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脊髓损伤患者中心血管疾病患病率的性别差异:一项基于人群的研究。

Sex differences in heart disease prevalence among individuals with spinal cord injury: A population-based study.

机构信息

Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.

International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.

出版信息

J Spinal Cord Med. 2024 Jul;47(4):559-565. doi: 10.1080/10790268.2022.2147891. Epub 2023 Mar 28.

Abstract

CONTEXT/OBJECTIVE: The risk for cardiovascular disease is amplified following spinal cord injury, but whether risk differs between the sexes remains unknown. Here, we evaluated sex differences in the prevalence of heart disease among individuals with spinal cord injury, and compared sex differences with able-bodied individuals.

DESIGN

The design was a cross-sectional study. Multivariable logistic regression analysis was conducted, using inverse probability weighting to account for the sampling method and to adjust for confounders.

SETTING

Canada.

PARTICIPANTS

Individuals who participated in the national Canadian Community Health Survey.

INTERVENTIONS

Not applicable.

OUTCOME MEASURES

Self-reported heart disease.

RESULTS

Among 354 individuals with spinal cord injury, the weighted prevalence of self-reported heart disease was 22.9% in males and 8.7% in females, with an inverse-probability weighted odds ratio of 3.44 (95% CI 1.70-6.95) for males versus females. Among 60,605 able-bodied individuals, the prevalence of self-reported heart disease was 5.8% in males and 4.0% in females, with an inverse probability weighted odds ratio of 1.62 (95% CI 1.50-1.75) for males versus females. The effect of male sex on increasing heart disease prevalence was about two times higher among individuals with spinal cord injury than able-bodied individuals (relative difference in inverse probability weighted odds ratios = 2.12, 95% CI 1.08-4.51).

CONCLUSION

Males with spinal cord injury exhibit a significantly higher prevalence of heart disease, compared with females with spinal cord injury. Moreover, relative to able-bodied individuals, spinal cord injury amplifies sex-related differences in heart disease. Overall, this work will inform targeted cardiovascular prevention strategies, and may also inform a better understanding of cardiovascular disease progression in both able-bodied and individuals with spinal cord injury.

摘要

背景/目的:脊髓损伤后心血管疾病的风险会增加,但男女风险是否存在差异尚不清楚。在此,我们评估了脊髓损伤患者中心脏病的患病率是否存在性别差异,并将其与健康个体进行了比较。

设计

这是一项横断面研究。采用逆概率加权法进行多变量逻辑回归分析,以考虑抽样方法并调整混杂因素。

地点

加拿大。

参与者

参与加拿大全国社区健康调查的个体。

干预措施

无。

结局指标

自我报告的心脏病。

结果

在 354 名脊髓损伤患者中,男性自我报告心脏病的加权患病率为 22.9%,女性为 8.7%,男性与女性相比,逆概率加权比值比为 3.44(95%可信区间为 1.70-6.95)。在 60605 名健康个体中,男性自我报告心脏病的患病率为 5.8%,女性为 4.0%,男性与女性相比,逆概率加权比值比为 1.62(95%可信区间为 1.50-1.75)。与健康个体相比,脊髓损伤患者中男性性别对增加心脏病患病率的影响大约高出两倍(逆概率加权比值比的相对差异=2.12,95%可信区间为 1.08-4.51)。

结论

与女性脊髓损伤患者相比,男性脊髓损伤患者的心脏病患病率显著更高。此外,与健康个体相比,脊髓损伤放大了与性别相关的心脏病差异。总的来说,这项工作将为有针对性的心血管预防策略提供信息,也可能更好地理解健康个体和脊髓损伤患者中心血管疾病的进展。

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