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利用初级保健电子病历识别早发性代谢综合征的性别特异性差异。

Identifying Sex-Specific Differences in Young-Onset Metabolic Syndrome Using Primary Care Electronic Medical Record.

机构信息

School of Public Health, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada.

Alberta Diabetes Institute, Edmonton, Alberta, Canada.

出版信息

Metab Syndr Relat Disord. 2023 Apr;21(3):133-140. doi: 10.1089/met.2022.0065.

Abstract

To apply a case definition to a Northern Alberta-based primary care practice population and to assess the sex-specific characteristics of young-onset metabolic syndrome (MetS). We carried out a cross-sectional study to identify and estimate the prevalence of MetS using electronic medical record (EMR) data and perform descriptive comparative analyses of demographic and clinical characteristics between males and females. Northern Alberta Primary Care Research Network (NAPCReN) consists of EMR patient data from 77 physicians among 18 clinics. Patients with one or more clinic visit between 2015 and 2018, between 18 and 40 years old, residing in Northern Alberta. Comparison of prevalence in MetS between sexes as well as sex-specific distribution of MetS characteristics [body mass index (BMI), fasting blood glucose, glycated hemoglobin, triglycerides, and high-density lipoprotein cholesterol (HDL-C), presence of hypertension, and presence of diabetes]. Of 15,766 patients, 4.4% ( = 700) had young-onset MetS based on recorded data, prevalence was nearly twice as high in males (6.1%,  = 354) compared with females (3.5%,  = 346). The most prevalent risk factor for MetS consisted of having an elevated BMI for both females (90.9%) and males (91.5%). In the presence of MetS, more females had lower HDL-C [68.2% females (F) vs. 52.5% males (M)], and higher prevalence of diabetes (21.4% F vs. 9.0% M), whereas more males had hypertriglyceridemia (60.4% F vs. 79.7% M) and hypertension (12.4% F vs. 15.8% M). Females also had consistently higher percentages of absent laboratory data compared with males when identified as having MetS and BMI ≥25 kg/m. Males have nearly twice the prevalence of young-onset MetS compared with females, with notable sex-specific differences in the manifestation of MetS, although we suspect that this is partially due to underreporting where the absence of anthropomorphic and laboratory investigations point to a lack of testing. Sex-specific screening for MetS, especially among young females of childbearing years, is important for downstream prevention.

摘要

将病例定义应用于艾伯塔省北部的初级保健实践人群,并评估青年发病代谢综合征(MetS)的性别特征。我们进行了一项横断面研究,使用电子病历(EMR)数据来确定和估计 MetS 的患病率,并对男性和女性的人口统计学和临床特征进行描述性比较分析。艾伯塔省北部初级保健研究网络(NAPCReN)由 18 家诊所的 77 名医生的 EMR 患者数据组成。患者在 2015 年至 2018 年间有一次或多次诊所就诊,年龄在 18 至 40 岁之间,居住在艾伯塔省北部。比较男女之间 MetS 的患病率以及 MetS 特征的性别特异性分布[体重指数(BMI)、空腹血糖、糖化血红蛋白、甘油三酯和高密度脂蛋白胆固醇(HDL-C)、高血压和糖尿病的存在]。在 15766 名患者中,根据记录数据,有 4.4%(700 人)患有青年发病 MetS,男性(6.1%,354 人)的患病率几乎是女性(3.5%,346 人)的两倍。对于 MetS 最常见的风险因素是女性(90.9%)和男性(91.5%)的 BMI 升高。在患有 MetS 的情况下,更多的女性的 HDL-C 水平较低[68.2%的女性(F)与 52.5%的男性(M)],糖尿病的患病率更高(21.4%F 与 9.0%M),而更多的男性患有高甘油三酯血症(60.4%F 与 79.7%M)和高血压(12.4%F 与 15.8%M)。当确定患有 MetS 且 BMI≥25kg/m 时,女性的实验室数据缺失百分比也始终高于男性。与女性相比,男性青年发病 MetS 的患病率几乎是女性的两倍,尽管我们怀疑这部分是由于报告不足所致,因为缺乏人体测量和实验室检查表明缺乏检测。针对 MetS 的性别特异性筛查,尤其是在生育年龄的年轻女性中,对于下游预防非常重要。

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