与对照组相比，精神分裂症患者的外周动脉疾病。
Peripheral artery disease in patients with schizophrenia as compared to controls.
机构信息
Psychiatry - Aalborg University Hospital, Sdr. Skovvej 15, 9000, Aalborg, Denmark.
Department of Clinical Physiology, Viborg Regional Hospital, Viborg, Denmark.
出版信息
BMC Cardiovasc Disord. 2023 Mar 8;23(1):126. doi: 10.1186/s12872-023-03143-9.
BACKGROUND
Patients with schizophrenia have an increased prevalence of risk factors for peripheral artery disease (PAD) and is expected to have an increased prevalence of PAD. PAD can be detected utilizing toe-brachial index (TBI) which screens for vascular pathology proximal to the toes.
METHODS
Using a cross-sectional design, we defined the subpopulations: (1) Patients diagnosed with schizophrenia less than 2 years before inclusion (SCZ < 2), (2) Psychiatric healthy controls matched to subpopulation 1 on sex, age, and smoking status, and (3) Patients diagnosed with schizophrenia 10 or more years before inclusion (SCZ ≥ 10). TBI was calculated by dividing toe pressures by systolic brachial blood pressure, and PAD was defined by TBI < 0.70. Logistic regression analysis with PAD as outcome and sex, age, smoking status, BMI, skin temperature, diagnosis of schizophrenia, and comorbidities as explanatory variables was conducted.
RESULTS
PAD was present in 26.2% of patients diagnosed with SCZ < 2 (17 of 65) and in 18.5% of psychiatric healthy controls (12 of 65) with no statistically significant difference in prevalence rates (p = 0.29). PAD was present in 22.0% of patients diagnosed with SCZ ≥ 10 (31 of 141). In logistic regression, patients diagnosed with SCZ < 2 had an increased odds of PAD with psychiatric healthy controls as reference (Odds ratio = 2.80, 95% confidence interval 1.09-7.23, p = 0.03). The analysis was adjusted for age, sex, smoking status, BMI and comorbidities such as hypertension, diabetes and heart disease.
CONCLUSIONS
This study did not find statistically significant increased prevalence rates of PAD in patients with schizophrenia even though patients with SCZ were compared to psychiatric healthy controls using TBI. Utilizing logistic regression PAD was associated with schizophrenia diagnosis within the last 2 years, age and skin temperature. As PAD is initially asymptomatic, screening could be relevant in patients with schizophrenia if other risk factors are prevalent. Further large-scale multicenter studies are warranted to investigate schizophrenia as a potential risk factor for PAD.
TRIAL REGISTRATION
Clinicaltrials.gov identifier NCT02885792.
背景
精神分裂症患者外周动脉疾病（PAD）的风险因素患病率增加，预计 PAD 的患病率也会增加。可以通过测量趾肱指数（TBI）来检测 PAD，TBI 可筛查脚趾近端的血管病理。
方法
我们采用横断面设计，定义了以下亚人群：（1）入组前不到 2 年被诊断为精神分裂症的患者（SCZ<2）；（2）与亚人群 1 按性别、年龄和吸烟状况相匹配的精神科健康对照者；（3）入组前 10 年或更长时间被诊断为精神分裂症的患者（SCZ≥10）。TBI 通过用脚趾压力除以收缩压肱动脉血压来计算，TBI<0.70 定义为 PAD。采用逻辑回归分析，以 PAD 为因变量，性别、年龄、吸烟状况、BMI、皮肤温度、精神分裂症诊断和合并症为解释变量。
结果
在入组前不到 2 年被诊断为 SCZ<2 的患者（65 例中的 17 例，26.2%）和精神科健康对照者（65 例中的 12 例，18.5%）中存在 PAD，但患病率无统计学差异（p=0.29）。在入组前 10 年或更长时间被诊断为 SCZ≥10 的患者（141 例中的 31 例）中存在 PAD。在逻辑回归中，与精神科健康对照者相比，入组前不到 2 年被诊断为 SCZ 的患者 PAD 的比值比（OR）为 2.80（95%置信区间 1.09-7.23，p=0.03），具有 PAD 的可能性更高。该分析调整了年龄、性别、吸烟状况、BMI 和合并症，如高血压、糖尿病和心脏病。
结论
尽管使用 TBI 将精神分裂症患者与精神科健康对照者进行比较，但本研究并未发现精神分裂症患者 PAD 的患病率有统计学显著增加。利用逻辑回归，PAD 与最近 2 年内的精神分裂症诊断、年龄和皮肤温度相关。由于 PAD 最初是无症状的，如果存在其他危险因素，对精神分裂症患者进行筛查可能是相关的。需要进一步开展大规模多中心研究，以调查精神分裂症是否是 PAD 的潜在危险因素。
试验注册
Clinicaltrials.gov 标识符 NCT02885792。
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