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Outline
This study aimed to analyze the changes in multimorbidity of eight common chronic non-communicable diseases (NCDs), including hypertension, diabetes, coronary heart disease (CHD), stroke, hyperlipidemia, obesity, chronic obstructive pulmonary disease (COPD), and asthma among rural residents in Yunnan Province between 2014 and 2024.
A multistage stratified random sampling method was used to select 9 886 and 10 012 permanent residents aged ≥35 years in rural Yunnan in 2014 and 2024, respectively. Face-to-face questionnaire surveys and physical examinations were conducted for each participant. Association rule mining (ARM) based on the Apriori algorithm was applied to identify patterns of NCDs multimorbidity.
In 2024, the prevalence of multimorbidity involving eight NCDs was 24.4%. The prevalence of multimorbidity was higher among illiterate individuals than among those with primary school education or above (χ2=7.951),higher among those with higher annual per capita household income than among those with lower income (χ2=27.653), and higher among those with good access to medical services than among those with poor access (χ2=12.160) (all P<0.05). The prevalence of NCDs multimorbidity increased with age and level of socioeconomic position (SEP) (,
, P<0.001). Compared to 2014, the age-standardized prevalence of NCDs multimorbidity was increased in 2024 (22.8%vs 14.5%, χ2=225.436, P<0.001), and was also observed among subgroups categorized by gender (male: χ2=123.835;female: χ2=101.711), age (35-44: χ2=54.919; 45-54: χ2=42.635; 55-64: χ2=64.961; 65-74: χ2=47.197; ≥75: χ2=23.344), education level(illiterate: χ2=62.723; primary school or above: χ2=153.712), income (low: χ2=70.620; high: χ2=142.048), access to medical services (poor: χ2=51.375; good: χ2=167.027), and SEP (low: χ2=53.353; middle: χ2=33.151; high: χ2=132.913) (P<0.001). The average number of NCDs among multimorbid patients increased from 2.34 in 2014 to 2.40 in 2024, and was also observed among female patients, illiterate patients, and patients with poor access to medical services. A total of 8 and 13 association rules were identified in 2014 and 2024, respectively. Compared with 2014, two new binary multimorbidity patterns (diabetes + CHD,obesity + dyslipidemia) and four new ternary multimorbidity patterns (diabetes + hypertension + dyslipidemia, diabetes +hypertension + CHD, diabetes + hypertension + obesity, hypertension + dyslipidemia + obesity) have been identified in 2024.
Both the prevalence of multimorbidity and the number of NCDs in multimorbid patients have increased in rural Yunnan Province, and multimorbidity patterns were becoming increasingly complex and diverse. Targeted NCDs management strategies should be tailored according to the epidemiologic profiles of multimorbidity to improve prevention and control of NCDs.
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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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