Division of Cardiology, Department of Pediatrics, Rush University Medical Center, Chicago, Illinois.
Department of Pediatrics, Case Western Reserve University Hospital, Cleveland, Ohio.
Am J Cardiol. 2022 Sep 15;179:90-95. doi: 10.1016/j.amjcard.2022.05.031. Epub 2022 Jul 22.
Adults with congenital heart disease (ACHD) are at risk of developing metabolic syndrome (MetS) at a younger age. We sought to obtain the prevalence of MetS in ACHD from a large population-based database in the United States. We conducted a retrospective cohort study of patients with ACHD in Explorys (IBM Inc., Armonk, New York) database from 2008 to 2019. The ACHD cohort included patients aged 20 to 39 years, with moderate and severe congenital heart disease, as defined by ACHD anatomic and physiologic classification. Patients were diagnosed with MetS using the modified International Diabetes Federation's diagnostic criteria. Logistic regression analysis was performed to compare the risk of MetS in the ACHD cohort. MetS was diagnosed in 1,860 of 6,720 patients with ACHD (27.6%). Among 7,359,470 controls, MetS was seen in 742,010 (10.1%). The average age of MetS in ACHD was 31.5 and 32.7 years in controls (p <0.001). The risk of MetS was higher in ACHD versus controls (odds ratio [OR] 2.75 [2.61 to 2.89], p <0.001). The risk of MetS in ACHD was higher in men (OR 3.01 [2.78 to 3.26], p <0.001) and those aged <25 years (men OR 7.57 [6.31 to 9.07], women OR 4.66 [3.85 to 5.63]; p <0.001). The risk of MetS was higher in patients with severe versus moderate ACHD (OR 1.4 [1.56 to 1.74], p <0.001). In conclusion, MetS and its risk factors are more common in young ACHD than in the general population.
患有先天性心脏病 (ACHD) 的成年人在年轻时患代谢综合征 (MetS) 的风险更高。我们试图从美国的一个大型基于人群的数据库中获得 ACHD 患者的 MetS 患病率。我们对 2008 年至 2019 年在 IBM Inc. 的 Explorys (位于纽约州阿蒙克) 数据库中的 ACHD 患者进行了回顾性队列研究。ACHD 队列包括年龄在 20 至 39 岁之间、患有中度和重度先天性心脏病的患者，这些疾病由 ACHD 解剖和生理分类定义。使用改良的国际糖尿病联合会诊断标准诊断 MetS。Logistic 回归分析用于比较 ACHD 队列中 MetS 的风险。在 6720 名 ACHD 患者中，有 1860 名患有 MetS（27.6%）。在 7359470 名对照者中，有 742010 名患有 MetS（10.1%）。ACHD 中 MetS 的平均年龄为 31.5 岁，对照组为 32.7 岁（p <0.001）。与对照组相比，ACHD 中 MetS 的风险更高（比值比 [OR] 2.75 [2.61 至 2.89]，p <0.001）。ACHD 中 MetS 的风险在男性（OR 3.01 [2.78 至 3.26]，p <0.001）和年龄 <25 岁的患者中更高（男性 OR 7.57 [6.31 至 9.07]，女性 OR 4.66 [3.85 至 5.63]；p <0.001）。与中度 ACHD 相比，严重 ACHD 患者的 MetS 风险更高（OR 1.4 [1.56 至 1.74]，p <0.001）。总之，与一般人群相比，年轻的 ACHD 患者中 MetS 及其危险因素更为常见。
