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智力残疾与心血管疾病风险:一项基于人群的队列研究。

Intellectual disabilities and risk of cardiovascular diseases: A population-based cohort study.

作者信息

Cho In Young, Koo Hye Yeon, Um Yoo Jin, Park Yong-Moon Mark, Kim Kyung Mee, Lee Chung Eun, Han Kyungdo

机构信息

Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea.

Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.

出版信息

Disabil Health J. 2025 Apr;18(2):101754. doi: 10.1016/j.dhjo.2024.101754. Epub 2024 Nov 17.

Abstract

BACKGROUND

While intellectual disability is associated with higher mortality rates due to circulatory diseases, it is unclear whether intellectual disability is associated with higher risk of myocardial infarction (MI) and stroke than the general population.

OBJECTIVES

We aimed to analyze the risk of cardiovascular diseases (CVD), specifically myocardial infarction (MI) and ischemic stroke, and death due to circulatory diseases in individuals with disability.

METHODS

This retrospective cohort study used data from the National Disability Registration System linked to the Korean National Health Insurance Service database. Individuals who underwent national health examinations in 2009 were followed until 2020. Cox-proportional hazard analyses were performed to estimate the risk of CVD, MI, ischemic stroke, and circulatory disease deaths with adjustment for covariates.

RESULTS

A total of 3642 individuals with intellectual disability (mean [SD] age 39.1 [12.6], 28.8 % female) and 3,889,794 individuals without intellectual disability (mean [SD] age 47.1 [13.9], 45.6 % female) were included. Compared to those without intellectual disability, those with intellectual disability had higher risk of CVD (adjusted hazard ratio [aHR] 1.71, 95 % confidence interval [CI] 1.45-2.02), ischemic stroke (aHR 2.21, 95 % CI 1.81-2.69), and death due to circulatory diseases (aHR 4.20, 95 % CI 3.24-5.45), and a non-significant risk for MI (aHR 1.24, 95 % CI 0.95-1.63) after full adjustment for covariates.

CONCLUSIONS

Individuals with intellectual disability were at increased risk of CVD, in particular ischemic stroke, and death due to circulatory diseases. Healthcare professionals should be aware of increased CVD risk in individuals with intellectual disability.

摘要

背景

虽然智力残疾与循环系统疾病导致的较高死亡率相关,但尚不清楚智力残疾者患心肌梗死(MI)和中风的风险是否高于普通人群。

目的

我们旨在分析残疾个体患心血管疾病(CVD),特别是心肌梗死(MI)和缺血性中风的风险,以及因循环系统疾病导致的死亡风险。

方法

这项回顾性队列研究使用了与韩国国民健康保险服务数据库相关联的国家残疾登记系统的数据。对2009年接受全国健康检查的个体进行随访至2020年。进行Cox比例风险分析以估计在对协变量进行调整后CVD、MI、缺血性中风和循环系统疾病死亡的风险。

结果

共纳入3642名智力残疾个体(平均[标准差]年龄39.1[12.6]岁,28.8%为女性)和3889794名无智力残疾个体(平均[标准差]年龄47.1[13.9]岁,45.6%为女性)。与无智力残疾者相比,智力残疾者在对协变量进行全面调整后,患CVD的风险更高(调整后风险比[aHR]1.71,95%置信区间[CI]1.45 - 2.02)、缺血性中风(aHR 2.21,95%CI 1.81 - 2.69)以及因循环系统疾病导致的死亡(aHR 4.20,95%CI 3.24 - 5.45)风险,而患MI的风险无显著差异(aHR 1.24,95%CI 0.95 - 1.63)。

结论

智力残疾个体患CVD,尤其是缺血性中风以及因循环系统疾病导致死亡的风险增加。医疗保健专业人员应意识到智力残疾个体患CVD的风险增加。

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