ABSTRACT
Objective To characterize the multimorbidity patterns of chronic diseases in middle-aged and elderly people in China，and explore the correlation and intensity among chronic diseases by using association rules. Methods A total of 17 796 people over 45 years old from 9 provinces and cities in China were sampled and surveyed. The data were analyzed by Apriori algorithm in R3.4.3 software to investigate the multimorbidity of chronic diseases. Results Among total 17 796 respondents, the number of patients with at least one chronic disease was 12 245 (68.81%), and the number of patients with two or more chronic diseases was 7 321 (41.15%). Among the selected association rules, according to the ranking of support degree, the most common three chronic disease multimorbidities were dyslipidemia and heart disease, diabetes mellitus and dyslipidemia, asthma and chronic lung disease. The rule support was 6.77%, 5.27%, 4.28%, and the rule confidence was 34.38%, 43.14%, and 70.81%, respectively. Multiple results of association rules pointed to heart disease. After screening, the greatest association rules were found in the age group over 75 years old. Conclusions Heart disease exists in a variety of chronic disease multimorbidity patterns. Screening and prevention measures should be strengthened. Dyslipidemia is strongly associated with diabetes and hypertension, and male patients are more vulnerable to suffer from dyslipidemia. Chronic diseases intend to be more common and complicated along with age increase.
ABSTRACT
Previous studies suggested that smoking and passive smoking could increase the risk of breast cancer, but the results were inconsistent, especially for Chinese females. Thus, we systematically searched cohort and case-control studies investigating the associations of active and passive smoking with breast cancer risk among Chinese females in four English databases (PubMed, Embase, ScienceDirect, and Wiley) and three Chinese databases (CNKI, WanFang, and VIP). Fifty-one articles (3 cohort studies and 48 case-control studies) covering 17 provinces of China were finally included in this systematic review. Among Chinese females, there was significant association between passive smoking and this risk of breast cancer [odds ratio (OR): 1.62; 95% confidence interval (CI): 1.39-1.85; I2 = 75.8%, P < 0.001; n = 26] but no significant association between active smoking and the risk of breast cancer (OR: 1.04; 95% CI: 0.89-1.20; I2 = 13.9%, P = 0.248; n = 31). The OR of exposure to husband's smoking and to smoke in the workplace was 1.27 (95% CI: 1.07-1.50) and 1.66 (95% CI: 1.07-2.59), respectively. The OR of light and heavy passive smoking was 1.11 and 1.41, respectively, for women exposed to their husband's smoke (< 20 and ≥ 20 cigarettes per day), and 1.07 and 1.87, respectively, for those exposed to smoke in the workplace (< 300 and ≥ 300 min of exposure per day). These results imply that passive smoking is associated with an increased risk of breast cancer, and the risk seems to increase as the level of passive exposure to smoke increases among Chinese females. Women with passive exposure to smoke in the workplace have a higher risk of breast cancer than those exposed to their husband's smoking.