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共享的遗传因素可能无法解释多发性硬化症中并发炎症性疾病风险增加的原因。

Shared genetic factors may not explain the raised risk of comorbid inflammatory diseases in multiple sclerosis.

机构信息

Department of Neurology, Karolinska University Hospital Huddinge, Sweden.

出版信息

Mult Scler. 2012 Oct;18(10):1430-6. doi: 10.1177/1352458512438240. Epub 2012 Mar 14.

Abstract

BACKGROUND

Comorbid inflammatory conditions in multiple sclerosis (MS) patients suggest shared risks with MS.

OBJECTIVE

To estimate if the risk of immune-mediated disease in MS patients and their parents is increased.

METHODS

Swedish register data were analysed using Cox regression to estimate immune-mediated disease risk among 11284 fathers and 12006 mothers of MS patients, compared with 123158 fathers and 129409 mothers of index subjects without MS. Similar analyses were conducted among 20276 index subjects with MS and 203951 without.

RESULTS

Parents of patients with MS did not have a significantly altered immune-mediated disease risk. Patients with MS had a consistently raised risk for several immune-mediated diseases: ulcerative colitis, Crohn's disease, type 1 diabetes, psoriasis, polyarthritis nodosa and pemphigoid. The risk was more pronounced for diseases diagnosed subsequent to MS onset.

CONCLUSION

The increased occurrence of other immune-mediated diseases in MS patients may not be due to shared genetic factors and surveillance bias is likely to be the main or possibly the entire explanation. If not entirely explained by surveillance bias, a modestly raised occurrence of comorbid diseases may be due to shared environmental risks or factors related to MS disease characteristics.

摘要

背景

多发性硬化症(MS)患者合并炎症性疾病提示与 MS 存在共同风险。

目的

评估 MS 患者及其父母的免疫介导性疾病风险是否增加。

方法

使用 Cox 回归分析来自瑞典登记处的数据,以比较 MS 患者的 11284 名父亲和 12006 名母亲与无 MS 的对照人群的 123158 名父亲和 129409 名母亲的免疫介导性疾病风险,同时对 20276 名 MS 患者和 203951 名无 MS 患者进行了类似的分析。

结果

MS 患者的父母免疫介导性疾病风险并未显著改变。MS 患者始终存在多种免疫介导性疾病的风险增加:溃疡性结肠炎、克罗恩病、1 型糖尿病、银屑病、多发性关节炎结节和天疱疮。与 MS 发病后诊断的疾病相比,风险更为显著。

结论

MS 患者中其他免疫介导性疾病的发生率增加可能不是由于遗传因素共同导致的,监测偏倚很可能是主要的甚至是全部的解释。如果不能完全用监测偏倚来解释,那么合并疾病的发生率适度增加可能是由于共同的环境风险或与 MS 疾病特征相关的因素所致。

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