Trends and all-cause mortality associated with multimorbidity of non-communicable diseases among adults in the United States, 1999-2018: a retrospective cohort study
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
OBJECTIVES: Multimorbidity of non-communicable diseases (NCDs) has brought enormous challenges to public health, becoming a major medical burden. However, the patterns, temporal trends, and all-cause mortality associated with NCD multimorbidity over time have not been well described in the United States. METHODS: All adult participants were sourced from nationally representative data from the National Health and Nutrition Examination Survey. In total, 55,081 participants were included in trend analysis, and 38,977 participants were included in Cox regression. RESULTS: The 5 NCDs with the largest increases over the study period were diabetes, osteoporosis, obesity, liver conditions, and cancer. The estimated prevalence of multimorbidity increased with age, especially for middle-aged participants with 5 or more NCDs; in general, the prevalence of NCD multimorbidity was higher among females than males. Participants with 5 or more NCDs were at 4.49 times the risk of all-cause mortality of participants without any diseases. Significant interactions were found between multimorbidity and age group (p for interaction <0.001), race/ethnicity (p for interaction<0.001), and educational attainment (p for interaction=0.010). CONCLUSIONS: The prevalence of multiple NCDs significantly increased from 1999 to 2018. Those with 5 or more NCDs had the highest risk of all-cause mortality, especially among the young population. The data reported by this study could serve as a reference for additional NCD research.
Abstract
OBJECTIVES: Multimorbidity of non-communicable diseases (NCDs) has brought enormous challenges to public health, becoming a major medical burden. However, the patterns, temporal trends, and all-cause mortality associated with NCD multimorbidity over time have not been well described in the United States. METHODS: All adult participants were sourced from nationally representative data from the National Health and Nutrition Examination Survey. In total, 55,081 participants were included in trend analysis, and 38,977 participants were included in Cox regression. RESULTS: The 5 NCDs with the largest increases over the study period were diabetes, osteoporosis, obesity, liver conditions, and cancer. The estimated prevalence of multimorbidity increased with age, especially for middle-aged participants with 5 or more NCDs; in general, the prevalence of NCD multimorbidity was higher among females than males. Participants with 5 or more NCDs were at 4.49 times the risk of all-cause mortality of participants without any diseases. Significant interactions were found between multimorbidity and age group (p for interaction <0.001), race/ethnicity (p for interaction<0.001), and educational attainment (p for interaction=0.010). CONCLUSIONS: The prevalence of multiple NCDs significantly increased from 1999 to 2018. Those with 5 or more NCDs had the highest risk of all-cause mortality, especially among the young population. The data reported by this study could serve as a reference for additional NCD research.
참고문헌 (32)
- Lenzi J, "Burden of multimorbidity in relation to age, gender and immigrant status : a cross-sectional study based on administrative data", BMJ Open, 6, pp.e012812~ (2016)
- Tugwell P, "Multimorbidity and comorbidity are now separate MESH headings", J Clin Epidemiol, 105, pp.6~8 (2019)
- Benziger CP, "The Global Burden of Disease Study and the preventable burden of NCD", Glob Heart, 11, pp.393~397 (2016)
- Divo MJ, "Ageing and the epidemiology of multimorbidity", Eur Respir J, 44, pp.1055~1068 (2014)
- Marengoni A, "Aging with multimorbidity : a systematic review of the literature", Ageing Res Rev, 10, pp.430~439 (2011)
- Brilleman SL, "Implications of comorbidity for primary care costs in the UK : a retrospective observational study", Br J Gen Pract, 63, pp.e274~e282 (2013)
- Global Burden of Disease Study 2013 Collaborators, "Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013 : a systematic analysis for the Global Burden of Disease Study 2013", Lancet, 386, pp.743~800 (2015)
- Ward BW, "Prevalence of multiple chronic conditions among US adults : estimates from the National Health Interview Survey, 2010", Prev Chronic Dis, 10, pp.E65~ (2013)
- Tinetti ME, "Association between guideline recommended drugs and death in older adults with multiple chronic conditions : population based cohort study", BMJ, pp.h4984~ (2015)
- Curtin LR, "National Health and Nutrition Examination Survey: sample design, 2007-2010", Vital Health Stat 2, pp.1~23 (2013)
- Zhang N, "Type 2 diabetes mellitus unawareness, prevalence, trends and risk factors : National Health and Nutrition Examination Survey(NHANES)1999-2010", J Int Med Res, 45, pp.594~609 (2017)
- Al-Ibrahim AA, "Healthy eating index versus alternate healthy index in relation to diabetes status and health markers in U. S. adults : NHANES 2007-2010", Nutr J, 18, pp.26~ (2019)
- Miao H, "Association between blood lead level and uncontrolled hypertension in the US population(NHANES 1999-2016)", J Am Heart Assoc, 9, pp.e015533~ (2020)
- Hanmer J, "The diagnosis of asymptomatic disease is associated with fewer healthy days : a cross sectional analysis from the national health and nutrition examination survey", Br J Health Psychol, 24, pp.88~101 (2019)
- Funk LM, "Electronic health record data versus the National Health and Nutrition Examination Survey(NHANES) : a comparison of overweight and obesity rates", Med Care, 55, pp.598~605 (2017)
- Chang HJ, "Associations between lifestyle factors and reduced kidney function in US older adults : NHANES 1999-2016", Int J Public Health, 66, pp.1603966~ (2021)
- Booth JN 3rd, "Trends in prehypertension and hypertension risk factors in US adults : 1999-2012", Hypertension, 70, pp.275~284 (2017)
- Szlejf C, "Medical adverse events in elderly hospitalized patients: a prospective study", Clinics(Sao Paulo), 67, pp.1247~1252 (2012)
- Assimakopoulos K, "Quality of life in patients with nonalcoholic fatty liver disease : a systematic review", J Psychosom Res, 112, pp.73~80 (2018)
- Lynch CP, "Geographic and racial", ethnic variations in patterns of multimorbidity burden in patients with type 2 diabetes, 2015, pp.30, 25~32
- National Guideline Centre (UK), "Multimorbidity: assessment, prioritisation and management of care for people with commonly occurring multimorbidity", National Institute for Health and Care Excellence (NICE), ~ (2016)
- Feely A, "Estimating multimorbidity prevalence with the Canadian Chronic Disease Surveillance System", Health Promot Chronic Dis Prev Can, 37, pp.215~222 (2017)
- He Z, "Prevalence of multiple chronic conditions among older adults in Florida and the United States : comparative analysis of the OneFlorida data trust and national inpatient sample", J Med Internet Res, 20, pp.e137~ (2018)
- Jamerson K, "Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients", N Engl J Med, 359, pp.2417~2428 (2008)
- Ivanovic B, "Hypercholesterolemia and hypertension : two sides of the same coin", Am J Cardiovasc Drugs, 15, pp.403~414 (2015)
- NCD Risk Factor Collaboration(NCD-RisC), "Trends in adult body-mass index in 200 countries from 1975 to 2014 : a pooled analysis of 1698 population-based measurement studies with 19·2 million participants", Lancet, 387, pp.1377~1396 (2016)
- Hall JE, "Obesity-induced hypertension : interaction of neurohumoral and renal mechanisms", Circ Res, 116, pp.991~1006 (2015)
- Klop B, "Dyslipidemia in obesity : mechanisms and potential targets", Nutrients, 5, pp.1218~1240 (2013)
- Berg AH, "Adipose tissue, inflammation, and cardiovascular disease", Circ Res, 96, pp.939~949 (2005)
- van Breukelen-van der Stoep DF, "Marked underdiagnosis and undertreatment of hypertension and hypercholesterolaemia in rheumatoid arthritis", Rheumatology(Oxford), 55, pp.1210~1216 (2016)
- Marlow EC, "Mortality by education before and during the COVID-19 pandemic, U. S., 2017-2020", Am J Prev Med, 64, pp.105~116 (2023)
- Yevgeniy Feyman, "Racial and ethnic disparities in excess mortality among U.S. veterans during the COVID-19 pandemic", Health Services Research, 58(3), pp.642~653 (2022), Wiley[DOI]