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在肥胖率不断上升的时代重新评估特发性颅内高压的发病率

Re-evaluating the Incidence of Idiopathic Intracranial Hypertension in an Era of Increasing Obesity.

作者信息

Kilgore Khin P, Lee Michael S, Leavitt Jacqueline A, Mokri Bahram, Hodge David O, Frank Ryan D, Chen John J

机构信息

College of Medicine, Mayo Clinic, Jacksonville, Florida; Department of Ophthalmology, Mayo Clinic, Jacksonville, Florida.

Department of Neuro-Ophthalmology, University of Minnesota, Minneapolis, Minnesota.

出版信息

Ophthalmology. 2017 May;124(5):697-700. doi: 10.1016/j.ophtha.2017.01.006. Epub 2017 Feb 7.

Abstract

PURPOSE

To re-evaluate the population-based incidence of idiopathic intracranial hypertension (IIH) and to determine if it mirrors the rise in obesity.

DESIGN

Retrospective, population-based cohort.

PARTICIPANTS

All residents of Olmsted County, Minnesota, diagnosed with IIH between January 1, 1990, and December 31, 2014.

METHODS

All cases of IIH were identified using the Rochester Epidemiology Project, which is a record-linkage system of medical records for all patient-physician encounters among Olmsted County, Minnesota, residents. All medical records were reviewed to confirm a diagnosis of IIH. The incidence rates of IIH were compared against the incidence of obesity in Minnesota over the same period.

MAIN OUTCOME MEASURES

Incidence of IIH, lumbar puncture opening pressures, and body mass index.

RESULTS

There were 63 new cases of IIH, yielding an overall age- and gender-adjusted annual incidence of 1.8 per 100 000 (95% confidence interval, 1.3-2.2) between 1990 and 2014. It increased from 1.0 per 100 000 (1990-2001) to 2.4 per 100 000 (2002-2014; P = 0.007). The incidence of IIH was 3.3 per 100 000 in women and 0.3 per 100 000 in men (P ≤ 0.001). In obese women 15 to 44 years of age, the incidence was 22.0 per 100 000 compared with 6.8 per 100 000 among all women in the same age group. A strong correlation was observed between IIH incidence rates and obesity rates in Minnesota (R = 0.70, P = 0.008).

CONCLUSIONS

The incidence of IIH has increased since 1990, which is highly correlated with the rise in obesity during the same period.

摘要

目的

重新评估特发性颅内高压(IIH)的人群发病率,并确定其是否反映了肥胖率的上升。

设计

基于人群的回顾性队列研究。

参与者

明尼苏达州奥尔姆斯特德县所有在1990年1月1日至2014年12月31日期间被诊断为IIH的居民。

方法

使用罗切斯特流行病学项目识别所有IIH病例,该项目是明尼苏达州奥尔姆斯特德县居民所有医患接触的医疗记录链接系统。对所有医疗记录进行审查以确认IIH诊断。将IIH发病率与同期明尼苏达州的肥胖发病率进行比较。

主要观察指标

IIH发病率、腰椎穿刺初压和体重指数。

结果

共有63例新的IIH病例,1990年至2014年期间,总体年龄和性别调整后的年发病率为每10万人1.8例(95%置信区间,1.3 - 2.2)。发病率从每10万人1.0例(1990 - 2001年)增加到每10万人2.4例(2002 - 2014年;P = 0.007)。IIH发病率女性为每10万人3.3例,男性为每10万人0.3例(P≤0.001)。在15至44岁的肥胖女性中,发病率为每10万人22.0例,而同年龄组所有女性的发病率为每10万人6.8例。明尼苏达州IIH发病率与肥胖率之间存在很强的相关性(R = 0.70,P = 0.008)。

结论

自1990年以来,IIH发病率有所上升,这与同期肥胖率的上升高度相关。

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