Multimorbidity in Middle-Aged Adults with Cerebral Palsy
Multimorbidity in Middle-Aged Adults with Cerebral Palsy
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DOI：
10.1016/j.amjmed.2016.11.044
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发表时间：
2017-06-01
影响因子：
5.9
通讯作者：
Peterson, Mark D.
中科院分区：
文献类型：
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作者：
Cremer, Nicole;Hurvitz, Edward A.;Peterson, Mark D.
目的：脑瘫患者的去脂体重较少，相对肥胖程度较高，体能和体力活动参与度较低，但该人群中与年龄相关的多种疾病的患病率尚未确定。本研究的目的是调查中年脑瘫患者样本中与生活方式相关的慢性疾病和多重发病的患病率。方法：使用电子病历搜索引擎软件对临床中年脑瘫患者样本进行检查。我们的队列包括 435 名年龄在 40 至 60 岁之间的个体，他们拥有国际疾病分类、临床修改、脑瘫诊断代码第 9 版和第 10 版修订版。评估了12种慢性疾病的患病率，包括骨质减少/骨质疏松症、心肌梗死、中风、冠状动脉疾病、糖耐量受损/2型糖尿病、其他心血管疾病、类风湿性关节炎、骨关节炎、哮喘、肺气肿、高血压前期/高血压和高脂血症的现有诊断或历史记录。使用多变量逻辑模型来估计多发病（即> = 2种慢性病），调整年龄、性别、吸烟状况、肥胖和粗大运动功能分类系统（GMFCS）。结果：有137种独特的多发病组合。与非肥胖个体相比，GMFCS I-III（75.8% vs 53.6%）和 GMFCS IV-V（79.0% vs 64.2%）的多重发病率在肥胖个体中显着更高，但与 GMFCS I-III 的非肥胖个体（53.6%）相比，GMFCS IV-V 的非肥胖个体（64.2%）的多重发病率也显着更高。肥胖状况（比值比，2.20；95% 置信区间，1.32-2.79）和 GMFCS IV-V 类别（比值比，1.81；95% 置信区间，1.32-3.68）均与多种疾病独立相关。肥胖和较高的 GMFCS 水平与较高的风险独立相关。 (C) 2017 Elsevier Inc. 保留所有权利。
OBJECTIVE: Individuals with cerebral palsy have less lean body mass, greater relative adiposity, and lower fitness and physical activity participation, and yet the prevalence of age-related multimorbidity in this population has yet to be established. The study objective was to examine the prevalence of lifestyle-related chronic conditions and multimorbidity in a sample of middle-aged adults with cerebral palsy.METHODS: A clinic-based sample of middle-aged adults with cerebral palsy was examined using Electronic Medical Records Search Engine software. Our cohort included 435 individuals aged 40 to 60 years, with an International Classification of Diseases, Clinical Modification, 9th and 10th Revisions Diagnosis Code for cerebral palsy. Prevalence of 12 chronic conditions was evaluated, including existing diagnoses or historical record of osteopenia/osteoporosis, myocardial infarction, stroke, coronary artery disease, impaired glucose tolerance/type 2 diabetes, other cardiovascular conditions, rheumatoid arthritis, osteoarthritis, asthma, emphysema, prehypertension/hypertension, and hyperlipidemia. Multivariate logistic models were used to estimate multimorbidity (ie, >= 2 chronic conditions), adjusting for age, sex, smoking status, obesity, and Gross Motor Function Classification System (GMFCS).RESULTS: There were 137 unique multimorbidity combinations. Multimorbidity was significantly more prevalent among obese versus nonobese individuals for both GMFCS I-III (75.8% vs 53.6%) and GMFCS IV-V (79.0% vs 64.2%), but was also significantly higher in nonobese individuals with GMFCS IV-V (64.2%) compared with nonobese individuals with GMFCS I-III (53.6%). Both the obesity status (odds ratio, 2.20; 95% confidence interval, 1.32-2.79) and the GMFCS IV-V category (odds ratio, 1.81; 95% confidence interval, 1.32-3.68) were independently associated with multimorbidity.CONCLUSIONS: Middle-aged adults with cerebral palsy have high estimates of multimorbidity; both obesity and higher GMFCS levels are independently associated with greater risk. (C) 2017 Elsevier Inc. All rights reserved.