Department of Research and Evaluation, Kaiser Permanente, Southern California, Pasadena, CA, USA.
Neurology. 2013 May 7;80(19):1734-9. doi: 10.1212/WNL.0b013e3182918cc2.
To determine whether the incidence of multiple sclerosis (MS) varies by race/ethnicity in a multiethnic, population-based cohort.
We conducted a retrospective cohort study of more than 9 million person-years of observation from the multiethnic, community-dwelling members of Kaiser Permanente Southern California health plan from January 1, 2008 to December 31, 2010. Incidence of MS and risk ratios comparing incidence rates between racial/ethnic groups were calculated using Poisson regression.
We identified 496 patients newly diagnosed with MS who met McDonald criteria. The average age at diagnosis was 41.6 years (range 8.6-78.3 years) and 70.2% were women. The female preponderance was more pronounced among black (79.3%) than white, Hispanic, and Asian individuals with MS (67.8%, 68.1%, and 69.2%, respectively; p = 0.03). The incidence of MS was higher in blacks (10.2, 95% confidence interval [CI] 8.4-12.4; p < 0.0001) and lower in Hispanics (2.9, 95% CI 2.4-3.5; p < 0.0001) and Asians (1.4, 95% CI 0.7-2.4; p < 0.0001) than whites (6.9, 95% CI 6.1-7.8). Black women had a higher risk of MS (risk ratio 1.59, 95% CI 1.27-1.99; p = 0.0005) whereas black men had a similar risk of MS (risk ratio 1.04, 95% CI = 0.67-1.57) compared with whites.
Our findings do not support the widely accepted assertion that blacks have a lower risk of MS than whites. A possible explanation for our findings is that people with darker skin tones have lower vitamin D levels and thereby an increased risk of MS, but this would not explain why Hispanics and Asians have a lower risk of MS than whites or why the higher risk of MS among blacks was found only among women.
在一个多民族的基于人群的队列中，确定多发性硬化症（MS）的发病率是否因种族/民族而异。
我们对 2008 年 1 月 1 日至 2010 年 12 月 31 日期间，来自 Kaiser Permanente 南加州健康计划的多民族、社区居住成员的超过 900 万人年的观察进行了回顾性队列研究。使用泊松回归计算 MS 的发病率和比较不同种族/民族组发病率的风险比。
我们发现了 496 名符合麦克唐纳标准的新诊断为 MS 的患者。诊断时的平均年龄为 41.6 岁（范围 8.6-78.3 岁），70.2%为女性。患有 MS 的黑人（79.3%）比白人、西班牙裔和亚裔女性的女性优势更为明显（67.8%、68.1%和 69.2%，分别；p=0.03）。黑人的 MS 发病率较高（10.2，95%置信区间[CI]8.4-12.4；p<0.0001），西班牙裔（2.9，95%CI2.4-3.5；p<0.0001）和亚裔（1.4，95%CI0.7-2.4；p<0.0001）的发病率较低。白人（6.9，95%CI6.1-7.8）。黑人女性患 MS 的风险更高（风险比 1.59，95%CI1.27-1.99；p=0.0005），而黑人男性患 MS 的风险与白人相似（风险比 1.04，95%CI=0.67-1.57）。
我们的研究结果不支持黑人患 MS 的风险低于白人的普遍观点。我们研究结果的一个可能解释是，肤色较深的人维生素 D 水平较低，因此患 MS 的风险增加，但这并不能解释为什么西班牙裔和亚裔患 MS 的风险低于白人，或者为什么黑人患 MS 的风险较高仅在女性中发现。
