Enger Cheryl, Jones Meghan E, Kryzhanovskaya Ludmila, Doherty Michael, McAfee Andrew T
Epidemiology, OptumInsight (formerly Ingenix, i3 Drug Safety), Ann Arbor, MI 48108, USA.
Int J Adolesc Med Health. 2013;25(1):3-11. doi: 10.1515/ijamh-2013-0002.
The risks of developing diabetes and dyslipidemia among adolescents with schizophrenia and bipolar disorder have not been well-characterized. This study was designed to characterize these risks and compare them among adolescents in the general population.
This retrospective cohort study used claims data from a large U.S. health insurer to identify adolescents (13-17 years) with claims for schizophrenia or bipolar disorder from 1997 to 2006. Adolescents without evidence of schizophrenia or bipolar disorder were randomly selected for comparison. Study outcomes were new diagnoses of diabetes and dyslipidemia.
We identified 17,884 adolescents with schizophrenia or bipolar disorder and 188,059 for the general population cohort. The incidence rate per 100,000 person-years of diabetes was higher in the schizophrenia or bipolar disorder cohort [424.3 (95% CI: 344.5-517.3)] than in the general population cohort (90.0 [95% CI: 79.6-101.3]). The incidence rate per 100,000 person-years of dyslipidemia was 346.4 (95% CI: 274.9-431.0) in the schizophrenia or bipolar disorder cohort and 86.6 (95% CI: 76.4-97.7) in the general population cohort. The adjusted hazard ratios of developing diabetes and dyslipidemia in the schizophrenia or bipolar disorder cohort relative to the general population cohort were 1.76 (95% CI: 1.15-2.72) and 1.66 (95% CI: 1.22-2.28), respectively. Adolescents with schizophrenia or bipolar disorder treated with antipsychotics had a higher risk of developing diabetes and dyslipidemia than those who were untreated.
Adolescents with schizophrenia or bipolar disorder had significantly increased risks of developing diabetes and dyslipidemia compared to adolescents without these disorders.
精神分裂症和双相情感障碍青少年患糖尿病和血脂异常的风险尚未得到充分描述。本研究旨在描述这些风险,并在普通人群的青少年中进行比较。
这项回顾性队列研究使用了美国一家大型健康保险公司的理赔数据,以确定1997年至2006年期间有精神分裂症或双相情感障碍理赔记录的青少年(13 - 17岁)。随机选择无精神分裂症或双相情感障碍证据的青少年作为对照。研究结局为糖尿病和血脂异常的新诊断病例。
我们确定了17884名患有精神分裂症或双相情感障碍的青少年以及188059名普通人群队列中的青少年。精神分裂症或双相情感障碍队列中糖尿病的每10万人年发病率[424.3(95%可信区间:344.5 - 517.3)]高于普通人群队列(90.0 [95%可信区间:79.6 - 101.3])。精神分裂症或双相情感障碍队列中血脂异常的每10万人年发病率为346.4(95%可信区间:274.9 - 431.0),普通人群队列中为86.6(95%可信区间:76.4 - 97.7)。与普通人群队列相比,精神分裂症或双相情感障碍队列中患糖尿病和血脂异常的调整后风险比分别为1.76(95%可信区间:1.15 - 2.72)和1.66(95%可信区间:1.22 - 2.28)。使用抗精神病药物治疗的精神分裂症或双相情感障碍青少年患糖尿病和血脂异常的风险高于未治疗的青少年。
与没有这些疾病的青少年相比,患有精神分裂症或双相情感障碍的青少年患糖尿病和血脂异常的风险显著增加。