Exploring multimorbidity profiles in middle-aged inpatients: a network-based comparative study of China and the United Kingdom

作者全名："Bao, Yining; Lu, Pengyi; Wang, Mengjie; Zhang, Xueli; Song, Aowei; Gu, Xiaoyun; Ma, Ting; Su, Shu; Wang, Lin; Shang, Xianwen; Zhu, Zhuoting; Zhai, Yuhang; He, Mingguang; Li, Zengbin; Liu, Hanting; Fairley, Christopher K.; Yang, Jiangcun; Zhang, Lei"

作者地址："[Bao, Yining; Lu, Pengyi; Wang, Mengjie; Li, Zengbin; Liu, Hanting; Zhang, Lei] Xian Jiaotong Univ Hlth Sci Ctr, China Australia Joint Res Ctr Infect Dis, Sch Publ Hlth, Xian 710061, Shaanxi, Peoples R China; [Bao, Yining; Fairley, Christopher K.; Zhang, Lei] Alfred Hlth, Melbourne Sexual Hlth Ctr, Melbourne, Vic, Australia; [Bao, Yining; Fairley, Christopher K.; Zhang, Lei] Monash Univ, Fac Med Nursing & Hlth Sci, Cent Clin Sch, Melbourne, Vic, Australia; [Zhang, Xueli] Southern Med Univ, Guangdong Prov Peoples Hosp, Med Res Inst, Guangdong Acad Med Sci, Guangzhou, Peoples R China; [Zhang, Xueli] Southern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Eye Inst, Guangdong Acad Med Sci,Dept Ophthalmol, Guangzhou, Peoples R China; [Song, Aowei; Ma, Ting; Yang, Jiangcun] Shaanxi Prov Peoples Hosp, Dept Transfus Med, 256 Youyi West Rd, Xian 710068, Peoples R China; [Gu, Xiaoyun] Shaanxi Hlth Informat Ctr, Dept Informat Technol, Xian, Peoples R China; [Su, Shu] ChongQing Med Univ, Affiliated Hosp 2, Clin Res Management Off, Chongqing, Peoples R China; [Wang, Lin] Monash Univ, Fac IT, AIM Lab, Melbourne, Vic, Australia; [Wang, Lin] Harbin Engn Univ, Coll Intelligent Syst Sci & Engn, Harbin 150001, Peoples R China; [Shang, Xianwen] Univ Melbourne, Royal Melbourne Hosp, Melbourne, Vic, Australia; [Zhu, Zhuoting; He, Mingguang] Royal Victorian Eye & Ear Hosp, Ctr Eye Res Australia, Melbourne, Vic, Australia; [Zhu, Zhuoting; He, Mingguang] Univ Melbourne, Dept Surg, Div Ophthalmol, Melbourne, Vic, Australia; [Zhai, Yuhang] Univ Illinois, Gies Coll Business, Champaign, IL USA"

通信作者："Zhang, L (通讯作者)，Xian Jiaotong Univ Hlth Sci Ctr, China Australia Joint Res Ctr Infect Dis, Sch Publ Hlth, Xian 710061, Shaanxi, Peoples R China.; Zhang, L (通讯作者)，Alfred Hlth, Melbourne Sexual Hlth Ctr, Melbourne, Vic, Australia.; Zhang, L (通讯作者)，Monash Univ, Fac Med Nursing & Hlth Sci, Cent Clin Sch, Melbourne, Vic, Australia.; Yang, JC (通讯作者)，Shaanxi Prov Peoples Hosp, Dept Transfus Med, 256 Youyi West Rd, Xian 710068, Peoples R China."

来源：BMC MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001124803800003

JCR分区：Q1

影响因子：9.3

年份：2023

卷号：21

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Multimorbidity; Comorbidity; Network analysis; Middle-aged; Inpatients; China; United Kingdom

摘要："BackgroundMultimorbidity is better prevented in younger ages than in older ages. This study aims to identify the differences in comorbidity patterns in middle-aged inpatients from China and the United Kingdom (UK).MethodsWe utilized 184,133 and 180,497 baseline hospitalization records in middle-aged populations (40-59 years) from Shaanxi, China, and UK Biobank. Logistic regression was used to calculate odds ratios and P values for 43,110 unique comorbidity patterns in Chinese inpatients and 21,026 unique comorbidity patterns in UK inpatients. We included the statistically significant (P values adjusted by Bonferroni correction) and common comorbidity patterns (the pattern with prevalence > 1/10,000 in each dataset) and employed network analysis to construct multimorbidity networks and compare feature differences in multimorbidity networks for Chinese and UK inpatients, respectively. We defined hub diseases as diseases having the top 10 highest number of unique comorbidity patterns in the multimorbidity network.ResultsWe reported that 57.12% of Chinese inpatients had multimorbidity, substantially higher than 30.39% of UK inpatients. The complete multimorbidity network for Chinese inpatients consisted of 1367 comorbidities of 341 diseases and was 2.93 x more complex than that of 467 comorbidities of 215 diseases in the UK. In males, the complexity of the multimorbidity network in China was 2.69 x more than their UK counterparts, while the ratio was 2.63 x in females. Comorbidities associated with hub diseases represented 68.26% of comorbidity frequencies in the complete multimorbidity network in Chinese inpatients and 55.61% in UK inpatients. Essential hypertension, dyslipidemia, type 2 diabetes mellitus, and gastritis and duodenitis were the hub diseases in both populations. The Chinese inpatients consistently demonstrated a higher frequency of comorbidities related to circulatory and endocrine/nutritional/metabolic diseases. In the UK, aside from these comorbidities, comorbidities related to digestive and genitourinary diseases were also prevalent, particularly the latter among female inpatients.ConclusionsChinese inpatients exhibit higher multimorbidity prevalence and more complex networks compared to their UK counterparts. Multimorbidity with circulatory and endocrine/nutritional/metabolic diseases among both Chinese and UK inpatients necessitates tailored surveillance, prevention, and intervention approaches. Targeted interventions for digestive and genitourinary diseases are warranted for the UK."

基金机构："National Key R&D Program of China; Yanan blood center, Erqin Bai at Yulin blood center, Shengli Yan at Weinan blood center; Xianyang blood center"

基金资助正文："We would like to acknowledge the contribution of the following individuals for their contribution to data collection from Shaanxi, China, including Xiaoli Cao and Zhendong Sun at Shaanxi Provincial Blood Center, Ke Ding at Hanzhong blood center, Bing Shi at Yanan blood center, Erqin Bai at Yulin blood center, Shengli Yan at Weinan blood center, Guoqiang Zhang at Tongchuan blood center, Hailin Zhang at Baoji blood center, Zhangxue Hu at Ankang blood center, Guancheng Yuan at Shangluo blood center, Xin liang at Xianyang blood center, Xiaodong Su, Xinxin Xie, and Wenhua Wang at Shaanxi Provincial People's Hospital."