Li Yonghong, Matsushita Fumika, Chen Zhen, Jones Robert S, Bare Lance A, Petersen Jeannine M, Hinckley Alison F
Quest Diagnostics, San Juan Capistrano, CA, USA.
Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA.
Public Health Rep. 2025 Apr 1:333549251314419. doi: 10.1177/00333549251314419.
Serologic testing is a useful adjunct for the diagnosis of Lyme disease, a major public health problem in certain US regions. We aimed to determine whether Lyme disease serologic testing and results differed by sex and age group.
We identified 2 cohorts of individuals across all ages who underwent serologic testing for Lyme disease at a national reference laboratory in 2019 (cohort 1) and 2022 (cohort 2). If an individual had multiple tests in the same year, we included only the first test. We excluded individuals who had been tested in the previous 5 years.
Cohorts 1 and 2 consisted of 578 052 and 550 674 people, respectively. Fewer males than females were tested in cohort 1 (42.7% vs 57.3%) and cohort 2 (42.3% vs 57.7%), although similar numbers were tested for both sexes among nonadults. More males than females had a positive test result in cohort 1 (53.9% more males) and cohort 2 (52.9% more males). The odds ratio of receiving a positive test result among males versus females was 2.09 (95% CI, 2.01-2.17) in cohort 1 and 2.12 (95% CI, 2.05-2.19) in cohort 2. Among people with positive test results, females (except children) were more likely than males to have positive immunoglobulin M and negative immunoglobulin G results, which can serve as a marker of early infection (odds ratio = 1.43 [95% CI, 1.31-1.55] in cohort 1 and 1.38 [95% CI, 1.29-1.47] in cohort 2).
Further studies are needed to understand whether the observed differences in Lyme disease testing and positivity result from sex- and age-associated disparities in social behavior, health care seeking, clinical practice, or other factors.
血清学检测是诊断莱姆病的一项有用辅助手段，莱姆病在美国某些地区是一个重大的公共卫生问题。我们旨在确定莱姆病血清学检测及结果是否因性别和年龄组而异。
我们确定了2组各年龄段的个体，他们于2019年（第1组）和2022年（第2组）在一家国家参考实验室接受了莱姆病血清学检测。如果一个人在同一年进行了多次检测，我们只纳入第一次检测。我们排除了在过去5年内接受过检测的个体。
第1组和第2组分别包括578052人和550674人。在第1组（42.7%对57.3%）和第2组（42.3%对57.7%）中，接受检测的男性少于女性，尽管在非成年人中，两性接受检测的人数相似。在第1组（男性阳性检测结果比女性多53.9%）和第2组（男性阳性检测结果比女性多52.9%）中，男性的阳性检测结果多于女性。在第1组中，男性与女性相比获得阳性检测结果的比值比为2.09（95%CI，2.01 - 2.17），在第2组中为2.12（95%CI，2.05 - 2.19）。在检测结果为阳性的人群中，女性（儿童除外）比男性更有可能出现免疫球蛋白M阳性和免疫球蛋白G阴性结果，这可作为早期感染的一个标志物（在第1组中比值比 = 1.43 [95%CI，1.31 - 1.55]，在第2组中为1.38 [95%CI，1.29 - 1.47]）。
需要进一步研究以了解莱姆病检测及阳性率方面观察到的差异是否源于社会行为、就医行为、临床实践或其他因素中与性别和年龄相关的差异。
