Department of Medicine, University of Manitoba, Winnipeg, Canada.
Acta Neurol Scand. 2011 Aug;124(2):135-41. doi: 10.1111/j.1600-0404.2010.01436.x. Epub 2010 Sep 29.
Comorbidity may be associated with the clinical phenotype of disease and may affect prognostication and treatment decisions. Using the North American Research Committee on Multiple Sclerosis Registry, we described comorbidities present at onset and diagnosis of multiple sclerosis (MS) and examined whether comorbidities present at onset were associated with clinical course or age of MS symptom onset.
In 2006, 8983 participants reported their physical and mental comorbidities; smoking status; height; and past and present weight. We compared clinical course at onset and age of symptom onset by comorbidity status.
At MS onset, a substantial proportion of participants had physical (24%) or mental (8.4%) comorbidities. The mean (SD) age of MS onset was 31.2 (9.0) years. Vascular, autoimmune, cancer, visual, and musculoskeletal comorbidities were associated with a later age of symptom onset. Among men and women, the odds of a relapsing course at onset were increased if mental comorbidities (OR 1.48; 1.08-2.01) were present at symptom onset. In women, gastrointestinal comorbidities (OR 1.78; 1.25-2.52) and obesity (OR 2.08 1.53-2.82) at MS onset were also associated with a relapsing course at onset.
Comorbidity is frequently present at onset of MS and is associated with differences in clinical characteristics.
合并症可能与疾病的临床表型有关，并可能影响预后和治疗决策。利用北美多发性硬化症研究委员会的登记资料，我们描述了多发性硬化症（MS）发病和诊断时存在的合并症，并探讨了发病时存在的合并症是否与临床病程或 MS 症状发作年龄有关。
2006 年，8983 名参与者报告了他们的身体和精神合并症、吸烟状况、身高以及过去和现在的体重。我们根据合并症状况比较了发病时的临床病程和发病年龄。
在 MS 发病时，相当一部分参与者存在身体（24%）或精神（8.4%）合并症。MS 发病的平均（标准差）年龄为 31.2（9.0）岁。血管、自身免疫、癌症、视力和肌肉骨骼合并症与症状发作年龄较晚有关。在男性和女性中，如果在症状发作时存在精神合并症（OR 1.48；1.08-2.01），则发病时出现复发病程的可能性增加。在女性中，MS 发病时存在胃肠道合并症（OR 1.78；1.25-2.52）和肥胖（OR 2.08；1.53-2.82）也与发病时出现复发病程有关。
合并症在 MS 发病时经常存在，并与临床特征的差异有关。
