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Chronic Disease Epidemiology: Advances in Research and Methods

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 31712

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Prof. Dr. Ahmed A. Arif

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Guest Editor

Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC 28223, USA
Interests: chronic disease epidemiology; occupational epidemiology; spatial epidemiology; rare and orphan diseases
Special Issues, Collections and Topics in MDPI journals

Dr. Rajib Paul

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College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC 28223, USA
Interests: bayesian methods; biostatistics; spatio-temporal analysis; social epidemiology; diabetes; and infectious diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Globally, chronic diseases such as cancer, heart diseases, respiratory diseases, and diabetes are rising. This trend has strained healthcare resources in both resource-rich and resource-poor countries. The control of infectious diseases through public health and medical interventions has increased life expectancy in most countries. However, most middle-to-low-income countries experience a poor quality of life. In high-income countries such as the U.S., life expectancy has been stagnant for the past several years. According to the Global Burden of Disease report, a sharp increase in obesity in adults might be fueling the rise in diabetes and heart disease globally. In the older age group, 63% of the global burden of respiratory diseases such as chronic obstructive pulmonary disease (COPD) and lung cancer are shared by low-to-middle income countries, likely due to exposure to indoor and outdoor air pollution. The coronavirus disease 2019 (Covid-19) global pandemic has affected disproportionally those with underlying chronic health conditions (comorbidities). It is still unknown what the long-term health consequences might be for those who recovered from the Covid-19 infection or had an asymptomatic infection.

For this Special Issue, we welcome original articles and reviews on epidemiological research and/or methods focusing on chronic diseases. Research articles based on primary or secondary data focusing on social determinants of health, access to care, interventions, longitudinal studies, and risk factors of chronic diseases are encouraged. This Special Issue will also consider articles on the impact of chronic health conditions on Covid-19 severity. Epidemiological methods based on spatiotemporal analyses, Bayesian methods, multilevel modeling, time series analysis, or causal inference using theoretical or empirical approaches are also of interest. Research-to-practice articles highlighting the successful implementation of evidence-based research will also be considered.

Prof. Dr. Ahmed A. Arif
Dr. Rajib Paul
Guest Editors

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Keywords

chronic disease epidemiology
heart disease
cancer
COPD
diabetes
interventions
social determinants of health
access to care
epidemiologic methods
spatiotemporal analysis
Bayesian methods
multilevel modeling
time series analysis
evidence-based research
obesity
comorbidities
longitudinal
Covid-19 severity

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Published Papers (11 papers)

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14 pages, 2546 KiB

Open AccessArticle

The Bidirectional Relationship between Chronic Kidney Disease and Hyperuricemia: Evidence from a Population-Based Prospective Cohort Study

by Zhibin Ma, Xiao Wang, Jia Zhang, Chao Yang, Hongmei Du, Feng Dou, Jianjian Li, Yini Zhao, Peiqin Quan and Xiaobin Hu

Int. J. Environ. Res. Public Health 2023, 20(3), 1728; https://doi.org/10.3390/ijerph20031728 - 18 Jan 2023

Cited by 5 | Viewed by 1873

Abstract

Background. Although several studies have examined the association between chronic kidney disease (CKD) and hyperuricemia (HUA), the direction of the association remains unclear. We aimed to investigate whether there was a bidirectional association between them. Methods. The present study was conducted in three analyses. Analysis I included 25,433 participants free of HUA at baseline to evaluate the associations between CKD and estimated glomerular filtration rate (eGFR) with incident HUA. Analysis II had 28,422 participants free of CKD at baseline to analyze the relationships between HUA and serum uric acid (sUA) with new-onset CKD. Cox proportional hazards regression models were applied to evaluate the association involved in Analysis I and II. Analysis III included 31,028 participants with complete data and further dissected the bidirectional association between sUA and eGFR using cross-lag models. Results. New-onset HUA and CKD were observed in the first round of the follow-up study among 1597 and 1212 participants, respectively. A significantly higher risk of HUA was observed in individuals with CKD compared to individuals without CKD (HR = 1.58, 95% CI: 1.28–1.95). The adjusted HRs (95% CIs) of HUA were 3.56 (2.50–5.05) for the participants in the group of eGFR less than 60 mL·min⁻¹·1.73 m⁻², 1.61 (1.42–1.83) for those in the group of eGFR between 60 and 90 mL·min⁻¹·1.73 m⁻², and 1.74 (1.42–2.14) for those in the group of eGFR more than 120 mL·min⁻¹·1.73 m⁻², compared with the group of eGFR between 90 and 120 mL·min⁻¹·1.73 m⁻². A higher risk of CKD was also observed in individuals with HUA compared to individuals without HUA (HR = 1.28, 95% CI: 1.12–1.47). Compared with the first quintile of sUA, the adjusted HR (95% CI) of CKD was 1.24 (1.01–1.51) for the participants in the fourth quantile. There was a bidirectional relationship between sUA and eGFR, with the path coefficients (ρ₁ = −0.024, p < 0.001) from baseline eGFR to follow-up sUA and the path coefficients (ρ₂ = −0.015, p = 0.002) from baseline sUA to follow-up eGFR. Conclusions. The present study indicated that CKD and HUA were closely associated, and there was a bidirectional relationship between sUA and eGFR. Full article

(This article belongs to the Special Issue Chronic Disease Epidemiology: Advances in Research and Methods)

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12 pages, 874 KiB

Open AccessArticle

Association between Reproductive Factors and Type 2 Diabetes: A Cross-Sectional Study

by Yuting Yu, Jing Li, Yonggen Jiang, Maryam Zaid, Qi Zhao, Na Wang, Xing Liu, Yun Qiu, Junjie Zhu, Xin Tong, Shuheng Cui, Yiling Wu, Jianguo Yu and Genming Zhao

Int. J. Environ. Res. Public Health 2022, 19(2), 1019; https://doi.org/10.3390/ijerph19021019 - 17 Jan 2022

Cited by 5 | Viewed by 2566

Abstract

(1) Introduction: The available studies on the association between type 2 diabetes mellitus (T2DM) and menopause report conflicting results. (2) Objective: This study aimed to investigate the association of menopausal status, age at menopause, and length of the reproductive period with T2DM. (3) Methods: This cross-sectional study is part of the ‘China Eastern Cohort Study’, which is a community-based cohort study. Multistage, stratified, clustered sampling was used to recruit the study participants in Shanghai, China. Age at menarche and menopause was recorded, and reproductive period was calculated. Weighted logistic regression was used to calculate the prevalence ratios (PRs) with 95% confidence intervals (CIs) of T2DM. Restricted cubic splines were used to assess the relationship between age at menopause, reproductive period, and T2DM. (4) Results: A total of 20,128 women were included. The prevalence of T2DM was 13.7%. Postmenopausal women exhibited a higher prevalence of T2DM than premenopausal women (p < 0.001) and an unfavorable metabolic profile, including higher body mass index, hypertension, and hyperlipidemia. A higher risk of T2DM was observed in postmenopausal women (PR2.12, 95%CI: 1.79–2.51, p < 0.001) compared with premenopausal women, independently of confounding factors. After adjustment for confounding factors, age at menopause and reproductive period were not significantly associated with T2DM. (5) Conclusions: Postmenopausal status is associated with T2DM, while menopausal age and reproductive period are not associated with T2DM. Menopausal status should be considered during T2DM screening. Full article

(This article belongs to the Special Issue Chronic Disease Epidemiology: Advances in Research and Methods)

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14 pages, 1654 KiB

Open AccessArticle

Epidemiology of Chronic Obstructive Pulmonary Disease (COPD) Comorbidities in Lithuanian National Database: A Cluster Analysis

by Elena Jurevičienė, Greta Burneikaitė, Laimis Dambrauskas, Vytautas Kasiulevičius, Edita Kazėnaitė, Rokas Navickas, Roma Puronaitė, Giedrė Smailytė, Žydrūnė Visockienė and Edvardas Danila

Int. J. Environ. Res. Public Health 2022, 19(2), 970; https://doi.org/10.3390/ijerph19020970 - 15 Jan 2022

Cited by 6 | Viewed by 3350

Abstract

Various comorbidities and multimorbidity frequently occur in chronic obstructive pulmonary disease (COPD), leading to the overload of health care systems and increased mortality. We aimed to assess the impact of COPD on the probability and clustering of comorbidities. The cross-sectional analysis of the nationwide Lithuanian database was performed based on the entries of the codes of chronic diseases. COPD was defined on the code J44.8 entry and six-month consumption of bronchodilators. Descriptive statistics and odds ratios (ORs) for associations and agglomerative hierarchical clustering were carried out. 321,297 patients aged 40–79 years were included; 4834 of them had COPD. A significantly higher prevalence of cardiovascular diseases (CVD), lung cancer, kidney diseases, and the association of COPD with six-fold higher odds of lung cancer (OR 6.66; p < 0.0001), a two-fold of heart failure (OR 2.61; p < 0.0001), and CVD (OR 1.83; p < 0.0001) was found. Six clusters in COPD males and five in females were pointed out, in patients without COPD—five and four clusters accordingly. The most prevalent cardiovascular cluster had no significant difference according to sex or COPD presence, but a different linkage of dyslipidemia was found. The study raises the need to elaborate adjusted multimorbidity case management and screening tools enabling better outcomes. Full article

(This article belongs to the Special Issue Chronic Disease Epidemiology: Advances in Research and Methods)

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11 pages, 992 KiB

Open AccessArticle

Geographic Disparities in Readmissions for Peripheral Artery Disease in South Carolina

by Brian Witrick, Corey A. Kalbaugh, Lu Shi, Rachel Mayo and Brian Hendricks

Int. J. Environ. Res. Public Health 2022, 19(1), 285; https://doi.org/10.3390/ijerph19010285 - 28 Dec 2021

Cited by 2 | Viewed by 2072

Abstract

Readmissions constitute a major health care burden among peripheral artery disease (PAD) patients. This study aimed to 1) estimate the zip code tabulation area (ZCTA)-level prevalence of readmission among PAD patients and characterize the effect of covariates on readmissions; and (2) identify hotspots of PAD based on estimated prevalence of readmission. Thirty-day readmissions among PAD patients were identified from the South Carolina Revenue and Fiscal Affairs Office All Payers Database (2010–2018). Bayesian spatial hierarchical modeling was conducted to identify areas of high risk, while controlling for confounders. We mapped the estimated readmission rates and identified hotspots using local Getis Ord (G*) statistics. Of the 232,731 individuals admitted to a hospital or outpatient surgery facility with PAD diagnosis, 30,366 (13.1%) experienced an unplanned readmission to a hospital within 30 days. Fitted readmission rates ranged from 35.3 per 1000 patients to 370.7 per 1000 patients and the risk of having a readmission was significantly associated with the percentage of patients who are 65 and older (0.992, 95%CI: 0.985–0.999), have Medicare insurance (1.013, 1.005–1.020), and have hypertension (1.014, 1.005–1.023). Geographic analysis found significant variation in readmission rates across the state and identified priority areas for targeted interventions to reduce readmissions. Full article

(This article belongs to the Special Issue Chronic Disease Epidemiology: Advances in Research and Methods)

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21 pages, 3158 KiB

Open AccessArticle

Occupational Disease as the Bane of Workers’ Lives: A Study of Its Incidence in Slovakia. Part 2

by Miriam Andrejiova, Miriama Pinosova and Miroslav Badida

Int. J. Environ. Res. Public Health 2021, 18(24), 12990; https://doi.org/10.3390/ijerph182412990 - 9 Dec 2021

Cited by 1 | Viewed by 2001

Abstract

The main objective of this article is to monitor the development of the number of occupational diseases related to selected physical factors in the working environment (noise, vibration and dust). Each region of Slovakia has its own specific social and economic conditions. Due to the existence of a strong correlation between the several regional variables observed, principal component analysis (PCA) was used to determine the new variables. Cluster analysis was used to group regions with similar characteristics. A dendrogram was created using the average linkage method, which illustrated the similarity of the regions studied. The value of the cophenetic correlation coefficient (CC = 0.90) confirms the validity of the average linkage method. The result of the cluster analysis is the grouping of the eight regions into five homogenic groups (clusters). An analysis of the data shows that Slovakia’s regional differences significantly influence the incidence of occupational diseases in individual regions. It is shown that, in Slovakia, the development of the number of occupational diseases has seen a favourable trend in the long term. Full article

(This article belongs to the Special Issue Chronic Disease Epidemiology: Advances in Research and Methods)

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12 pages, 1404 KiB

Open AccessArticle

Association of the Reproductive Period with Decreased Estimated Glomerular Filtration Rate in Menopausal Women: A Study from the Shanghai Suburban Adult Cohort and Biobank (2016–2020)

by Yuting Yu, Qi Zhao, Yonggen Jiang, Na Wang, Xing Liu, Yun Qiu, Junjie Zhu, Xin Tong, Shuheng Cui, Maryam Zaid, Jing Li, Jianguo Yu and Genming Zhao

Int. J. Environ. Res. Public Health 2021, 18(19), 10451; https://doi.org/10.3390/ijerph181910451 - 5 Oct 2021

Cited by 3 | Viewed by 2079

Abstract

In previous studies, it has been documented that a short reproductive period is associated with a higher risk of diabetes, cardiovascular disease, and chronic kidney disease. This study aims to investigate the association of the reproductive period length with decreased renal function. This study obtained data from “the Shanghai Suburban Adult Cohort and Biobank”. An estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m² indicated decreased renal function during follow-up. Participants were grouped into quintiles by reproductive period. Logistic regression analysis was performed to examine the association between the reproductive period and decreased renal function. A total of 5503 menopausal women with baseline eGFR > 60 mL/min/1.73 m² were included. Age, eGFR, and metabolic equivalent of task (MET) at baseline were 61.0 (range, 36.0–74.0) years, 92.2 (range, 60.1–194.5) mL/min/1.73 m², and 1386 (range, 160–6678), respectively. A reproductive period of 37–45 years was associated with a lower risk of decreased eGFR (OR: 0.59, 95% CI: 0.35–1.00, p = 0.049) after adjusting for confounding variables. METs decreased the risk of decreased eGFR in women with a reproductive period of 37–45 years (OR: 0.43, 95% CI: 0.23–0.81, p = 0.010). Women with a longer reproductive period have a lower risk of decreased renal function. METs had an opposite influence on renal function in women with longer (decreased risk) or shorter (increased risk) reproductive periods. Full article

(This article belongs to the Special Issue Chronic Disease Epidemiology: Advances in Research and Methods)

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11 pages, 382 KiB

Open AccessArticle

The Determinants of Living with Long-Term Conditions: An International Cross-Sectional Study

by Silvia Corchon, Carmen Rodríguez-Blázquez, Alfonso Meneses, Marta Aranda-Gallardo, Lorena López, Maria Eugenia Ursúa, Maria Victoria Navarta-Sanchez, Mari Carmen Portillo and Leire Ambrosio

Int. J. Environ. Res. Public Health 2021, 18(19), 10381; https://doi.org/10.3390/ijerph181910381 - 2 Oct 2021

Cited by 3 | Viewed by 2520

Abstract

It is essential that healthcare and social professionals understand the daily lives of people with chronic diseases, and the variables that influence them. The aim of this study was to identify the determinants influencing the process of living with long-term conditions. To investigate this, an observational, international, cross-sectional study was carried out. A consecutive sample of 1788 Spanish-speaking population living with chronic obstructive pulmonary disease, chronic heart failure and type 2 diabetes mellitus were included. Descriptive statistics and multiple linear regression models were performed. The linear regression models identified that social support (β = 0.39, p < 0.001) and the satisfaction with life (β = 0.37, p < 0.001) were the main determinants in the process of living with a long-term condition (49% of the variance). Age (β = −0.08, p = 0.01) and disease duration (β = 0.07, p = 0.01) were determinants only in the chronic heart failure subgroup, and country was significant in the chronic obstructive pulmonary disease subgroup (β = −0.15, p = 0.002). Satisfaction with life and social support were key determinants influencing the process of living with long-term conditions. As such, those aspects should be included in the design of interventions focused on the achievement of a positive living in people with long-term conditions. Full article

(This article belongs to the Special Issue Chronic Disease Epidemiology: Advances in Research and Methods)

10 pages, 551 KiB

Open AccessArticle

Multiplicity Eludes Peer Review: The Case of COVID-19 Research

by Oliver Gutiérrez-Hernández and Luis Ventura García

Int. J. Environ. Res. Public Health 2021, 18(17), 9304; https://doi.org/10.3390/ijerph18179304 - 3 Sep 2021

Cited by 3 | Viewed by 3157

Abstract

Multiplicity arises when data analysis involves multiple simultaneous inferences, increasing the chance of spurious findings. It is a widespread problem frequently ignored by researchers. In this paper, we perform an exploratory analysis of the Web of Science database for COVID-19 observational studies. We examined 100 top-cited COVID-19 peer-reviewed articles based on p-values, including up to 7100 simultaneous tests, with 50% including >34 tests, and 20% > 100 tests. We found that the larger the number of tests performed, the larger the number of significant results (r = 0.87, p < 10⁻⁶). The number of p-values in the abstracts was not related to the number of p-values in the papers. However, the highly significant results (p < 0.001) in the abstracts were strongly correlated (r = 0.61, p < 10⁻⁶) with the number of p < 0.001 significances in the papers. Furthermore, the abstracts included a higher proportion of significant results (0.91 vs. 0.50), and 80% reported only significant results. Only one reviewed paper addressed multiplicity-induced type I error inflation, pointing to potentially spurious results bypassing the peer-review process. We conclude the need to pay special attention to the increased chance of false discoveries in observational studies, including non-replicated striking discoveries with a potentially large social impact. We propose some easy-to-implement measures to assess and limit the effects of multiplicity. Full article

(This article belongs to the Special Issue Chronic Disease Epidemiology: Advances in Research and Methods)

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9 pages, 327 KiB

Open AccessArticle

Is Rheumatoid Arthritis Related to Coffee Consumption in Korea? A Nationwide Cross-Sectional Observational Study

by Sang-Gyun Kim, Jong Woo Kang, Seong Min Jeong, Gwan Gyu Song, Sung Jae Choi and Jae Hyun Jung

Int. J. Environ. Res. Public Health 2021, 18(15), 7880; https://doi.org/10.3390/ijerph18157880 - 25 Jul 2021

Cited by 4 | Viewed by 2570

Abstract

Coffee consumption is gradually increasing in Korea. As a result, interest in the relationship between coffee consumption and various diseases is growing. Several factors affect the development of rheumatoid arthritis (RA), and coffee consumption may be related. We conducted a nationwide cross-sectional study using data from the Korea National Health and Nutrition Examination Survey (2012–2016). A total of 12,465 eligible participants (4819 men and 7646 women) were included in the study. Participants with RA were defined as those who were diagnosed and currently being treated by physicians. Daily coffee consumption amounts were categorized as none, <1 cup, 1–2 cups, 2–3 cups, and ≥3 cups a day based on a self-report. A multivariable logistic regression model was employed, and we calculated the odds ratios (ORs) and 95% confidence intervals (CIs) for the odds of participants having RA with respect to coffee consumption. Compared to the no-coffee group, the ORs for RA in the <1 cup and 1–2 cups groups were 2.99 (95% CI 0.33–27.28) and 2.63 (95% CI 0.31–22.63) in men, respectively, and the ORs for RA for women in the <1 cup, 1–2 cups, 2–3 cups, and ≥3 cups groups were 0.62 (95% CI 0.31–1.26), 0.67 (95% CI 0.33–1.37), 1.08 (95% CI 0.35–3.36), and 1.43 (95% CI 0.25–8.36), respectively. Our study concludes, therefore, that daily coffee consumption is not related to the prevalence of RA in the general Korean population. Full article

(This article belongs to the Special Issue Chronic Disease Epidemiology: Advances in Research and Methods)

13 pages, 342 KiB

Open AccessArticle

Psychological State after an Acute Coronary Syndrome: Impact of Physical Limitations

by Miguel-Ángel Serrano-Rosa, Eva León-Zarceño, Cristina Giglio, Salvador Boix-Vilella, Antonio Moreno-Tenas, Lidia Pamies-Aubalat and Vicente Arrarte

Int. J. Environ. Res. Public Health 2021, 18(12), 6473; https://doi.org/10.3390/ijerph18126473 - 15 Jun 2021

Cited by 8 | Viewed by 2954

Abstract

The aim of this study was to investigate how physical limitations after ACS influence patients’ quality of life and health perception. This was a longitudinal clinical study. We recruited 146 patients diagnosed with ACS. The patients performed a stress test (Bruce’s protocol) for the evaluation of physical limitations and were classified according to the test result: without physical limitations (more than 10 METS), with some physical limitations (7 to 9 METS), and with high physical limitations (less than 6 METS). Significant differences were found between the three groups immediately after the diagnosis of ACS and after a period of three months, regarding health perception, anxiety, depression, sexual relationships, distress, and adjustment to disease. These differences resulted larger between the group with less limitations and the group with higher limitations. After 3 months, however, there was an overall improvement in all variables. In conclusion, physical limitations after ACS seem to influence perceived quality of life determined by measuring general health, vitality, total adaptation, emotional role, social adaptation, depression, and anxiety. Therefore, the highest the physical limitations, the poorer the psychological conditions and vice versa, even 3 months after ACS diagnosis. Full article

(This article belongs to the Special Issue Chronic Disease Epidemiology: Advances in Research and Methods)

29 pages, 5332 KiB

Open AccessArticle

Occupational Disease as the Bane of Workers’ Lives: A Chronological Review of the Literature and Study of Its Development in Slovakia. Part 1

by Miriama Piňosová, Miriam Andrejiova, Miroslav Badida and Marek Moravec

Int. J. Environ. Res. Public Health 2021, 18(11), 5910; https://doi.org/10.3390/ijerph18115910 - 31 May 2021

Cited by 4 | Viewed by 3781

Abstract

This article not only offers a chronological overview of the development of occupational medicine, but also offers a summary of occupational diseases recommended by the ILO and legislative decisions that have influenced how we approach assessment today. We consider that these areas form a whole in which they cannot function without each other and they would lose their relevance if the system was collapsed. By excluding even one part of it, we would find ourselves at the beginning of the era of occupational medicine, and a large number of employees would once again be exposed to conditions that previously led to considerable illness and mortality of employees. The article also examines legislation and the development of occupational diseases in Slovakia in the period 1997–2019. Using basic statistical methods and time series, a trend model for the time series of the development of the number of occupational diseases over the last 20 years is created. The modeling also includes a forecast for the development of the number of occupational diseases for the next 5 years. The model created shows a favorable, decreasing trend in the number of occupational diseases in Slovakia. Full article

(This article belongs to the Special Issue Chronic Disease Epidemiology: Advances in Research and Methods)

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