Eshtiaghi Arshia, Margolin Edward A, Micieli Jonathan A
Faculty of Medicine (AE), Department of Ophthalmology and Vision Sciences (EM, JAM), Division of Neurology (EM, JAM), Department of Medicine, University of Toronto, Toronto, Canada; and Kensington Vision and Research Centre (JAM), Toronto, Canada.
J Neuroophthalmol. 2023 Jun 1;43(2):197-201. doi: 10.1097/WNO.0000000000001680. Epub 2022 Aug 2.
Previous studies have identified an association between obesity and socioeconomic variables such as poverty, minority status, and a low level of education. Because obesity is a major risk factor for the development of idiopathic intracranial hypertension (IIH), this study aims to identify and assess relationships between socioeconomic and geographic variables in patients with IIH in Canada.
A retrospective chart review was performed to identify female patients with IIH presenting to 2 neuro-ophthalmology clinics in Toronto between 2014 and 2022. Consecutive female patients younger than 50 years who did not have IIH were identified as controls. Patient age, body mass index (BMI), and postal code were obtained from electronic medical records. Patient postal codes were then converted to geographic dissemination areas based on the 2016 Canadian census, and data on socioeconomic outcomes were collected from Statistics Canada.
Three hundred twenty-two female patients with IIH (mean age: 32.3 ± 10) and 400 female controls (mean age: 33.9 ± 9) were included. The mean BMI was 35.0 ± 8 for patients with IIH and 26.7 ± 7 for control patients ( P < 0.00001). There was a significant difference between dissemination areas resided by patients with IIH and control patients for median income ($34640 vs $36685 CAD, P = 0.02) and rate of postsecondary degree attainment (57.7% vs 60.5%, P = 0.01). There were no significant differences in the percentage of visible minorities, percentage of immigrants, knowledge of official languages, percentage of married individuals, average household size, or unemployment rate. There was a weak but significant inverse relationship between the rate of postsecondary degree attainment in dissemination areas resided by patients with IIH and their BMI ( P = 0.01, R 2 = 0.02).
Patients with IIH reside in geographic areas with lower average levels of income and education than control patients. Patients with lower levels of education may be at higher risk of elevated BMI and therefore disease incidence and progression.
先前的研究已经确定肥胖与社会经济变量之间存在关联，如贫困、少数族裔身份和低教育水平。由于肥胖是特发性颅内高压（IIH）发展的主要危险因素，本研究旨在确定并评估加拿大IIH患者的社会经济和地理变量之间的关系。
进行了一项回顾性病历审查，以确定2014年至2022年间在多伦多两家神经眼科诊所就诊的IIH女性患者。将年龄小于50岁且无IIH的连续女性患者作为对照。从电子病历中获取患者年龄、体重指数（BMI）和邮政编码。然后根据2016年加拿大人口普查将患者邮政编码转换为地理分布区域，并从加拿大统计局收集社会经济结果数据。
纳入了322例IIH女性患者（平均年龄：32.3±10岁）和400例女性对照（平均年龄：33.9±9岁）。IIH患者的平均BMI为35.0±8，对照患者为26.7±7（P<0.00001）。IIH患者和对照患者居住的分布区域在中位数收入（34640加元对36685加元，P = 0.02）和高等学位获得率（57.7%对60.5%，P = 0.01）方面存在显著差异。在可见少数族裔比例、移民比例、官方语言知识、已婚个体比例、平均家庭规模或失业率方面没有显著差异。IIH患者居住的分布区域的高等学位获得率与其BMI之间存在微弱但显著的负相关（P = 0.01，R² = 0.02）。
与对照患者相比，IIH患者居住在平均收入和教育水平较低的地理区域。教育水平较低的患者BMI升高的风险可能更高，因此疾病的发病率和进展风险也更高。
