Key lifestyles and health outcomes across 16 prevalent chronic diseases: A network analysis of an international observational study.
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Li Jiaying, Fong Daniel Yee Tak, Lok Kris Yuet Wan, Wong Janet Yuen Ha, Man Ho Mandy, Choi Edmond Pui Hang, Pandian Vinciya, Davidson Patricia M, Duan Wenjie, Tarrant Marie, Lee Jung Jae, Lin Chia-Chin, Akingbade Oluwadamilare, Alabdulwahhab Khalid M, Ahmad Mohammad Shakil, Alboraie Mohamed, Alzahrani Meshari A, Bilimale Anil S, Boonpatcharanon Sawitree, Byiringiro Samuel, Hasan Muhammad Kamil Che, Schettini Luisa Clausi, Corzo Walter, De Leon Josephine M, De Leon Anjanette S, Deek Hiba, Efficace Fabio, El Nayal Mayssah A, El-Raey Fathiya, Ensaldo-Carrasco Eduardo, Escotorin Pilar, Fadodun Oluwadamilola Agnes, Fawole Israel Opeyemi, Goh Yong-Shian Shawn, Irawan Devi, Khan Naimah Ebrahim, Koirala Binu, Krishna Ashish, Kwok Cannas, Le Tung Thanh, Leal Daniela Giambruno, Lezana-Fernández Miguel Ángel, Manirambona Emery, Mantoani Leandro Cruz, Meneses-González Fernando, Mohamed Iman Elmahdi, Mukeshimana Madeleine, Nguyen Chinh Thi Minh, Nguyen Huong Thi Thanh, Nguyen Khanh Thi, Nguyen Son Truong, Nurumal Mohd Said, Nzabonimana Aimable, Omer Nagla Abdelrahim Mohamed Ahmed, Ogungbe Oluwabunmi, Poon Angela Chiu Yin, Reséndiz-Rodriguez Areli, Puang-Ngern Busayasachee, Sagun Ceryl G, Shaik Riyaz Ahmed, Shankar Nikhil Gauri, Sommer Kathrin, Toro Edgardo, Tran Hanh Thi Hong, Urgel Elvira L, Uwiringiyimana Emmanuel, Vanichbuncha Tita, Youssef Naglaa
Аннотация
METHODS: We surveyed 16 512 adults from July 2020 to August 2021 in 30 territories. Participants self-reported their medical histories and the perceived impact of COVID-19 on 18 lifestyle factors and 13 health outcomes. For each disease subgroup, we generated lifestyle, health outcome, and bridge networks. Variables with the highest centrality indices in each were identified central or bridge. We validated these networks using nonparametric and case-dropping subset bootstrapping and confirmed central and bridge variables' significantly higher indices through a centrality difference test.
FINDINGS: Among the 48 networks, 44 were validated (all correlation-stability coefficients >0.25). Six central lifestyle factors were identified: less consumption of snacks (for the chronic disease: anxiety), less sugary drinks (cancer, gastric ulcer, hypertension, insomnia, and pre-diabetes), less smoking tobacco (chronic obstructive pulmonary disease), frequency of exercise (depression and fatty liver disease), duration of exercise (irritable bowel syndrome), and overall amount of exercise (autoimmune disease, diabetes, eczema, heart attack, and high cholesterol). Two central health outcomes emerged: less emotional distress (chronic obstructive pulmonary disease, eczema, fatty liver disease, gastric ulcer, heart attack, high cholesterol, hypertension, insomnia, and pre-diabetes) and quality of life (anxiety, autoimmune disease, cancer, depression, diabetes, and irritable bowel syndrome). Four bridge lifestyles were identified: consumption of fruits and vegetables (diabetes, high cholesterol, hypertension, and insomnia), less duration of sitting (eczema, fatty liver disease, and heart attack), frequency of exercise (autoimmune disease, depression, and heart attack), and overall amount of exercise (anxiety, gastric ulcer, and insomnia). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05).
CONCLUSION: To effectively manage chronic diseases during the COVID-19 pandemic, enhanced interventions and optimised resource allocation toward central lifestyle factors, health outcomes, and bridge lifestyles are paramount. The key variables shared across chronic diseases emphasise the importance of coordinated intervention strategies.