School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
Schizophr Res. 2010 Mar;117(1):75-82. doi: 10.1016/j.schres.2009.12.016. Epub 2010 Jan 18.
To evaluate the prevalence of cardiovascular risk factors (CV-RF) and disease (CV-D) in people with schizophrenia.
We conducted a period-prevalence study using a population-based cohort from Alberta administrative databases. Schizophrenia was identified using billing codes; all other individuals served as non-schizophrenic controls. Modifiable CV-RF (hypertension, dyslipidemia, diabetes) and established CV-D (acute coronary syndrome (ACS), chronic ischemic heart disease (IHD), heart failure (HF), stroke, arrhythmia) were identified using previously validated methods. Analyses were conducted using multivariable logistic regression.
From 1995 to 2006, 28,755 people (1.2%) were identified with schizophrenia and compared with 2,281,636 non-schizophrenic controls. Individuals with schizophrenia were older (mean age 47.6 years vs. 45.3) and had lower socioeconomic status (59% received healthcare subsidies vs. 21%; OR: 5.55; 95% CI: 5.42-5.69) than controls. Of the CV-RF, diabetes was more common in those with schizophrenia than controls, particularly in younger males (ages 30-39, 3.8% vs. 1.4%, aOR: 1.57; 95% CI: 1.30-1.91) and females (ages 30-39, 5.8% vs. 2.4%, aOR: 1.72; 95% CI: 1.44-2.04). The prevalence of CV-D was significantly higher in people with schizophrenia than controls (27% vs. 17%, OR: 1.76; 95% CI: 1.72-1.81).
On a population-wide basis, people with schizophrenia had a higher prevalence of diabetes and cardiovascular disease than those without schizophrenia, particularly at a younger age. Female sex offered no cardiovascular protection in those with schizophrenia. Our data suggest monitoring for diabetes and other cardiovascular risk factors should begin at the time of diagnosis of schizophrenia, particularly in females with schizophrenia.
评估精神分裂症患者心血管风险因素（CV-RF）和疾病（CV-D）的患病率。
我们使用来自艾伯塔省行政数据库的基于人群的队列进行了一项现况研究。使用计费代码来识别精神分裂症；所有其他个体均作为非精神分裂症对照。使用先前验证过的方法来识别可改变的 CV-RF（高血压、血脂异常、糖尿病）和已确立的 CV-D（急性冠脉综合征（ACS）、慢性缺血性心脏病（IHD）、心力衰竭（HF）、中风、心律失常）。使用多变量逻辑回归进行分析。
1995 年至 2006 年，共确定了 28755 名（1.2%）精神分裂症患者，并与 2281636 名非精神分裂症对照进行比较。精神分裂症患者年龄较大（平均年龄为 47.6 岁 vs. 45.3 岁），社会经济地位较低（59%接受医疗保健补贴 vs. 21%；OR：5.55；95%CI：5.42-5.69）。在心血管风险因素中，糖尿病在精神分裂症患者中比对照组更为常见，尤其是在年轻男性（30-39 岁，3.8% vs. 1.4%，aOR：1.57；95%CI：1.30-1.91）和女性（30-39 岁，5.8% vs. 2.4%，aOR：1.72；95%CI：1.44-2.04）中。与对照组相比，精神分裂症患者心血管疾病的患病率明显更高（27% vs. 17%，OR：1.76；95%CI：1.72-1.81）。
在人群范围内，与非精神分裂症患者相比，精神分裂症患者的糖尿病和心血管疾病患病率更高，尤其是在更年轻的年龄。在精神分裂症患者中，女性没有提供心血管保护。我们的数据表明，特别是在患有精神分裂症的女性中，应在诊断为精神分裂症时开始监测糖尿病和其他心血管风险因素。
