PDF(Pubmed)
Abstract：
BACKGROUND: Lipodystrophy is characterized by progressive loss of adipose tissue and consequential metabolic abnormalities. With new treatments emerging for lipodystrophy, there is a growing need to understand the prevalence of specific comorbidities that may be commonly associated with lipodystrophy to contextualize the natural history of lipodystrophy without any disease modifying therapy.
OBJECTIVE: To examine the risk of specific clinical characteristics in people living with lipodystrophy (LD) in 2018-2019 compared with the general US population, among the commercially insured US population.
METHODS: A retrospective cohort study was conducted using the 2018-2019 Clinformatics® Data Mart database. An adult LD cohort (age ≥ 18 years) with at least ≥ 1 inpatient or ≥ 2 outpatient LD diagnoses was created. The LD cohort included non-HIV-associated LD (non-HIV-LD) and HIV-associated LD (HIV-LD) subgroups and compared against age- and sex-matched control groups with a 1:4 ratio from the general population with neither an LD or an HIV diagnosis using odds ratios (ORs) with 95% confidence intervals.
RESULTS: We identified 546 individuals with non-HIV-LD (mean age, 60.3 ± 14.9 years; female, 67.6%) and 334 individuals with HIV-LD (mean age, 59.2 ± 8.3 years; female, 15.0%) in 2018-2019. Compared with the general population, individuals with non-HIV-LD had higher risks (odds ratio [95% confidence interval]) for hyperlipidemia (3.32 [2.71-4.09]), hypertension (3.58 [2.89-4.44]), diabetes mellitus (4.72 [3.85-5.79]), kidney disease (2.78 [2.19-3.53]), liver fibrosis or cirrhosis (4.06 [1.66-9.95]), cancer (2.20 [1.59-3.01]), and serious infections resulting in hospitalization (3.00 [2.19-4.10]). Compared with individuals with HIV, those with HIV-LD have higher odds of hypertension (1.47 [1.13-1.92]), hyperlipidemia (2.46 [1.86-3.28]), and diabetes (1.37 [1.04-1.79]).
CONCLUSIONS: LD imposes a substantial burden on affected individuals due to a high prevalence of metabolic comorbidities and other complications as compared with the general non-LD population. Future longitudinal follow-up studies investigating the causality between LD and observed comorbidities are warranted.
OBJECTIVE: To examine the risk of specific clinical characteristics in people living with lipodystrophy (LD) in 2018-2019 compared with the general US population, among the commercially insured US population.
METHODS: A retrospective cohort study was conducted using the 2018-2019 Clinformatics® Data Mart database. An adult LD cohort (age ≥ 18 years) with at least ≥ 1 inpatient or ≥ 2 outpatient LD diagnoses was created. The LD cohort included non-HIV-associated LD (non-HIV-LD) and HIV-associated LD (HIV-LD) subgroups and compared against age- and sex-matched control groups with a 1:4 ratio from the general population with neither an LD or an HIV diagnosis using odds ratios (ORs) with 95% confidence intervals.
RESULTS: We identified 546 individuals with non-HIV-LD (mean age, 60.3 ± 14.9 years; female, 67.6%) and 334 individuals with HIV-LD (mean age, 59.2 ± 8.3 years; female, 15.0%) in 2018-2019. Compared with the general population, individuals with non-HIV-LD had higher risks (odds ratio [95% confidence interval]) for hyperlipidemia (3.32 [2.71-4.09]), hypertension (3.58 [2.89-4.44]), diabetes mellitus (4.72 [3.85-5.79]), kidney disease (2.78 [2.19-3.53]), liver fibrosis or cirrhosis (4.06 [1.66-9.95]), cancer (2.20 [1.59-3.01]), and serious infections resulting in hospitalization (3.00 [2.19-4.10]). Compared with individuals with HIV, those with HIV-LD have higher odds of hypertension (1.47 [1.13-1.92]), hyperlipidemia (2.46 [1.86-3.28]), and diabetes (1.37 [1.04-1.79]).
CONCLUSIONS: LD imposes a substantial burden on affected individuals due to a high prevalence of metabolic comorbidities and other complications as compared with the general non-LD population. Future longitudinal follow-up studies investigating the causality between LD and observed comorbidities are warranted.
摘要：
背景：脂肪营养不良的特征是脂肪组织的进行性丧失和随之而来的代谢异常。随着脂肪营养不良的新治疗方法的出现，越来越需要了解可能通常与脂肪营养不良相关的特定合并症的患病率,以便在没有任何疾病修饰治疗的情况下了解脂肪营养不良的自然史.
目的：为了检查2018-2019年脂肪营养不良（LD）患者与普通美国人群相比的特定临床特征的风险，在有商业保险的美国人口中。
方法：使用2018-2019Clinformatics®DataMart数据库进行了一项回顾性队列研究。建立了至少≥1名住院患者或≥2名门诊LD诊断的成人LD队列（年龄≥18岁）。LD队列包括非HIV相关的LD（非HIV-LD）和HIV相关的LD（HIV-LD）亚组，并与年龄和性别匹配的对照组进行比较，使用95％置信区间的比值比（ORs）与普通人群中没有LD或HIV诊断的比例为1：4。
结果：我们确定了546例非HIV-LD患者（平均年龄，60.3±14.9岁；女性，67.6%)和334名HIV-LD患者(平均年龄，59.2±8.3岁；女性，15.0%），2018-2019年。与普通人群相比，非HIV-LD患者患高脂血症的风险较高(比值比[95%置信区间])(3.32[2.71-4.09]),高血压（3.58[2.89-4.44]），糖尿病（4.72[3.85-5.79]），肾病（2.78[2.19-3.53]），肝纤维化或肝硬化（4.06[1.66-9.95]），癌症（2.20[1.59-3.01]），以及导致住院的严重感染（3.00[2.19-4.10]）。与艾滋病毒感染者相比，患有HIV-LD的人患高血压的几率更高（1.47[1.13-1.92]），高脂血症（2.46[1.86-3.28]），和糖尿病（1.37[1.04-1.79]）。
结论：与一般非LD人群相比，由于代谢合并症和其他并发症的患病率较高，LD给受影响的个体带来了巨大的负担。有必要进行未来的纵向随访研究，以调查LD与观察到的合并症之间的因果关系。
目的：为了检查2018-2019年脂肪营养不良（LD）患者与普通美国人群相比的特定临床特征的风险，在有商业保险的美国人口中。
方法：使用2018-2019Clinformatics®DataMart数据库进行了一项回顾性队列研究。建立了至少≥1名住院患者或≥2名门诊LD诊断的成人LD队列（年龄≥18岁）。LD队列包括非HIV相关的LD（非HIV-LD）和HIV相关的LD（HIV-LD）亚组，并与年龄和性别匹配的对照组进行比较，使用95％置信区间的比值比（ORs）与普通人群中没有LD或HIV诊断的比例为1：4。
结果：我们确定了546例非HIV-LD患者（平均年龄，60.3±14.9岁；女性，67.6%)和334名HIV-LD患者(平均年龄，59.2±8.3岁；女性，15.0%），2018-2019年。与普通人群相比，非HIV-LD患者患高脂血症的风险较高(比值比[95%置信区间])(3.32[2.71-4.09]),高血压（3.58[2.89-4.44]），糖尿病（4.72[3.85-5.79]），肾病（2.78[2.19-3.53]），肝纤维化或肝硬化（4.06[1.66-9.95]），癌症（2.20[1.59-3.01]），以及导致住院的严重感染（3.00[2.19-4.10]）。与艾滋病毒感染者相比，患有HIV-LD的人患高血压的几率更高（1.47[1.13-1.92]），高脂血症（2.46[1.86-3.28]），和糖尿病（1.37[1.04-1.79]）。
结论：与一般非LD人群相比，由于代谢合并症和其他并发症的患病率较高，LD给受影响的个体带来了巨大的负担。有必要进行未来的纵向随访研究，以调查LD与观察到的合并症之间的因果关系。
