Noncommunicable chronic diseases clusters in Brazilian adults and older adults: correlations as multimorbidity

Christofoletti, Marina; Del Duca, Giovani Firpo; Benedet, Jucemar; Malta, Deborah Carvalho

doi:10.1590/1414-462X202331020184

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Sumário

ORIGINAL ARTICLE • Cad. saúde colet. 31 (2) • 2023 • https://doi.org/10.1590/1414-462X202331020184 copy

Noncommunicable chronic diseases clusters in Brazilian adults and older adults: correlations as multimorbidity

Agrupamento de doenças crônicas não transmissíveis em adultos e idosos brasileiros: correlações como multimorbidade

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background

Health has dynamic conditions and overlapping pathophysiological factors. For health prevention and promotion, actions are necessary to understand the most common risk combinations.

Objective

Describe noncommunicable chronic diseases (NCDs) clusters and investigate specific multimorbidity combinations in Brazilian adults and older adults.

Method

This study used data from Vigitel 2013 survey held in the Brazilian capitals (52,929 interviews). A self-report of diabetes, dyslipidemia, hypertension, and obesity was used. The analyses were the descriptive cluster of NCDs and an adjusted binary logistic regression (odds ratio [OR]), stratified by age.

Results

Among adults, the clusters of diabetes, dyslipidemia, hypertension, and obesity (O/E = 18.74) and diabetes, hypertension, and obesity (O/E = 16.83) were higher. There was a higher clustering between diabetes and obesity (O/E = 7.25). Among adults, diabetes was associated with dyslipidemia (OR: 3.04), hypertension (OR: 3.84), and hypertension with obesity (OR: 3.34). In older adults, hypertension was associated with diabetes (OR: 2.79), dyslipidemia (OR: 2.06), and obesity (OR: 2.26).

Conclusion

Other diseases combined with diabetes and hypertension were more frequent in adults and older adults. It is suggested to combine preventive and control measures for these diseases for the non-occurrence of new diagnoses.

Keywords:
chronic disease; related-diagnostic groups; risk index; cluster analysis; cross-sectional studies

Number of NCDs	NCDs
Number of NCDs	Diabetes	Dyslipidemia	Hypertension	Obesity	n	% ^a a Weighted values O	% ^a E	O/E (95%CI) ^b b Confidence interval of 95% in the weighted sample
4	+	+	+	+	215	0.58	0.03	18.74 (13.64;24.46)
3	+	-	+	+	702	1.94	0.12	16.83 (14.12;19.78)
	+	+	-	+	167	0.43	0.12	3.48 (1.32;7.66)
	+	+	+	-	72	0.21	0.16	1.29 (0.03;7.50)
	-	+	+	+	282	0.7	0.64	1.09 (0.22;3.08)
2	+	-	-	+	1,163	3.27	0.46	7.10 (5.72;8.777)
	+	+	-	-	844	2.16	0.65	3.31 (2.22;4.76)
	-	-	+	+	1,368	2.94	2.40	1.23 (0.72;2.04)
	+	-	+	-	101	0.3	0.61	0.49 (0.00;3.59)
	-	+	+	-	252	0.67	3.40	0.20 (0.01;2.19)
	-	+	-	+	188	0.47	2.57	0.18 (0.00;1.94)
1	+	-	-	-	2,597	7.64	2.43	3.14 (2.52;3.90)
	-	+	-	-	2,641	6.65	13.58	0.49 (0.26;0.84)
	-	-	+	-	3,741	8.5	12.66	0.67 (0.43;0.98)
	-	-	-	+	301	0.8	9.58	0.08 (0.08;2.38)
0	-	-	-	-	20,003	62.74	50.58	1.24 (0.08;1.83)

Number of NCDs	NCDs
Number of NCDs	Diabetes	Dyslipidemia	Hypertension	Obesity	n	% ^a a Weighted values O	% ^a E	O/E (95%CI) ^b b Confidence interval of 95% in the weighted sample
4	+	+	+	+	303	2.70	0.70	3.87 (2.06;6.82)
3	+	-	+	+	533	4.30	1.12	3.83 (2.06;6.82)
	+	+	-	+	222	2.20	0.54	4.08 (1.87;7.56)
	+	+	+	-	40	0.40	3.41	0.12 (0.00;8.81)
	-	+	+	+	632	5.60	2.97	1.89 (1.00;2029)
2	+	-	-	+	689	6.30	0.87	7.25 (5.43;9.46)
	+	+	-	-	175	1.60	2.64	0.61 (0.01;3.14)
	-	-	+	+	1,693	12.20	4.77	2.56 (18.4;3.41)
	+	-	+	-	74	0.50	5.50	0.09 (0.0;4.86)
	-	+	+	-	580	5.70	14.52	0.39 (0.04;1.24)
	-	+	-	+	206	1.60	2.29	0.70 (0.01;2.67)
1	+	-	-	-	407	3.40	4.25	0.80 (0.15;2.14)
	-	+	-	-	2,330	18.50	11.24	1.65 (1.16;2.23)
	-	-	+	-	1,245	8.10	23.39	0.35 (0.07;0.08)
	-	-	-	+	325	2.50	3.69	0.68 (0.01;2.21)
0	-	-	-	-	3,097	24.40	18.09	1.35 (0.09;1.83)

Variable		Crude		Model 1		Model 2		Model 3
Variable	(%)^a a Weighted values	OR^a (95%IC)	p	OR^a (95%IC)	p	OR^a (95%IC)	p	OR^a (95%IC)	p
Diabetes and Dyslipidemia	2.0	4.84 (3.95;5.93)	<0.001	2.90 (2.27;3.69)	<0.001	3.09 (2.48;3.85)	<0.001	3.04 (2.43;3.79)	<0.001
Diabetes and Hypertension	2.4	7.42 (6.05;9.09)	<0.001	4.12 (3.27;5.19)	<0.001	3.87 (3.12;4.79)	<0.001	3.84 (3.10;4.76)	<0.001
Diabetes and Obesity	1.5	3.02 (2.42;3.77)	<0.001	2.14 (1.67;2.75)	<0.001	2.22 (1.77;2.80)	<0.001	2.20 (1.74;2.79)	<0.001
Dyslipidemia and Hypertension	6.4	3.71 (3.32;4.14)	<0.001	2.30 (2.03;2.60)	<0.001	2.33(2.05;2.64)	<0.001	2.31(2.04;2.62)	<0.001
Dyslipidemia and Obesity	5.0	2.39 (2.12;2.71)	<0.001	1.94 (1.68;2.24)	<0.001	1.99(1.75;2.27)	<0.001	1.97(1.72;2.25)	<0.001
Hypertension and Obesity	6.3	3.97 (3.53;4.48)	<0.001	3.41 (2.98;3.91)	<0.001	3.37(2.93;3.86)	<0.001	3.34(2.91;3.83)	<0.001

Variable		Crude		Model 1		Model 2		Model 3
Variable	(%)^a a Weighted values	OR^a (95%IC)	p	OR^a (95%IC)	p	OR^a (95%IC)	p	OR^a (95%IC)	p
Diabetes and Dyslipidemia	10.7	2.02 (1.69;2.41)	<0.001	2.12 (1.73;2.61)	<0.001	2.00 (1.67;2.39)	<0.001	1.96 (1.63;2.35)	<0.001
Diabetes and Hypertension	16.5	2.92 (2.42;3.52)	<0.001	3.17 (2.56;3.93)	<0.001	2.84 (2.34;3.44)	<0.001	2.79 (2.30;3.39)	<0.001
Diabetes and Obesity	5.7	1.50 (1.19;1.88)	0.001	1.68 (1.30;2.17)	<0.001	1.44 (1.14;1.82)	0.002	1.36 (1.07;1.73)	0.011
Dyslipidemia and Hypertension	25.8	2.16 (1.87;2.51)	<0.001	2.16 (1.82;2.55)	<0.001	2.08 (1.78;2.42)	<0.001	2.06 (1.77;2.39)	<0.001
Dyslipidemia and Obesity	9.0	1.33 (1.09;1.63)	0.005	1.28 (1.01;1.61)	0.041	1.27 (1.03;1.57)	0.025	1.23 (1.00;1.51)	0.051
Hypertension and Obesity	15.4	2.26 (1.81;2.83)	<0.001	2.42 (1.89;3.10)	<0.001	2.36 (1.84;3.04)	<0.001	2.26 (1.76;2.91)	<0.001

Instituto de Estudos em Saúde Coletiva da Universidade Federal do Rio de Janeiro Avenida Horácio Macedo, S/N, CEP: 21941-598, Tel.: (55 21) 3938 9494 - Rio de Janeiro - RJ - Brazil
E-mail: cadernos@iesc.ufrj.br

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[1] Correspondence: Marina Christofoletti. E-mail: marinachriss@outlook.com