心血管危险因素与多发性硬化症中的病变负担增加和脑萎缩有关。
Cardiovascular risk factors are associated with increased lesion burden and brain atrophy in multiple sclerosis.
机构信息
Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.
Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.
出版信息
J Neurol Neurosurg Psychiatry. 2016 Feb;87(2):181-7. doi: 10.1136/jnnp-2014-310051. Epub 2015 Feb 26.
BACKGROUND
Cardiovascular (CV) risk factors have been associated with changes in clinical outcomes in patients with multiple sclerosis (MS).
OBJECTIVES
To investigate the frequency of CV risks in patients with MS and their association with MRI outcomes.
METHODS
In a prospective study, 326 patients with relapsing-remitting MS and 163 patients with progressive MS, 61 patients with clinically isolated syndrome (CIS) and 175 healthy controls (HCs) were screened for CV risks and scanned on a 3T MRI scanner. Examined CV risks included hypertension, heart disease, smoking, overweight/obesity and type 1 diabetes. MRI measures assessed lesion volumes (LVs) and brain atrophy. Association between individual or multiple CV risks and MRI outcomes was examined adjusting for age, sex, race, disease duration and treatment status.
RESULTS
Patients with MS showed increased frequency of smoking (51.7% vs 36.5%, p = 0.001) and hypertension (33.9% vs 24.7%, p=0.035) compared with HCs. In total, 49.9% of patients with MS and 36% of HCs showed ≥ 2 CV risks (p = 0.003), while the frequency of ≥ 3 CV risks was 18.8% in the MS group and 8.6% in the HCs group (p = 0.002). In patients with MS, hypertension and heart disease were associated with decreased grey matter (GM) and cortical volumes (p < 0.05), while overweight/obesity was associated with increased T1-LV (p < 0.39) and smoking with decreased whole brain volume (p = 0.049). Increased lateral ventricle volume was associated with heart disease (p = 0.029) in CIS.
CONCLUSIONS
Patients with MS with one or more CV risks showed increased lesion burden and more advanced brain atrophy.
背景
心血管（CV）危险因素与多发性硬化症（MS）患者的临床结局变化有关。
目的
调查 MS 患者的 CV 风险频率及其与 MRI 结果的关系。
方法
在一项前瞻性研究中，对 326 例复发缓解型 MS 患者、163 例进展型 MS 患者、61 例临床孤立综合征（CIS）患者和 175 例健康对照者（HCs）进行 CV 风险筛查，并在 3T MRI 扫描仪上进行扫描。检查的 CV 风险包括高血压、心脏病、吸烟、超重/肥胖和 1 型糖尿病。MRI 测量评估了病变体积（LVs）和脑萎缩。在调整年龄、性别、种族、疾病持续时间和治疗状态后，检查了个体或多种 CV 风险与 MRI 结果之间的关系。
结果
与 HCs 相比，MS 患者的吸烟（51.7% vs 36.5%，p = 0.001）和高血压（33.9% vs 24.7%，p=0.035）发生率更高。总的来说，MS 患者中有 49.9%和 HCs 中有 36%有≥2 个 CV 风险（p = 0.003），而 MS 组中有 18.8%和 HCs 组中有 8.6%有≥3 个 CV 风险（p = 0.002）。在 MS 患者中，高血压和心脏病与灰质（GM）和皮质体积减少有关（p < 0.05），而超重/肥胖与 T1-LV 增加有关（p < 0.39），吸烟与全脑体积减少有关（p = 0.049）。在 CIS 中，侧脑室体积增加与心脏病有关（p = 0.029）。
结论
有一个或多个 CV 风险的 MS 患者表现出更高的病变负担和更严重的脑萎缩。
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