Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA.
Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA.
Dev Med Child Neurol. 2019 Apr;61(4):484-489. doi: 10.1111/dmcn.13777. Epub 2018 Apr 27.
To examine the longitudinal trends of cardiometabolic diseases in a large sample of adults with cerebral palsy (CP).
The Optum Clinformatics Data Mart is a de-identified nationwide claims database of beneficiaries from a single private payer. Beneficiaries were included if they had an International Classification of Diseases, Ninth Revision, Clinical Modification code for a diagnosis of CP. Adults with at least 3 years of continuous enrollment on a single plan between 2002 and 2009 were included in the final analyses (n=2659). We examined the longitudinal trends of incident diabetes mellitus, hypercholesterolemia, hypertension, cardiac dysrhythmias, and atherosclerosis, stratified by age categories: 18 to 39 years, 40 to 59 years, and 60 years and over. Kaplan-Meier product-limit survival curves were compared across age categories for each of the cardiometabolic outcomes, and a Cox proportional hazards regression was run to determine adjusted hazard ratios.
The cumulative incidence of each of the cardiometabolic diseases ranged from 6.0% for atherosclerosis to 34.4% for hypercholesterolemia at 3 years and over. Risk-adjusted Cox proportional hazard models revealed that age was a robust predictor of survival for each outcome, with higher hazard ratio ranges in middle age (hazard ratio 1.41-2.72) and older adults (hazard ratio 2.20-5.93) compared with young adults.
Adults with CP have high rates of cardiometabolic diseases; and disease-free survival shortens significantly with higher ages.
Adults with cerebral palsy have high rates of cardiometabolic diseases. Disease-free survival of all cardiometabolic diseases shortens significantly with higher ages. The highest rates were for hypercholesterolemia and hypertension.
在大型脑瘫（CP）成人样本中研究心血管代谢疾病的纵向趋势。
Optum Clinformatics Data Mart 是一个去识别的全国性索赔数据库，涵盖了单一私人支付方的受益人的信息。如果受益人的国际疾病分类，第九修订版，临床修正码有 CP 的诊断，他们就会被纳入研究。2002 年至 2009 年期间，至少有 3 年在单个计划中连续注册的成年人被纳入最终分析（n=2659）。我们研究了糖尿病、高胆固醇血症、高血压、心律失常和动脉粥样硬化等心血管代谢疾病的纵向趋势，按年龄分类：18 至 39 岁、40 至 59 岁和 60 岁及以上。对于每种心血管代谢结局，我们在年龄组之间比较 Kaplan-Meier 乘积限生存曲线，并运行 Cox 比例风险回归以确定调整后的风险比。
每种心血管代谢疾病的累积发病率从 3 年及以上的动脉粥样硬化的 6.0%到高胆固醇血症的 34.4%不等。风险调整的 Cox 比例风险模型显示，年龄是每个结局生存的有力预测因素，中年（风险比 1.41-2.72）和老年（风险比 2.20-5.93）的风险比范围高于年轻人。
脑瘫成年人有很高的心血管代谢疾病发病率；无病生存率随着年龄的增长显著缩短。
脑瘫成年人有很高的心血管代谢疾病发病率。所有心血管代谢疾病的无病生存率随着年龄的增长显著缩短。发病率最高的是高胆固醇血症和高血压。
