Sadovnick A D
Department of Medical Genetics and Faculty of Medicine, Division of Neurology, University of British Columbia, Vancouver, Canada.
J Neurol Sci. 2009 Nov 15;286(1-2):1-5. doi: 10.1016/j.jns.2009.09.005. Epub 2009 Sep 26.
The role of gender in the natural history of multiple sclerosis (MS) is multi-faceted. Earliest debate on this topic was about the sex ratio (female:male) among affected individuals. It was only clearly shown within the last 4 decades that females are more often affected. The sex ratio continues to intrigue researchers. An observed increase in the sex ratio among more recently born MS patients has now been taken as a clear indication that the rate of MS is truly increasing in many geographical areas. This temporal increase in females has been relatively rapid, implicating environmental rather than genetic risk factors. Gender issues in MS expand beyond the scope of sex ratio. Gender has an impact on various aspects of MS, including age of onset, "parent-of-origin" effects (seen in half-siblings, twin sibships, avuncular pairs, transmission of HLA haplotype), recurrence risks for relatives of MS patients and the topic of reproduction when one parent has MS. Gender issues can also confound data collection and analyses with respect to studies on comorbidity, risk factors and family history. In fact, it has now been clearly validated and quantified that among persons with MS, there is a sex-specificity of recall and reporting bias as well a greater female awareness of medical history.
性别在多发性硬化症（MS）自然史中的作用是多方面的。关于这个话题的最早争论是关于受影响个体中的性别比例（女性：男性）。直到最近40年才清楚地表明女性更常受到影响。性别比例继续引起研究人员的兴趣。在最近出生的MS患者中观察到的性别比例增加，现在已被视为许多地理区域MS发病率确实在上升的明确迹象。女性中的这种时间上的增加相对较快，这意味着是环境而非遗传风险因素。MS中的性别问题超出了性别比例的范围。性别对MS的各个方面都有影响，包括发病年龄、“起源父母”效应（在同父异母或同母异父的兄弟姐妹、双胞胎、叔侄对、HLA单倍型的传递中可见）、MS患者亲属的复发风险以及一方患有MS时的生育话题。性别问题在关于合并症、风险因素和家族史的研究的数据收集和分析方面也可能造成混淆。事实上，现在已经明确证实并量化，在MS患者中，存在回忆和报告偏差的性别特异性，以及女性对病史的更高认知度。
