基于随机森林模型的新疆成人慢性病共病影响因素分析  

Factors influencing multimorbidity among adults in Xinjiang based on random forest model

作　　者：任茜格 者炜[2] 张艺[2] 张俊[2] 依力夏提·库来西 方萍[2] 张妞妞 廖佩花[2] REN Qiange;ZHE Wei;ZHANG Yi;ZHANG Jun;YILIXIATI Kulaixi;FANG Ping;ZHANG Niuniu;LIAO Peihua(School of Public Health,Xinjiang Medical University,Urumqi,Xinjiang 830000,China;Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention,Urumqi,Xinjiang 830000,China)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐830000 [2]新疆维吾尔自治区疾病预防控制中心,新疆乌鲁木齐830000

出　　处：《实用预防医学》2025年第2期181-185,共5页Practical Preventive Medicine

基　　金：新疆维吾尔自治区自然科学基金资助项目(2024D01C66;2020D01C082)。

摘　　要：目的了解新疆成人常见慢性病共病患病情况及影响因素,为慢性病共病的预防和控制提供依据。方法数据来源于2018年新疆成人慢性病与营养监测调查资料,采用χ^(2)检验、χ^(2)趋势检验、多因素logistic回归和随机森林模型分析共病发生影响因素。结果新疆成人慢性病患病率为76.25%,共病患病率为47.41%,多因素logistic回归分析发现,45~59岁(OR=2.238)、60~74岁(OR=5.340)以及≥75岁(OR=6.439)、离婚/丧偶/分居(OR=1.501)、低收入(OR=1.388)、有慢性病家族史(OR=1.879)、超重(OR=1.206)和肥胖(OR=1.936)、有中心性肥胖(OR=1.687)、日均睡眠时间<7 h(OR=1.181)和有睡眠障碍(OR=2.000)均是共病独立危险因素(均P<0.05)。随机森林模型准确度为70.92%,灵敏度71.12%,特异度70.74%,曲线下面积值为0.765,基于基尼系数的变量重要性评分显示,年龄(165.74%)、睡眠障碍(72.41%)是影响共病发生的重要特征。结论新疆成人慢性病共病患病率较高,应尽早开展人群共病健康教育,实施精准预防管理措施,以有效降低新疆成人共病风险。Objective To understand the prevalence and influencing factors of multimorbidity among adults in Xinjiang,and to provide a basis for multimorbidity prevention and control.Methods The data were sourced from the Adult Chronic Disease and Nutrition Surveillance in Xinjiang in 2018.χ^(2)test,trendχ^(2)test,multi-factor logistic regression and random forest model were employed to analyze the factors influencing the occurrence of multimorbidity.Results The prevalence rates of chronic diseases and multimorbidity among adults in Xinjiang were 76.25%and 47.41%respectively.Multi-factor logistic regression analysis revealed that 45-59 years old(OR=2.238),60-74 years old(OR=5.340),≥75 years old(OR=6.439),the divorced/widowed/separated(OR=1.501),low income(OR=1.388),having a family history of chronic diseases(OR=1.879),overweight(OR=1.206),obesity(OR=1.936),central obesity(OR=1.687),average daily sleep time<7 hours(OR=1.181),and having sleep disorders(OR=2.000)were all independent risk factors for multimorbidity(all P<0.05).The accuracy of the random forest model was 70.92%,and the sensitivity,specificity and the value of area under the curve(AUC)were 71.12%,70.74%and 0.765 respectively.The variable importance score based on the Gini coefficient showed that age(165.74%)and sleep disorders(72.41%)were important characteristics affecting the occurrence of multimorbidity.Conclusion The prevalence rate of multimorbidity among adults in Xinjiang was relatively high.It is necessary to carry out health education on multimorbidity among the population as soon as possible,and implement precise prevention and management measures so as to effectively reduce the risk of multimorbidity among adults in Xinjiang.

关 键 词：慢性病 共病 影响因素 随机森林 

分 类 号：R181.38[医药卫生—流行病学]