2型糖尿病患者常见慢性病共存状态模式的现况研究

高宁; 盛丹; 唐绍琰; 王敏珍

doi:10.16462/j.cnki.zhjbkz.2025.02.005

2型糖尿病患者常见慢性病共存状态模式的现况研究

doi: 10.16462/j.cnki.zhjbkz.2025.02.005

兰州大学公共卫生学院流行病与卫生统计学研究所, 兰州 730000

基金项目:

甘肃省杰出青年基金 23JRRA1019

河北省糖尿病基础医学研究重点实验室开放课题 KF2023-02

详细信息

通讯作者:
王敏珍, E-mail: wangmzh@lzu.edu.cn

中图分类号: R181.3
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- 被引次数: 0
出版历程
- 收稿日期: 2024-07-23
- 修回日期: 2024-11-18
- 网络出版日期: 2025-03-08
- 刊出日期: 2025-02-10

A cross-sectional study of common comorbidity patterns in patients with type 2 diabetes mellitus

Institution of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China

Funds:

Gansu Outstanding Youth Fund 23JRRA1019

Hebei Province Key Laboratory of Basic Medical Research of Diabetes Province Open Project KF2023-02

More Information

Corresponding author: WANG Minzhen, E-mail: wangmzh@lzu.edu.cn

摘要

摘要: 目的探讨2型糖尿病患者共患病情况及其慢性病共存状态(简称共病)模式, 为2型糖尿病患者的共病管理提供数据支持。方法以金昌队列2011年6月―2013年12月基线调查中的3 592例2型糖尿病患者为研究对象, 结合流行病学调查、体格检查和临床生化的资料, 纳入患病率>5%的18种慢性病, 分析2型糖尿病患者的共患病现状。采用Apriori算法探索常见共病模式, 并通过网络图、分组矩阵图和平行坐标图对结果进行可视化。结果在金昌队列研究中, 2型糖尿病患者共病率为98.58%(3 541/3 592), 以2~4种共病为主。单病种排序前3位的疾病分别为高脂血症(78.29%)、高血压(63.20%)和脂肪肝(46.97%)。2型糖尿病患者最常见的二元、三元和四元共病模式分别为：高血压和高脂血症, 高血压、高脂血症和脂肪肝, 以及心律失常、脂肪肝、高脂血症和高血压。不同性别和年龄段的共病模式存在差异。结论金昌队列2型糖尿病患者普遍存在共病现象, 高脂血症、高血压和脂肪肝是共病模式的核心疾病, 应加强2型糖尿病患者中这3种慢性病的筛查和预防。
- 2型糖尿病 /
- 慢性病 /
- 共病模式 /
- 现况研究
Abstract: Objective To investigate the comorbidity conditions and patterns among patients with type 2 diabetes mellitus, and to provide data support for the management of comorbidities in these patients. Methods The participants of the present study included 3 592 patients with type 2 diabetes from the Jinchang cohort, based on baseline surveys conducted from June 2011 to December 2013. By combining data from epidemiological investigations, physical examinations, and clinical biochemical tests, our study included 18 chronic diseases with prevalence rates greater than 5%, and the comorbidity status of patients with type 2 diabetes were analyzed. The Apriori algorithm was used to explore common comorbidity patterns, and the results were visualized through network diagrams, grouped matrix plots, and parallel coordinate plots. Results The comorbidity rate among the Jinchang cohort patients with type 2 diabetes was as high as 98.58% (3 541/3 592), primarily involving 2-4 comorbidities. The top three individual diseases were hyperlipidemia (78.29%), hypertension (63.20%), and fatty liver (46.97%). The most common binary, ternary, and quaternary comorbidity patterns were hypertension and hyperlipidemia, followed by hypertension and hyperlipidemia and fatty liver, and finally arrhythmia and fatty liver and hyperlipidemia and hypertension, respectively. Differences in comorbidity patterns were observed across different genders and age groups. Conclusions Comorbidity is a common phenomenon among patients with type 2 diabetes in the Jinchang cohort, with hyperlipidemia, hypertension, and fatty liver being the core diseases in these patterns. There should be an emphasis on screening and prevention of these three chronic diseases among patients with type 2 diabetes.
- Type 2 diabetes mellitus /
- Chronic disease /
- Comorbidity pattern /
- Cross-sectional study

HTML全文

图 1 2型糖尿病患者常见共病网络图

Figure 1. Network diagram of common co-morbidities in patients with type 2 diabetes

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图 2 2型糖尿病患者常见二元共病模式分组矩阵图

Figure 2. Matrix of common dichotomous co-morbidity patterns grouped in patients with type 2 diabetes

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图 3 2型糖尿病患者常见三元共病模式分组矩阵图

Figure 3. Matrix of common triadic co-morbidity pattern groupings in type 2 diabetes

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图 4 2型糖尿病患者常见四元共病模式平行坐标图

Figure 4. Parallel coordinate diagram of common quadratic co-morbiditypatterns in patients with type 2 diabetes

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表 1 2型糖尿病患者基本情况

Table 1. Basic information of patients with type 2 diabetes

特征	男性^①	女性^①	总人群^①	χ²/Z值	P值
民族				0.376	0.540
汉族	2 397(96.54)	1 075(96.93)	3 472(96.66)
少数民族	86(3.46)	34(3.07)	120(3.34)
年龄/岁	60.00(49.00, 68.00)	61.00(53.00, 68.00)	60(50.00, 68.00)	-3.270	0.001
年龄组/岁				18.158	< 0.001
≤44	337(13.57)	95(8.57)	432(12.03)
＞44	2 146(86.43)	1 014(91.43)	3 160(87.97)
文化程度				58.905	< 0.001
小学及以下	727(29.28)	397(35.80)	1 124(31.29)
初高中/中专	1 303(52.48)	617(55.63)	1 920(53.45)
大专及以上	453(18.24)	95(8.57)	548(15.26)
家庭人均月收入/元				38.127	< 0.001
< 1 000	131(5.28)	24(2.16)	155(4.31)
1 000~＜2 000	1 126(45.35)	431(38.87)	1 557(43.35)
≥2 000	1 226(49.37)	654(58.97)	1 880(52.34)
婚姻状况				123.267	< 0.001
有配偶	2 282(91.90)	874(78.81)	3 156(87.86)
无配偶	201(8.10)	235(21.19)	436(12.14)
注：①以人数(占比/%)或M(P₂₅, P₇₅)表示。

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表 2 2型糖尿病患者常见共病检出现状

Table 2. Current status of detection of common co-morbidities in patients with type 2 diabetes

亚组	高脂血症	高血压	脂肪肝	心律失常	胆结石
总人群^①	2 812(78.29)	2 270(63.20)	1 687(46.97)	849(23.64)	629(17.51)
顺位	1	2	3	4	5
性别
男^①	1 944(78.29)	1 514(60.97)	1165(46.92)	661(26.62)	391(15.75)
顺位	1	2	3	4	5
女^①	868(78.27)	756(68.17)	522(47.07)	188(16.95)	238(21.46)
顺位	1	2	3	6	4
χ²值	< 0.001	17.062	0.007	39.706	17.326
P值	0.987	< 0.001	0.934	< 0.001	< 0.001
年龄组/岁
≤44^①	371(85.88)	192(44.44)	255(59.03)	81(18.75)	40(9.26)
顺位	1	3	2	4	7
＞44^①	2 441(77.25)	2 078(65.76)	1 432(45.32)	768(24.30)	589(18.64)
顺位	1	2	3	4	5
χ²值	16.661	74.237	28.685	6.495	23.149
P值	< 0.001	< 0.001	< 0.001	0.011	< 0.001
注：①以人数(占比/%)表示。

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表 3 2型糖尿病患者常见共病关联模式

Table 3. Association model of common comorbidity in patients with type 2 diabetes

前项	后项	总人群			男性			女性			≤44岁			＞44岁
前项	后项	S/%	C/%	L	S/%	C/%	L	S/%	C/%	L	S/%	C/%	L	S/%	C/%	L
二元共病
高血压	高脂血症	50.17	79.38	1.01	48.53	79.59	1.02	53.83	78.97	1.01				51.42	78.20	1.01
高脂血症	高血压	50.17	64.08	1.01	48.53	61.99	1.02	53.83	68.78	1.01				51.42	66.57	1.01
脂肪肝	高脂血症										55.09	93.33	1.09
高脂血症	脂肪肝										55.09	64.15	1.09
三元共病
高血压、高脂血症	脂肪肝	27.14	54.11	1.15	26.42	54.44	1.16	28.76	53.43	1.14	28.24	68.93	1.17	27.00	52.49	1.16
脂肪肝、高血压	高脂血症	27.14	85.90	1.10	26.42	86.09	1.10	28.76	85.52	1.09	28.24	95.31	1.11	27.00	84.71	1.10
脂肪肝、高脂血症	高血压	27.14	67.33	1.07	26.42	65.34	1.07	28.76	71.85	1.05	28.24	51.26	1.15	27.00	70.50	1.07
四元共病
心律失常、脂肪肝、高脂血症	高血压	5.93	70.53	1.12	6.36	69.30	1.14				4.40	51.35	1.16	6.14	73.21	1.11
心律失常、脂肪肝、高血压	高脂血症	5.93	82.56	1.05	6.36	82.29	1.05				4.40	90.48	1.05	6.14	81.86	1.06
高血压、心律失常、高脂血症	脂肪肝										4.40	59.38	1.01
胆结石、高血压、高脂血症	脂肪肝							8.21	62.76	1.33
胆结石、脂肪肝、高脂血症	高血压							8.21	80.53	1.18
胆结石、脂肪肝、高血压	高脂血症							8.21	88.35	1.13
注：S, 支持度, 表示数据集中前项和后项同时出现的概率; C, 置信度, 即条件概率, 前项出现的条件下后项出现的概率; L, 提升度, 前项出现的条件下后项出现的概率与后项单独出现的概率的比值。

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