Pediatric Cushing disease: disparities in disease severity and outcomes in the Hispanic and African-American populations.
Pediatric Cushing disease: disparities in disease severity and outcomes in the Hispanic and African-American populations.
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DOI：
10.1038/pr.2017.58
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发表时间：
2017-08
影响因子：
3.6
通讯作者：
Lodish MB
中科院分区：
文献类型：
--
作者：
Gkourogianni A;Sinaii N;Jackson SH;Karageorgiadis AS;Lyssikatos C;Belyavskaya E;Keil MF;Zilbermint M;Chittiboina P;Stratakis CA;Lodish MB
种族和社会经济差异对儿童库欣病（CD）严重程度和预后的影响知之甚少。纳入了129例CD儿童，其中45例为西班牙裔/拉丁裔或非裔美国人（HI/AA），84例为非西班牙裔白色人（非HW）。一个10点指数的严重程度（CD严重程度）纳入程度高皮质醇血症，葡萄糖耐量，高血压，拟人化的测量，疾病持续时间和肿瘤的特点。在CD严重程度的回归分析中评估了种族、民族、年龄、性别、当地肥胖患病率、估计的中位收入和获得护理的机会。HI/AA组的平均CD严重程度比非HW组差（4.9 ± 2.0 vs 4.1 ± 1.9，p = 0.023）;驱动因素包括较高的皮质醇水平和较大的肿瘤大小。多元回归模型证实，种族（p=0.027）和年龄（p=0.014）是CD严重程度恶化的最重要预测因素。术后中位随访时间为2.3年时，HI/AA患者的持续CD合并复发的相对风险是非HW患者的2.8倍（95% CI：1.2-6.5）。我们的数据显示，CD严重程度差异的驱动力是年龄较大和种族/民族。重要的是，少数民族儿童持续和复发CD的风险较高。
Little is known about the contribution of racial and socioeconomic disparities to severity and outcomes for children with Cushing disease (CD). 129 children with CD, 45 Hispanic/Latino or African American (HI/AA) and 84 non-Hispanic White (non-HW), are included. A 10-point index for rating severity (CD-severity) incorporated degree of hypercortisolemia, glucose tolerance, hypertension, anthropomorphic measurements, disease duration, and tumor characteristics. Race, ethnicity, age, gender, local obesity prevalence, estimated median income, and access to care were assessed in regression analyses of CD-severity. The mean CD-severity for the HI/AA group was worse than the non-HW group (4.9 ± 2.0 vs 4.1 ± 1.9, p = 0.023); driving factors included higher cortisol levels and larger tumor size. Multiple regression models confirmed that race (p=0.027) and older age (p=0.014) were the most important predictors of worse CD-severity. When followed up a median of 2.3 years after surgery, the relative risk of persistent CD combined with recurrence was 2.8 times higher in HI/AA compared to non-HW (95% CI: 1.2–6.5). Our data show that the driving forces for the discrepancy in severity of CD are older age and race/ethnicity. Importantly, risk of persistent and recurrent CD was higher in minority children.
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影响因子：
3.2
作者：
Aristizabal, Paula;Singer, Jenelle;Martinez, Maria E.
通讯作者：
Martinez, Maria E.
DOI：
10.1097/med.0000000000000127
发表时间：
2015-02-01
影响因子：
3.2
作者：
Lodish, Maya
通讯作者：
Lodish, Maya
影响因子：
3.2
作者：
Bhatia, Smita
通讯作者：
Bhatia, Smita
影响因子：
28.4
作者：
Zeng C;Wen W;Morgans AK;Pao W;Shu XO;Zheng W
通讯作者：
Zheng W
DOI：
10.1001/jama.2016.6361
发表时间：
2016-06-07
期刊：
JAMA
影响因子：
--
作者：
Ogden CL;Carroll MD;Lawman HG;Fryar CD;Kruszon-Moran D;Kit BK;Flegal KM
通讯作者：
Flegal KM