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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.
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.
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.
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.
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| 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 |
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