Caroff Stanley N, Leong Shirley H, Ng-Mak Daisy, Campbell E Cabrina, Berkowitz Rosalind M, Rajagopalan Krithika, Chuang Chien-Chia, Loebel Antony
Behavioral Health Service, Veterans Integrated Service Network (VISN) 4 Mental Illness Research, Education and Clinical Center (MIRECC), Corporal Michael J. Crescenz Veterans Affairs Medical Center and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA.
, 242 Hedgeman Road, Moorestown, NJ, 08057, USA.
Community Ment Health J. 2018 Aug;54(6):725-734. doi: 10.1007/s10597-017-0215-7. Epub 2017 Dec 28.
Socioeconomic disparities were assessed in predicting metabolic risk among veterans with serious mental illness. Veterans with schizophrenia, schizoaffective, or bipolar disorders were identified in VISN 4 facilities from 10/1/2010 to 9/30/2012. Differences between patients with and without metabolic syndrome were compared using t-tests, Chi square tests and multivariate logistic regressions. Among 10,132 veterans with mental illness, 48.8% had metabolic syndrome. Multivariate logistic regression analysis confirmed that patients with metabolic syndrome were significantly more likely to be older, male, African-American, married, and receiving disability pensions but less likely to be homeless. They were more likely to receive antipsychotics, antidepressants, or anticonvulsants. Bivariate cross-sectional analysis revealed that patients with metabolic syndrome had higher rates of coronary artery disease, cerebrovascular disease, and mortality, and that metabolic syndrome was more often associated with emergency visits and psychiatric or medical hospitalizations. Demographics, socioeconomic status and medications are independent predictors of metabolic syndrome and should be considered in broader screening of risk factors in order to provide preventive interventions for metabolic syndrome.
在患有严重精神疾病的退伍军人中，对社会经济差异在预测代谢风险方面进行了评估。在2010年10月1日至2012年9月30日期间，在VISN 4机构中识别出患有精神分裂症、分裂情感性障碍或双相情感障碍的退伍军人。使用t检验、卡方检验和多因素逻辑回归比较了患有和未患有代谢综合征的患者之间的差异。在10132名患有精神疾病的退伍军人中，48.8%患有代谢综合征。多因素逻辑回归分析证实，患有代谢综合征的患者更有可能年龄较大、为男性、非裔美国人、已婚且领取残疾抚恤金，但无家可归的可能性较小。他们更有可能接受抗精神病药物、抗抑郁药物或抗惊厥药物治疗。双变量横断面分析显示，患有代谢综合征的患者患冠状动脉疾病、脑血管疾病和死亡率的发生率较高，并且代谢综合征更常与急诊就诊以及精神科或内科住院相关。人口统计学、社会经济地位和药物治疗是代谢综合征的独立预测因素，在更广泛地筛查风险因素时应予以考虑，以便为代谢综合征提供预防性干预措施。
