644～3.328）
省份——0.2660.351
AIC3 8553 855
)], attaches=null, journal=Journal(id=1227664546253402114, delFlag=0, nameCn=现代预防医学, nameEn=Modern Preventive Medicine, nameHistory1=null, nameHistory2=null, issn=1003-8507, eissn=null, cn=51-1365/R, coden=null, periodic=3, language=CN, oaType=null, ccby=null, superviseOffice=null, ownerOffice=null, pubOffice=null, editorOffice=null, officeType=null, aims=null, clcCode=null, officeProv=null, officeCity=null, officeAddr=null, officeZip=null, officeEmail=null, officePhone=null, editDirector=null, officeDirector=null, officeDirectorPhone=null, officeStaffNum=null, officeEmpNum=null, coverPicUrl=IeiuPXEZi6AA+k0VfvoiOQ==, journalPrice=null, startedYear=null, abbrevIsoEn=Modern Preventive Medicine, journalRemark=null, publicationField=null, createdTime=1770627636734, updatedTime=1770628902248, createdBy=18614031015, updatedBy=13701087609, firstLetterCn=M, firstLetterEn=M, subjectCode=Life Sciences, subjectName=null, subjectCodeEn=Life Sciences, subjectNameEn=null, picCn=IeiuPXEZi6AA+k0VfvoiOQ==, picEn=/9iTl8/ndms4tBz1fL28Pg==, jcr=null, cjcr=null, exts=[JournalExt(id=1227669854342280188, language=CN, name=现代预防医学, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1770628902278, updatedTime=1770628902278, createdBy=13701087609, updatedBy=13701087609, submissionGuidelinesUrl=, submissionAuthorUrl=http://xdyfyxzz.paperopen.com/#/regist, submissionEditorUrl=http://xdyfyxzz.paperopen.com/#/Login, submissionReviewUrl=http://xdyfyxzz.paperopen.com/#/Login, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""}), JournalExt(id=1227669854396806141, language=EN, name=Modern Preventive Medicine, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1770628902291, updatedTime=1770628902291, createdBy=13701087609, updatedBy=13701087609, submissionGuidelinesUrl=, submissionAuthorUrl=http://xdyfyxzz.paperopen.com/#/regist, submissionEditorUrl=http://xdyfyxzz.paperopen.com/#/Login, submissionReviewUrl=http://xdyfyxzz.paperopen.com/#/Login, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""})], databaseList=null, tenantJournalId=1227665162245664772, websiteList=[Website(id=1227687234141352800, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1227665162245664772, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/xdyfyx/CN, language=CN, createTime=1770633045945, createBy=18614031015, updateTime=1770633090526, updateBy=18614031015, name=现代预防医学-中文, tplId=1146099689490845704, title=现代预防医学, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1227687735088051072, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=articleTextType, value=kx, createTime=1770633165380, updateTime=1770633165380, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735071273853, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=banner, value=null, createTime=1770633165376, updateTime=1770633165376, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735113216899, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=grayFlag, value=0, createTime=1770633165386, updateTime=1770633165386, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735062885244, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=logo, value=https://castjournals.cast.org.cn/joweb/xdyfyx/CN/file/pic?fileId=/XB5plC0xuykmQnycvtyrw==, createTime=1770633165374, updateTime=1770633165374, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735125799813, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=minRunFlag, value=0, createTime=1770633165389, updateTime=1770633165389, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735083856767, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/xdyfyx/CN/file/pic, createTime=1770633165379, updateTime=1770633165379, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735121605508, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=silenceFlag, value=0, createTime=1770633165388, updateTime=1770633165388, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735079662462, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_cn_619/, createTime=1770633165378, updateTime=1770633165378, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735096439681, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=themeColor, value=null, createTime=1770633165382, updateTime=1770633165382, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735104828290, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=themeStyle, value=null, createTime=1770633165384, updateTime=1770633165384, creator=18614031015, updator=18614031015)]), Website(id=1227687234338485094, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1227665162245664772, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/xdyfyx/EN, language=EN, createTime=1770633045992, createBy=18614031015, updateTime=1770633115374, updateBy=18614031015, name=现代预防医学-英文, tplId=1146101810881728533, title=Modern Preventive Medicine, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1227687709129507332, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=articleTextType, value=kx, createTime=1770633159191, updateTime=1770633159191, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709108535809, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=banner, value=null, createTime=1770633159186, updateTime=1770633159186, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709167256071, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=grayFlag, value=0, createTime=1770633159200, updateTime=1770633159200, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709095952896, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=logo, value=https://castjournals.cast.org.cn/joweb/xdyfyx/EN/file/pic?fileId=/XB5plC0xuykmQnycvtyrw==, createTime=1770633159183, updateTime=1770633159183, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709179838985, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=minRunFlag, value=0, createTime=1770633159203, updateTime=1770633159203, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709121118723, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/xdyfyx/EN/file/pic, createTime=1770633159189, updateTime=1770633159189, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709171450376, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=silenceFlag, value=0, createTime=1770633159201, updateTime=1770633159201, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709112730114, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_en_623/, createTime=1770633159187, updateTime=1770633159187, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709133701637, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=themeColor, value=null, createTime=1770633159192, updateTime=1770633159192, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709154673158, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=themeStyle, value=null, createTime=1770633159197, updateTime=1770633159197, creator=18614031015, updator=18614031015)])], journalTitle=现代预防医学, weixinUrl=null, journalUrl=http://xdyfyxzz.paperopen.com/, iacademicId=null, status=1, seqNo=null, journalTitleEn=Modern Preventive Medicine, journalPhotoCn=IeiuPXEZi6AA+k0VfvoiOQ==, journalPhotoEn=/9iTl8/ndms4tBz1fL28Pg==, journalFirstLetter=M, journalRecommend=null, journalNew=null, journalCollection=null, jcrJf=null, cjcrJf=null, jcrJfStr=null, cjcrJfStr=null, submissionFirstDecision=null, sciSubjectClassification=null, casSubjectClassification=null, citeScore=null, totalCitationFrequency=null, icpCode=null, psCode=null, advertisingLicenseCode=null, copyrightInformation=null, country=null, option=, provinceCode=null, provinceName=null, collectFlag=false), detailUrlCn=https://castjournals.cast.org.cn/joweb/xdyfyx/CN/10.20043/j.cnki.MPM.202311072, detailUrlEn=https://castjournals.cast.org.cn/joweb/xdyfyx/EN/10.20043/j.cnki.MPM.202311072, pdfUrlCn=https://castjournals.cast.org.cn/joweb/xdyfyx/CN/PDF/10.20043/j.cnki.MPM.202311072, pdfUrlEn=https://castjournals.cast.org.cn/joweb/xdyfyx/EN/PDF/10.20043/j.cnki.MPM.202311072, aliStartDate=null, aliEndDate=null, collectionFlag=false, citedCount=null, citedUrl=null, reference=null)
收藏切换
两种常见慢性病共病的影响因素分析
收藏切换
PDF下载
李瑞 1, 2 , 雷伟 1, 2 , 摆文丽 1, 2 , 李寅臻 1, 2 , 张亚洲 1, 2 , 张眉 1, 2 , 芮东升 1, 2 , 王奎 1, 2
现代预防医学 | 流行病与统计方法 2024,51(9): 1568-1573
收起
收藏切换
现代预防医学 | 流行病与统计方法 2024, 51(9): 1568-1573
两种常见慢性病共病的影响因素分析
全屏
李瑞1, 2, 雷伟1, 2, 摆文丽1, 2, 李寅臻1, 2, 张亚洲1, 2, 张眉1, 2, 芮东升1, 2, 王奎1, 2
作者信息
  • 1.石河子大学医学院预防医学系，新疆 石河子 832000
  • 2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000

    • 李瑞（1988—），男，硕士在读，研究方向：流行病与卫生统计学

通讯作者:

王奎，E-mail:
Analysis on influencing factors of multimorbidity of two common chronic diseases
Rui LI1, 2, Wei LEI1, 2, Wen-li BAI1, 2, Yin-zhen LI1, 2, Ya-zhou ZHANG1, 2, Mei ZHANG1, 2, Dong-sheng RUI1, 2, Kui WANG1, 2
Affiliations
  • Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, Chinas
出版时间: 2024-05-10 doi: 10.20043/j.cnki.MPM.202311072
文章导航
收藏切换
摘要
收起
目的

了解两种常见慢性病的危险因素，以期为慢性病共病预防和政府的疾病投入提供依据。

方法

采用中国健康与养老追踪调查（China health and retirement longitudinal study，CHARLS）2011—2018年四次随访数据。纳入高血压和风湿病或关节炎、胃部疾病和风湿病或关节炎两种慢性病共病人群2 992和1 952例。采用Cox比例风险模型和共享脆弱模型分析共病发生影响因素。

结果

高血压和风湿病或关节炎人群：居住在农村（HR=1.367，95%CI：1.096～1.705）、高年龄组（HR=1.342，95%CI：1.013～1.778）、肥胖（HR=2.424，95%CI：1.790～3.283）、首发病是风湿病或关节炎（HR= 3.797，95%CI：3.059～4.713）、其他慢性病数量大于1（HR=2.694，95%CI：2.042～3.555）人群发生共病的可能性更高，高受教育水平（HR=0.766，95%CI：0.594～0.988）人群发生共病可能性较低，共享脆弱模型拟合程度优于Cox模型。胃部疾病和风湿病或高血压人群：高年龄组（HR=0.392，95%CI：0.240～0.640）、受教育水平高（HR=0.667，95%CI：0.461～0.964）、超重（HR=0.720，95%CI：0.540～0.96）人群中共病发生的可能性较低，健康自评消极（HR=1.409，95%CI：1.038～1.912）、偏瘦（HR=1.935，95%CI：1.198～3.126）、慢性病数量大于1人群（HR=2.339，95%CI：1.644～3.328）发生共病可能性更高，该人群中两模型结果无太大差异。

结论

层次生存数据中，共享脆弱模型拟合效果高于传统模型。高血压和风湿病或关节炎共病人群中高年龄组、肥胖、首发病是风湿病或关节炎人群发病风险升高，高年龄组、超重人群中胃部疾病和风湿病或关节炎共病发生可能性更低。因此慢性病共病的预防应针对不同共病组合，分别确定高危人群，进行不同的干预行为，准确进行医疗资源的投入，降低政府的疾病负担。

慢性病共病  /  CHARLS数据  /  影响因素分析  /  层次结构数据
Objective

To understand the risk factors of two common chronic diseases in order to provide evidence for the prevention of common chronic diseases and government investment in disease management.

Methods

Four waves follow-up data of China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018 were used. In total 2 992 and 1 952 patients with hypertension and rheumatism or arthritis, stomach diseases and rheumatism or arthritis were included. Cox proportional hazard model and shared vulnerability model were used to analyze the influencing factors of multimorbidity.

Results

For people with hypertension and rheumatism or arthritis, living in rural areas (HR=1.367, 95%CI: 1.096-1.705), advanced age group (HR=1.342, 95%CI: 1.013-1.778), obesity (HR=2.424, 95%CI: 1.790-3.283), rheumatism or arthritis as first onset disease (HR=3.797, 95%CI: 3.059-4.713) and other chronic diseases more than 1 (HR=2.694, 95%CI: 2.042-3.555) were associated with a higher possibility of multimorbidity, while people with high education level (HR=0.766, 95%CI: 0.594-0.988) had a lower possibility of multimorbidity, and the shared vulnerability model outperformed Cox model. For people with stomach disease and rheumatism or hypertension: advanced age (HR=0.392, 95%CI: 0.240-0.640), highly educated (HR=0.667, 95%CI: 0.461-0.964),and overweight (HR=0.720, 95%CI: 0.540-0.96)) were associated with lower possibility to have multimorbidity, negative health self-assessment (HR=1.409, 95%CI: 1.038-1.912), being lean (HR=1.935, 95%CI: 1.198-3.126), and having more than 1 chronic diseases (HR=2.339, 95%CI: 1.644-3.328) were associated with higher possibility to have multimorbidity, and there was no significant difference between the two models in this population.

Conclusion

In the hierarchical survival data, the fitting effect of the shared fragile model is better than that of the traditional model. In the group of patients with hypertension and rheumatism or arthritis, there is an increased risk of rheumatism or arthritis in the older age group, obesity and the first onset of rheumatism or arthritis, and the incidence of stomach disease and rheumatism or arthritis is lower in the higher age group and overweight group. Therefore, the prevention measures of chronic multimorbidity should be taken based on different combinations of common diseases to identify high-risk groups respectively, carry out different intervention behaviors, accurately invest medical resources, and reduce the disease burden of the government.

Multimorbidity  /  CHARLS data  /  Influencing factor analysis  /  Hierarchical data
李瑞, 雷伟, 摆文丽, 李寅臻, 张亚洲, 张眉, 芮东升, 王奎. 两种常见慢性病共病的影响因素分析. 现代预防医学, 2024 , 51 (9) : 1568 -1573 . DOI: 10.20043/j.cnki.MPM.202311072
Rui LI, Wei LEI, Wen-li BAI, Yin-zhen LI, Ya-zhou ZHANG, Mei ZHANG, Dong-sheng RUI, Kui WANG. Analysis on influencing factors of multimorbidity of two common chronic diseases[J]. Modern Preventive Medicine, 2024 , 51 (9) : 1568 -1573 . DOI: 10.20043/j.cnki.MPM.202311072
正文
收起
慢性病共病（multimorbidity，MMD）指患者同时患有两种或两种以上的慢性病。慢性病病程时间较长、病因复杂且无法治愈，久而久之就会出现“疾病堆积”现象，因此慢性病患者往往会出现多种慢性病共存的现象。相比于患单种慢性病，多种慢性病的相互作用会对人群造成更大的健康危害，有研究结果显示，慢性病数量的增加会增加个体经济负担，机体衰弱发生风险[1]，患者的死亡风险降低患者预期寿命[2]。
持续升高的慢性病及共病患病率已成为各国卫生体系面临的重要问题[3-4]。近20年来中国慢性病共病患病率呈上升趋势，至2019年我国慢性病共病患病率为36.3%[5]，低于大多高收入国家，但正在逐渐接近高收入国家水平[6],成为威胁中国居民健康的重大公共卫生问题。在这种大背景下，对慢性病及共病的研究日益增多。现有研究主要集中在老年多重慢病的患病率、患病模式、影响因素及干预措施等方面[7]。但是对不同慢性病共病组合的影响因素研究较少。
本研究根据以往对于CHARLS数据的研究，对86种两种慢性病组合中患病率前两位的组合：关节炎或风湿病+胃部疾病(16.08%）、关节炎或风湿病+高血压(14.14%)两种共病的影响因素进行研究[8]。本研究将慢性病共病组合具体化，区别与以往研究中对于慢性病共病分析中将所有慢性病组合进行一体化的分析。以分析慢性病共病不同组合中的影响因素，以此针对不同人群提出不同的干预措施。
层次结构数据是一种将数据按照不同的层次或组进行组织的数据，其结构为低级单位嵌套于高级单位中。中国健康与养老追踪调查(China health and retirement longitudinal study，CHARLS)数据采用多阶段按规模大小成比例的概率抽样方法抽取全国28个省、自治区和直辖市的数据，其所有个体数据均包含在28个省份中，构成“个体-省份”的层次结构数据，层次结构数据最主要的特征为组内相关性，同一省份的个体在某些特征或表现上展现出更高的相似性。对于层次结构数据，依旧使用传统的Cox比例风险模型，违背了模型的“独立性”假设，会使Ⅰ类错误膨胀[9]。而共享脆弱模型在处理层次结构数据时，考虑了层次结构数据的相关性和异质性[10]。因此本研究使用共享脆弱模型进行多因素分析，同时以Cox比例风险模型作为对照。
1　资料与方法
收起
1.1　数据来源
本研究数据来源于CHARLS，该研究收集了代表中国28个省的45岁及以上中老年人家庭和个人的高质量微观数据[11]。本研究纳入标准：（1）2011—2015年CHARLS数据中有健康状态和功能问卷的随访人群，其中2011年数据全部纳入，2013和2015年纳入新随访数据，且根据后一次随访信息确定随访人群是否继续随访，失访人群的失访原因和时间；（2）年龄和性别信息完整的数据；（3）2011—2018年随访次数大于1次的数据；（4）基线调查未出现目标慢性病并且基线后至少出现一种目标慢性病。
1.2　指标定义
本研究终点事件为（1）在2011—2018年同时患有高血压和风湿病或关节炎；（2）在2011—2018年同时患有胃部疾病（不包括胃癌）和风湿病或关节炎。慢性病和慢性病患病时间：来自患者的自我报告“你是否被医生告诉过您患慢性病”和“您第一次诊断出慢性病患病时间”。首发病是风湿病或关节炎：根据慢性病患病时间，在两种慢性病共病组合中，风湿病或关节炎发病在前定义为是，否则定义为否。睡眠时间：调查对象过去一个月内平均每天晚上真正睡着的时间将其分为三类，小于7小时为睡眠不足、9小时及以上为睡眠时间过多、其余为睡眠充足。
1.3　统计方法
对基线数据进行统计描述。本研究中连续变量均转化为分类变量，使用［n（%）］表示，两组间比较使用χ2检验。使用Cox比例风险模型进行单因素分析，Schoenfeld残差的趋势检验法进行比例风险假设，Cox比例风险模型和共享脆弱模型进行多因素分析，计算风险比(Hazard Ratio, HR)、95%CI和赤池信息量准则（Akaike information criterion，AIC）值。本研究数据处理采用Python3.8.8，数据分析采用R4.2.2和SPSS 26软件进行。检验水准α=0.05。
2　结果
收起
2.1　研究对象的基本信息
根据研究共病不同纳入不同的研究人群：（1）高血压和风湿病或关节炎共病人群，该人群2011、2013和2015年分别纳入研究对象2 624、337和31例，共纳入研究对象2 992例。中位年龄56（49，63）岁；研究对象总计随访19 558人年，平均随访时间6.54年；随访期间发生共病432例，发病密度为22.09/千人年。（2）胃部疾病和风湿病或关节炎共病人群，该人群2011、2013和2015年分别纳入研究对象1 696、232和24例，共纳入研究对象1 952例。中位年龄56（49，63）岁；研究对象总计随访12 687人年，平均随访时间6.50年；随访期间发生共病260例，发病密度为20.49/千人年。
2.2　共病发生影响因素的单因素分析
对每个特征中是否发生共病进行描述，以生存时间、共病结局为因变量，以年龄、性别、居住类型、受教育水平、配偶情况、睡觉时间、吸烟、饮酒、健康自评、BMI、民族、发生共病前其他慢性病的数量和首发病是风湿病或关节炎为自变量，进行单因素Cox比例风险模型分析。结果显示，居住类型、年龄、受教育水平、睡眠时间、健康自评、BMI、民族、其他慢性病数量、首发病是风湿病与高血压和风湿病或关节炎共病发生有关，性别、受教育水平、健康自评、BMI和其他慢性病数量与胃部疾病和风湿病或关节炎共病有关（P<0.05）。见表1。
2.3　高血压和风湿病或关节炎共病发生影响因素的多因素分析
以生存时间、共病结局为因变量，根据单因素分析结果将P<0.1的变量作为自变量，构建Cox比例风险模型。采用相同的因变量和自变量，并以省份构建脆弱项，构建共享脆弱模型。对变量进行比例风险假设检验，发现首发病是风湿病或关节炎不满足比例风险假设，但是根据不同省份进行比例风险假设时发现，此变量在大部分省份满足比例风险假定，因此在构建模型时仍然将首发病是风湿病或关节炎纳入自变量。两种模型结果均显示，居住类型、年龄、受教育水平、BMI、首发病是风湿病或关节炎、其他慢性病数量与高血压和风湿病或关节炎共病发生有关，差异有统计学意义（P<0.05）。见表2。
两模型在该人群影响因素分析模型分析中发现的影响因素基本一致，但相较于Cox模型，共享脆弱模型中发现60～69岁年龄组与小于50岁年龄组相比有统计学差异。检验水准为α=0.1，共享脆弱模型脆弱项有统计学差异，表明不同省份间存在异质性，同省份内存在相关性。比较两模型AIC值，共享脆弱模型小于Cox比例风险模型，说明共享脆弱模型拟合程度较好。
2.4　胃部疾病和风湿病或关节炎共病发生的多因素
分析以生存时间、共病结局为因变量，根据单因素分析结果将P<0.1的变量作为自变量，且考虑到年龄作为以往研究发现的影响因素同时将其作为自变量，构建Cox比例风险模型。采用相同的因变量和自变量，以省份构建脆弱项，构建脆弱模型。各变量均满足比例风险假设。两模型结果均显示，年龄、受教育水平、健康自评、BMI、其他慢性病数量与胃部疾病和风湿病或关节炎共病发生有关，差异有统计学意义（P<0.05）。见表3。
两模型在该人群影响因素分析模型分析中发现的影响因素一致。检验水准为α=0.1，共享脆弱模型脆弱项无统计学差异，表明不同省份间不存在异质性。比较两模型AIC值，共享脆弱模型与Cox比例风险模型AIC值相等，说明共享脆弱模型拟合程度不亚于Cox比例风险模型。
3　讨论
收起
本研究数据为层次结构数据，采用了共享脆弱模型进行多因素分析，并使用Cox比例风险模型作为对照，计算两模型AIC值，使用AIC最小化模型法[12]估计两种模型的拟合优度。结果显示，高血压和风湿病或关节炎人群中存在中心效应，而胃部疾病和风湿病或关节炎人群中不存在。而且不论是否存在中心效应，共享脆弱模型拟合结果均不亚于Cox比例风险模型，与以往研究结果一致[13]。
本研究发现个人特征中年龄、居住类型和受教育水平对两种共病的发生有不同的影响。在高血压和风湿病或关节炎共病研究中发现，与小于50岁年龄组相比，50～59岁以及60～69岁年龄组发病风险升高，70岁以上年龄组发病风险也升高，但未达到显著水平，与以往研究结果基本相似[14]。在胃部疾病和风湿病或关节炎共病的研究中发现，相较于小于50岁年龄组，60～69岁以及70岁以上年龄组发生共病的风险降低；50～59岁年龄组虽然未满足统计学差异，但其趋势也是发病风险的降低，在以往的研究中未发现这种情况。可能是由于胃部疾病的主要影响因素为个人的饮食习惯，在60岁之后患者和其配偶进入退休状态，两人的饮食和作息规律，且退休之后不再承受工作压力，使得胃部疾病的发生率降低，从而使得慢性病共病的发生风险降低。本研究显示，居住于农村会使共病发生风险升高，而高教育水平会降低共病的发生风险，与以往研究结果一致[15]。
不良的行为习惯会使共病发生的风险升高。偏瘦会导致共病发生风险升高，与MIKE等[16]研究结果基本相似。BMI偏高在两种人群中存在不同的效应，肥胖在高血压和风湿病或关节炎人群中是危险因素，与以往研究一致[16]。而在胃部疾病和风湿病或关节炎中超重人群发病风险降低，与以往的在其他疾病的研究中发现了“肥胖悖论”有部分相似[17]。可能是脂肪可以产生部分在免疫功能中起重要作用的促炎性和抗炎性的脂肪因子，且超重患者消化系统较正常人群更加强健，使得肥胖患者发病风险降低。对自己健康状态消极的患者共病发生率升高，与李亚杰等[18]的研究结果相似。
其他慢性病对慢性病共病发生产生影响。发生慢性病共病前其他慢性病的数量大于2会导致慢性病共病发生率升高，可能是因为其他疾病的发生引起了患者的健康损失[15]，导致了共病发生风险的升高。在高血压和风湿病或关节炎共病人群中两种慢性病中首发病是风湿病或关节炎与首发病是高血压相比发病风险升高了3.8倍，在以往研究中未曾发现，可能是目前高血压有准确有效的控制手段，而风湿病或关节炎目前并无有效的控制方法。风湿病或关节炎患者的健康损失大于高血压患者的健康损失，导致共病发病风险的升高。
本研究的局限性：（1）平均随访时间短可能低估了两种慢性病共病的发生率；（2）本研究样本中某几个省份中样本量较少，结果可能会存在某些偏差；（3）本研究局限于CHARLS数据中发病率较高的两种共病，对于其他共病未进行研究，需根据以后的随访研究进行进一步分析。
综上所述，对于风湿病或关节炎和高血压共病的预防应关注居住于农村、高年龄、肥胖和先发生风湿病或关节炎的人群。而对于风湿病或关节炎和胃部疾病共病的预防，应该对健康自评消极和偏瘦的人群更加关注。同时不良的饮食习惯，吸烟、饮酒、缺乏锻炼等不良行为会导致机体肥胖、血压异常、自身免疫低下等一系列变化导致疾病的发生。因此，对于慢性病共病的预防除了对不同共病间共同的危险因素关注外，也应针对不同共病组合，分别确定高危人群，进行不同的干预行为，降低共病的发生风险。以此通过不同的人群的患病情况，准确的进行医疗资源的投入，以降低政府对于共病预防的疾病负担。特别需要注意的是，慢性病数量越多越容易诱发其他慢性病的发生，因此慢性病共病的预防对于其他慢性病的发生也有重要意义。而在数据分析中对于层次结构数据应考虑群组间的相互关系，选择合适的模型。
文献
收起
参考文献 引证文献
排序方式：
[1]
Marthias T, Anindya K, Ng N, et al. Impact of non-communicable disease multimorbidity on health service use, catastrophic health expenditure and productivity loss in Indonesia: a population-based panel data analysis study[J]. BMJ Open, 2021, 11(2): e041870.
[2]
王浩，张琳，方晓雅，等.中国中老年人慢性病共病现状及其空间分布研究[J].中国全科医学，2022，25（10）：1186-1190, 1196.
Wang H, Zhang L, Fang XY, et al. Prevalence and spatial analysis of chronic comorbidity among Chinese middle-aged and elderly People[J].Chinese General Practice, 2022, 25(10): 1186-1190, 1196.
[3]
World Health Organization. World health statistics 2022:monitoring health for the SDGs, sustainable development goals[EB/OL]. [2024-03-15]. https://www.who.int/.
[4]
Ng WH, Tipih T, Makoah NA, et al. Comorbidities in SARS-CoV-2 patients: a systematic review and Meta-Analysis[J]. mBio, 2021, 12(1): e03647-20.
[5]
何莉，张逸凡，沈雪纯，等.中国大陆地区居民慢性病共病的流行趋势:一项Meta分析[J].中国全科医学，2023，26（29）：3599-3607.
He L, Zhang YF, Shen XC, et al. Prevalence trends of multimorbidity among residents in mainland China:a Meta-analysis[J]. Chinese General Practice, 2023, 26(29): 3599-3607.
[6]
Ho ISS, Azcoaga-Lorenzo A, Akbari A, et al. Variation in the estimated prevalence of multimorbidity: systematic review and meta-analysis of 193 international studies[J]. BMJ Open, 2022, 12(4): e057017.
[7]
冯佳，王洁，余丹，等.2010—2021年国内外老年多重慢病研究热点分析[J].中国全科医学，2023，26（21）：2574-2580.
Feng J, Wang J, Yu D, et al. Analysis of research hotspots of multiple chronic conditions in the elderly in 2010-2021[J]. Chinese General Practice, 2023, 26(21): 2574-2580.
[8]
范潇茹，陈莎，施予宁，等.我国中老年人慢性病共病现状及其对卫生服务利用和医疗费用的影响研究[J].中国全科医学，2022，25（19）：2371-2378.
Fan XR, Chen S, Shi YN, et al. Multimorbidity prevalence and its association with health service utilization and medical costs among middle-aged and older Chinese People[J]. Chinese General Practice, 2022, 25(19):2371-2378.
[9]
Tawiah R, Bondell H. Multilevel joint frailty model for hierarchically clustered binary and survival data[J]. Medicine Statistics, 2023, 42(21): 3745-3763.
[10]
Kim SW, Schumacher M, Augustin NH. A shared frailty model for multivariate longitudinal data on adverse event of radiation therapy[J]. Biometrical Journal, 2021, 63(7): 1493-1506.
[11]
Zhao YH, Hu YS, Smith JP, et al. Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS)[J]. International Journal of Epidemiology, 2014, 43(1): 61-68.
[12]
Liu Q, Charleston MA, Richards SA, et al. Performance of AIC and Bic in selecting partition models and mixture models[J]. Systematic Biology, 2022, 72(1): 926.
[13]
Tesema GA, Seifu BL, Tessema ZT, et al.Incidence of infant mortality and its predictors in East Africa using Gompertz gamma shared frailty model[J]. Archives of Public Health, 2022, 80(1): 195.
[14]
梁丽芬，李静颖，赵静，等.太原市晋源区慢性病老年人共病现状及影响因素[J].护理研究，2023，37（8）：1492-1495.
Liang LF, Li JY, Zhao J, et al. Current situation and influencing factors on comorbidity among elderly People with chronic disease in Jinyuan district,Taiyuan city[J]. Chinese Nursing Research, 2023, 37(8): 1492-1495.
[15]
刘帅帅，张露文，陆翘楚，等.中国中老年人多重慢性病现状调查与健康损失因素探究:基于CHARLS 2018数据[J].实用医学杂志，2021，37（4）：518-524.
Liu SS, Zhang LW, Lu QC, et al. The prevalence of multi-morbidity and related functional limitation among middle-aged and Senior population in China: nationally evidence from CHARLS 2018[J]. The Journal of Practical Medicine, 2021, 37(4): 518-524.
[16]
Kivimäki M, Strandberg T, Pentti J, et al. Body-mass index and risk of obesity-related complex multimorbidity: an observational multicohort study[J].Lancet Diabetes Endocrinol, 2022, 10(4): 253-263.
[17]
Xie HL,Wei LS,Zhang HY,et al.Association of systemic inflammation with the obesity paradox in cancer: results from multi-cohort studies[J]. Inflammation Research, 2024, 73(2): 243-252.
[18]
李亚杰，李剑波，莘军龙，等.老年流动人口高血压和糖尿病患病现状及与自评健康的相关性研究[J].中国慢性病预防与控制，2022，30（5）：381-384.
Li YJ, Li JB, Shen JL, et al. Study on the prevalence of Hypertension and diabetes in the elderly floating population and their correlation with self rated health[J]. Chinese Journal of Prevention and Control of Chronic Diseases, 2022, 30(5): 381-384.
2024年第51卷第9期
PDF下载
39
17
引用本文
BibTeX
文章信息
doi: 10.20043/j.cnki.MPM.202311072
  • 接收时间：2023-11-06
  • 首发时间：2026-03-18
  • 出版时间：2024-05-10
补充材料
相关文章
文章信息
作者
出版历史
  • 收稿日期：2023-11-06
基金
作者信息
    1.石河子大学医学院预防医学系，新疆 石河子 832000
    2.重要新发传染病防控与公共卫生安全兵团重点实验室，新疆 石河子 832000

通讯作者:

王奎，E-mail:
参考文献
分享链接
https://castjournals.cast.org.cn/joweb/xdyfyx/CN/10.20043/j.cnki.MPM.202311072
分享至
全文二维码

扫描看全文

引用本文
BibTeX
本文的引用情况
2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
关闭全屏
相关链接
论文
最新文章
热读文章
热点专题
内参
蓝皮书
产业发展报告
传播力报告
期刊分级目录
资讯
学术新闻
行业新闻
学术会议
行业会议
关于
关于我们
联系我们
北京市海淀区学院南路86号
100081
010-62199257
qkjq@cast.org.cn

中国科学技术协会版权所有 京ICP 备10216604号-4 海淀分局备案 1101084647
科技导报社主办 中国科协信息中心技术支持