虽然与年龄有关的疾病的危险因素可能会增加多发病率(MM),早期生活剥夺也可能加速慢性疾病和MM的发展。
本研究探讨了MM在65-71岁以前出生的个体中的患病率和模式。during,第二次世界大战后,德国南部基于2008/9和2016年的两项大型横断面KORA(奥格斯堡地区合作健康研究)-年龄研究。MM被定义为患有至少两种慢性疾病,出生时期分为五个阶段:战前,早期战争,战争后期,饥荒,在饥荒时期之后。使用Logistic回归模型分析出生阶段对MM的影响,并调整社会人口统计学和生活方式危险因素。此外,我们使用聚集层次聚类来研究疾病的共现。
与其他阶段出生的参与者相比,在战争后期出生的参与者的MM和单一慢性疾病患病率最高(62.2%)。在调整社会人口统计学和生活方式因素后,出生在战争后期与MM的几率显着相关(OR=1.83,95%CI:1.15-2.91)。在女性中,关节的患病率,胃肠,眼部疾病,焦虑更高,而心脏病,中风,糖尿病在男性中更为常见。此外,负责观察到的关联的三个主要慢性疾病集群被确定为:关节和心身,心脏代谢和,其他内脏疾病。
我们的发现表明,在65-71岁的成年人中,不良的早期暴露可能会增加MM的风险。此外,确定的疾病集群不是偶然的,需要更多的调查。
While risk factors for age-related diseases may increase multimorbidity (MM), early life deprivation may also accelerate the development of chronic diseases and MM.
This
study explores the prevalence and pattern of MM in 65-71 year-old individuals born before, during, and after World War II in Southern Germany based on two large cross-sectional KORA (Cooperative Health Research in the Region of Augsburg) -Age studies in 2008/9 and 2016. MM was defined as having at least two chronic diseases, and birth periods were classified into five phases: pre-war, early war, late war, famine, and after the famine period. Logistic regression models were used to analyze the effect of the birth phases on MM with adjustment for sociodemographic and lifestyle risk factors. Furthermore, we used agglomerative hierarchical clustering to investigate the co-occurrence of diseases.
Participants born during the late war phase had the highest prevalence of MM (62.2%) and single chronic diseases compared to participants born during the other phases. Being born in the late war phase was significantly associated with a higher odds of MM (OR = 1.83, 95% CI: 1.15-2.91) after adjustment for sociodemographic and lifestyle factors. In women, the prevalence of joint, gastrointestinal, eye diseases, and anxiety was higher, while heart disease, stroke, and diabetes were more common in men. Moreover, three main chronic disease clusters responsible for the observed associations were identified as: joint and psychosomatic, cardiometabolic and, other internal organ diseases.
Our findings imply that adverse early-life exposure may increase the risk of MM in adults aged 65-71 years. Moreover, identified disease clusters are not coincidental and require more investigation.