Pinhas-Hamiel O, Livne M, Harari G, Achiron A
Pediatric Endocrinology and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel.
Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Eur J Neurol. 2015 Sep;22(9):1275-9. doi: 10.1111/ene.12738. Epub 2015 May 14.
Information about metabolic comorbidities in patients with multiple sclerosis (MS) is scarce. Our aim was to examine the prevalence of the metabolic syndrome (MetS) and its components in patients with long duration of MS and significant disability.
Demographic and clinical data, weight, height, waist circumference, blood pressure, and levels of fasting glucose, triglycerides and high density lipoprotein cholesterol (HDL-C) were obtained from 130 MS patients with Extended Disability Status Scale (EDSS) score ≥3.0.
Seventy-two percent were female, mean ± SD age 55.8 ± 6.0, range 45-65 years, disease duration 18.2 ± 10.1 years, EDSS 5.5 ± 1.0. Obesity [body mass index (BMI) ≥ 30 kg/m(2) ] was present in 18.5% and overweight (BMI 25.0-29.9 kg/m(2) ) in 34.6%. The prevalence of the MetS was 30% with no gender difference. Fifty-six percent had central obesity by waist circumference, 28% treated hypertension, 45.8% elevated blood pressure, 11% type 2 diabetes mellitus, 31.4% treated dyslipidemia, 28.8% elevated triglyceride levels and 31.4% had low HDL-C. MS patients with MetS were significantly older (59.0 ± 5.5 vs. 53.8 ± 5.5, P < 0.0001) and heavier (BMI 29.0 ± 6.9 vs. 25.1 ± 4.7, P = 0.0009). There were no differences between the groups in neurological disability by the EDSS (5.7 ± 1.0 vs. 5.4 ± 1.0), disease duration (18.4 ± 9.9 vs. 18.2 ± 10.2 years) and number of steroid courses received (6.6 ± 9.5 vs. 6.3 ± 8.4).
Compared to the general population, adult disabled MS patients had lower rates of obesity and overweight, as assessed by BMI. Despite these reduced rates, the prevalence of the MetS was similar to the general population. Specifically higher rates of increased waist circumference were found, suggesting that the lower BMI may be misleading in terms of health risk.
关于多发性硬化症（MS）患者代谢合并症的信息较少。我们的目的是研究病程较长且有明显残疾的MS患者中代谢综合征（MetS）及其各组分的患病率。
从130例扩展残疾状态量表（EDSS）评分≥3.0的MS患者中获取人口统计学和临床数据、体重、身高、腰围、血压以及空腹血糖、甘油三酯和高密度脂蛋白胆固醇（HDL-C）水平。
72%为女性，平均±标准差年龄55.8±6.0岁，范围45 - 65岁，病程18.2±10.1年，EDSS为5.5±1.0。肥胖[体重指数（BMI）≥30 kg/m²]的发生率为18.5%，超重（BMI 25.0 - 29.9 kg/m²）的发生率为34.6%。MetS的患病率为30%，无性别差异。56%的患者通过腰围判断有中心性肥胖，28%接受过高血压治疗，45.8%血压升高，11%患有2型糖尿病，31.4%接受过血脂异常治疗，28.8%甘油三酯水平升高，31.4%HDL-C水平较低。患有MetS的MS患者年龄显著更大（59.0±5.5对53.8±5.5，P < 0.0001）且体重更重（BMI 29.0±6.9对25.1±4.7，P = 0.0009）。两组在EDSS评估的神经功能残疾程度（5.7±1.0对5.4±1.0）、病程（18. April 4±9.9对18.2±10.2年）以及接受类固醇疗程的次数（6.6±9.5对6.3±8.4）方面无差异。
与一般人群相比，通过BMI评估，成年残疾MS患者的肥胖和超重发生率较低。尽管发生率降低，但MetS的患病率与一般人群相似。具体而言，发现腰围增加的发生率较高，这表明较低的BMI在健康风险方面可能具有误导性。
