多发性硬化症中的性功能及其与人口统计学、疾病和生活方式特征的关联：一项国际横断面研究。
Sexual function in multiple sclerosis and associations with demographic, disease and lifestyle characteristics: an international cross-sectional study.
作者信息
Marck Claudia H, Jelinek Pia L, Weiland Tracey J, Hocking Jane S, De Livera Alysha M, Taylor Keryn L, Neate Sandra L, Pereira Naresh G, Jelinek George A
机构信息
Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, 3065, VIC, Australia.
School of Medicine, Notre Dame University, Fremantle, WA, Australia.
出版信息
BMC Neurol. 2016 Nov 4;16(1):210. doi: 10.1186/s12883-016-0735-8.
BACKGROUND
Sexual dysfunction (SD) is very common in people with multiple sclerosis (PwMS) and contributes a significant burden of disease, particularly for young people. SD has direct neurological contributions from depression and fatigue, which occur commonly in PwMS. Modifiable factors may represent potential targets for treatment and prevention of SD. We aimed to assess the prevalence of SD and explore associations between SD and demographic and modifiable risk factors, as well as depression and fatigue in a large cohort of PwMS.
METHODS
We analysed self-reported data from a large, international sample of PwMS recruited via Web 2.0 platforms, including demographic, lifestyle and disease characteristics. Specific sexual function questions included 4 items from the sexual function scale and 1 item regarding satisfaction with sexual function, part of the MS Quality of Life-54 instrument.
RESULTS
2062 PwMS from 54 countries completed questions on sexual function. 81.1 % were women, mean age was 45 years, most (62.8 %) reported having relapsing-remitting MS. The majority (54.5 %) reported one or more problems with sexual function and were classified as having SD. Lack of sexual interest (41.8 % of women), and difficulty with erection (40.7 % of men) were most common. The median total sexual function score was 75.0 out of 100, and 43.7 % were satisfied with their sexual function. Regression modeling revealed independent associations between sexual function and satisfaction and a range of demographic factors, including age, as well as depression risk, antidepressant use, and fatigue in PwMS.
CONCLUSION
This cross-sectional study shows that SD and lack of satisfaction with sexual function are associated with depression risk and fatigue, as well as modifiable lifestyle factors diet and physical activity (after adjusting for depression and fatigue). Planned longitudinal follow-up of this sample may help clarify these associations and the underlying mechanisms. There is potential to prevent and treat SD in PwMS by addressing depression and fatigue and their determinants. Clinicians and PwMS should be aware of SD and associated factors as part of a comprehensive preventive approach to managing MS.
背景
性功能障碍（SD）在多发性硬化症患者（PwMS）中非常常见，并且造成了重大的疾病负担，尤其是对年轻人而言。SD直接受到抑郁症和疲劳的神经学影响，而抑郁症和疲劳在PwMS中很常见。可改变的因素可能是治疗和预防SD的潜在靶点。我们旨在评估SD的患病率，并探讨SD与人口统计学和可改变的风险因素之间的关联，以及在一大群PwMS中SD与抑郁症和疲劳之间的关联。
方法
我们分析了通过网络2.0平台招募的来自大型国际PwMS样本的自我报告数据，包括人口统计学、生活方式和疾病特征。特定的性功能问题包括性功能量表中的4个项目以及1个关于性功能满意度的项目，这是多发性硬化症生活质量-54工具的一部分。
结果
来自54个国家的2062名PwMS完成了性功能问题调查。其中81.1%为女性，平均年龄为45岁，大多数（62.8%）报告患有复发缓解型多发性硬化症。大多数（54.5%）报告存在一个或多个性功能问题，并被归类为患有SD。缺乏性兴趣（41.8%的女性）和勃起困难（40.7%的男性）最为常见。性功能总得分中位数为100分中的75.0分，43.7%的人对其性功能感到满意。回归模型显示性功能和满意度与一系列人口统计学因素之间存在独立关联，包括年龄，以及PwMS中的抑郁风险、抗抑郁药使用和疲劳。
结论
这项横断面研究表明，SD和对性功能的不满意与抑郁风险和疲劳以及可改变的生活方式因素（饮食和体育活动，在调整抑郁和疲劳因素后）相关。对该样本进行计划中的纵向随访可能有助于阐明这些关联及其潜在机制。通过解决抑郁症和疲劳及其决定因素，有可能预防和治疗PwMS中的SD。临床医生和PwMS应意识到SD及相关因素，将其作为管理多发性硬化症综合预防方法的一部分。
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