Prevalence of Common Disease Conditions in a Large Cohort of Individuals With Down Syndrome in the United States
Prevalence of Common Disease Conditions in a Large Cohort of Individuals With Down Syndrome in the United States
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DOI：
10.17294/2330-0698.1824
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发表时间：
2021-03-01
影响因子：
1.7
通讯作者：
Rzhetsky, Andrey
中科院分区：
文献类型：
--
作者：
Chicoine, Brian;Rivelli, Anne;Rzhetsky, Andrey
鉴于目前的预期寿命和唐氏综合征（DS）患者的数量，了解唐氏综合征在整个发育生命周期中常见的疾病状况是很重要的。本研究分析了大量DS患者的数据，以更好地了解这些疾病状况，为未来的筛查实践提供信息，制定医疗保健指南，并提高医疗保健资源的利用率。这项回顾性描述性研究纳入了长达28年的数据，收集了6078名DS患者和30326名年龄和性别匹配的对照组的数据。数据是从中西部一个大型卫生系统的电子病历中提取的。结果总体而言，与对照组相比，退行性椎体滑移患者的睾丸癌、白血病、烟雾病、精神健康状况、支气管炎和肺炎、胃肠道疾病、甲状腺疾病、神经系统疾病、寰枢椎半脱位、骨质疏松症、吞咽困难、眼/附件疾病、耳/乳突疾病和睡眠呼吸暂停的患病率更高。患有退行性椎体滑移的个体患实体瘤、心脏病、性传播疾病、艾滋病毒、流感、鼻窦炎、尿路感染和糖尿病的几率较低。淋巴瘤、皮肤黑色素瘤、中风、急性心肌梗死、肝炎、蜂窝织炎和骨关节炎的患病率也相似。虽然对唐氏综合症患者的合并症得出一个广泛的结论是具有挑战性的，但可以肯定的是，对唐氏综合症患者的护理不应该自动反映美国普通人群的筛查、预防或治疗指南。相反，对退行性痴呆患者的护理应反映这一人群的独特需求和常见合并症。
Purpose Given the current life expectancy and number of individuals living with Down syndrome (DS), it is important to learn common occurrences of disease conditions across the developmental lifespan. This study analyzed data from a large cohort of individuals with DS in an effort to better understand these disease conditions, inform future screening practices, tailor medical care guidelines, and improve utilization of health care resources.Methods This retrospective, descriptive study incorporated up to 28 years of data, compiled from 6078 individuals with DS and 30,326 controls matched on age and sex. Data were abstracted from electronic medical records within a large Midwestern health system.Results In general, individuals with DS experienced higher prevalence of testicular cancer, leukemias, moyamoya disease, mental health conditions, bronchitis and pneumonia, gastrointestinal conditions, thyroid disorder, neurological conditions, atlantoaxial subluxation, osteoporosis, dysphagia, diseases of the eyes/adnexa and of the ears/mastoid process, and sleep apnea, relative to matched controls. Individuals with DS experienced lower prevalence of solid tumors, heart disease conditions, sexually transmitted diseases, HIV, influenza, sinusitis, urinary tract infections, and diabetes. Similar rates of prevalence were seen for lymphomas, skin melanomas, stroke, acute myocardial infarction, hepatitis, cellulitis, and osteoarthritis.Conclusions While it is challenging to draw a widespread conclusion about comorbidities in individuals with Down syndrome, it is safe to conclude that care for individuals with DS should not automatically mirror screening, prevention, or treatment guidelines for the general U.S. population. Rather, care for those with DS should reflect the unique needs and common comorbidities of this population.