Jones Laura E, Carney Caroline P
Department of Epidemiology, The University of Iowa College of Public Health, Iowa City, IA, USA.
Ann Clin Psychiatry. 2006 Jul-Sep;18(3):149-55. doi: 10.1080/10401230600801085.
An increased risk for metabolic syndrome has been described for persons with psychotic and mood disorders. Our objectives were to determine whether the odds for metabolic syndrome (MetSyn) were increased among insured adults with and without mental illness, and to determine whether this risk extends beyond psychotic and affective disorders.
This was a retrospective analysis of a 100% sample of Blue Cross/Blue Shield of Iowa claims data. Three definitions of MetSyn were examined: 1) presence of any 3 or more components of MetSyn (obesity, hypertriglyceridemia, hypercholesterolemia, hypertension, and glucose intolerance/diabetes mellitus), 2) criteria #1 and/or claim for glucose intolerance/diabetes mellitus, and 3) criteria #1, criteria #2, and/or claim for obesity. ICD-9 codes were used to define obesity, hypertriglyceridemia, hypercholesterolemia, hypertension, and glucose intolerance/diabetes mellitus. Multivariate logistic regression was used to investigate the association between mental illness and MetSyn.
Prevalence of MetSyn for subjects with any mental illness as compared to those without was 4.9% vs. 2.0% (criteria #1), 8.1% vs. 4.2% (criteria #2), and 13.2% vs. 6.2% (criteria #3). MetSyn was more common (OR = 1.3-1.5) for subjects with any mental illness as compared to those without, regardless of which definition of MetSyn was used. Subjects with sexual disorders (OR = 1.7-1.8), sleep disorders (OR = 1.2-1.7), and mood disorders (OR = 1.3-1.6) had significantly higher odds of MetSyn compared to those without claims for mental disorders, regardless of which definition of MetSyn was used.
These results suggest that MetSyn is not only problematic among persons with psychosis and affective disorders, but that it also affects patients with other forms of mental illness. Clinicians should have a heightened awareness of metabolic risk factors, particularly when mental illness is present.
已有研究表明，患有精神病和情绪障碍的人群患代谢综合征的风险增加。我们的目标是确定患有和未患有精神疾病的参保成年人患代谢综合征（MetSyn）的几率是否增加，并确定这种风险是否超出精神病和情感障碍的范畴。
这是一项对爱荷华州蓝十字/蓝盾保险公司100%索赔数据样本的回顾性分析。研究了代谢综合征的三种定义：1）存在代谢综合征的任意3种或更多组成部分（肥胖、高甘油三酯血症、高胆固醇血症、高血压以及糖耐量异常/糖尿病）；2）标准1以及/或者糖耐量异常/糖尿病的索赔记录；3）标准1、标准2以及/或者肥胖的索赔记录。使用国际疾病分类第九版（ICD - 9）编码来定义肥胖、高甘油三酯血症、高胆固醇血症、高血压以及糖耐量异常/糖尿病。采用多因素逻辑回归分析来研究精神疾病与代谢综合征之间的关联。
与未患有任何精神疾病的受试者相比，患有任何精神疾病的受试者的代谢综合征患病率在标准1下分别为4.9%和2.0%，在标准2下分别为8.1%和4.2%，在标准3下分别为13.2%和6.2%。无论采用哪种代谢综合征的定义，患有任何精神疾病的受试者患代谢综合征的情况都比未患精神疾病的受试者更为常见（比值比 = 1.3 - 1.5）。与没有精神障碍索赔记录的受试者相比，患有性障碍（比值比 = 1.7 - 1.8）、睡眠障碍（比值比 = 1.2 - 1.7）和情绪障碍（比值比 = 1.3 - 1.6）的受试者患代谢综合征的几率显著更高，无论采用哪种代谢综合征的定义。
这些结果表明，代谢综合征不仅在患有精神病和情感障碍的人群中存在问题，而且也影响其他形式精神疾病的患者。临床医生应提高对代谢危险因素的认识，尤其是在存在精神疾病的情况下。
