Boisvenue, J.

ESTABLISHING A CASE DEFINITION AND CASE-FINDING ALGORITHM TO DESCRIBE THE SEX DIFFERENCES IN YOUNG-ONSET ADULT METABOLIC SYNDROME USING ELECTRONIC MEDICAL RECORD DATA FROM A PRIMARY CARE SETTING IN NORTHERN ALBERTA
Boisvenue, J.J., Oliva, C.U., Manca, D.P., Johnson, J.A., Yeung, R.O.

The prevalence of young-adult onset metabolic syndrome (MetS) in Canada remains poorly reported in primary care due to barriers including variation in case definitions and the use of a multitude of electronic medical record systems (EMRs). Our study aims to establish a case definition and case-finding algorithm to describe the prevalence and patterns of young onset MetS between sexes.

Using a cross-sectional study design, we developed a case definition and case-finding algorithm for the identification of MetS using EMR data from the Northern Alberta Primary Care Research Network (NAPCReN), part of the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). Our sample consisted of young-adults aged 18-40 years who attended a NAPCReN clinic between July 29, 2015 and July 29, 2018. Descriptive analysis stratified by sex and MetS status was performed for components of MetS. The prevalence of CPCSSN validated disease definitions for depression, diabetes, hypertension, and osteoarthritis were calculated.

The sample consisted of n=15 766 patients of whom 63.4% are female with a mean age 30.9±5.8 years. The prevalence of MetS was 4.4% and did not differ between sexes. Females with MetS had worse outcomes than males with MetS for BMI and HbA1c and higher proportions of depression (20.2% vs 13%), diabetes (21.6% vs. 9.1%), and osteoarthritis (2.9% vs. 2.2%). Importantly, among all patients with a BMI ≥25 kg/m2, females had a higher proportion of missing data than males for high-density lipoprotein cholesterol (83.8% vs 74.6%), triglyceride (82.8% vs. 72.9%), and hemoglobin A1c (70.4% vs. 66.0%). Fasting blood glucose contained the high proportion of missing data for those with elevated BMI (F 83.7%, M 84.5%).

Females with MetS had worse metabolic outcomes and were missing more data than their male counterparts. The developed case definition may help inform formal validation of MetS in CPCSSN.