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多发性硬化症是动脉粥样硬化的一个风险因素吗?

Is multiple sclerosis a risk factor for atherosclerosis?

作者信息

Yuksel Burcu, Koc Pinar, Ozaydin Goksu Eylem, Karacay Ertan, Kurtulus Fatma, Cekin Yesim, Bicer Gomceli Yasemin

机构信息

Antalya Training and Research Hospital, Neurology Department, Muratpasa, 07050 Antalya, Turkey.

Antalya Training and Research Hospital, Radiology Department, Muratpasa, 07050 Antalya, Turkey.

出版信息

J Neuroradiol. 2021 Mar;48(2):99-103. doi: 10.1016/j.neurad.2019.10.002. Epub 2019 Nov 7.

Abstract

BACKGROUND

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. We aimed to discuss possible predisposing factors to atherosclerosis such as carotid intima-media thickness (CIMT) and high-sensitivity C-reactive protein (Hs-CRP) levels in MS.

METHODS

Thirty-five ambulatory patients with relapsing-remitting MS (RRMS) (22 females and 13 males) and 34 healthy controls (21 females and 13 males) with similar demographic variables were included. Blood cell counts, cholesterol levels, vitamin D and B12, Hs-CRP levels, body mass index (BMI), history of smoking, and CIMT of both groups, Expanded Disability Status Scale (EDSS) scores, and disease duration of patients were recorded. Patients with a history of other vascular diseases such as hypertension, diabetes mellitus, peripheral artery disease, and acute relapses were excluded.

RESULTS

Sixty-nine participants were included. The mean age of the study population was 35.8±7.1 years. Right CIMT was significantly greater in the patient population (P<0.001). Spearman's correlation coefficient between age and right CIMT was r=0.41, P=0.01. When we compared the Hs-CRP with a cut-off value of ≤3, the right, left, and mean CIMT levels were not statistically significant (P=0.17; P=0.22; P=0.15). The mean serum vitamin D levels were higher in the patient group and this was statistically significant (P<0.001). The statistically significant factors identified with univariate analysis with P<0.2 were further entered into multivariate modelling.

CONCLUSION

CIMT seems to be affected in patients with MS by means of the disease itself and age. Thus, CIMT might reflect the predisposition to subclinical atherosclerosis more than Hs-CRP. Further investigation in a large MS population is still needed.

摘要

背景

多发性硬化症(MS)是一种中枢神经系统的炎性脱髓鞘疾病。我们旨在探讨多发性硬化症患者动脉粥样硬化的可能诱发因素,如颈动脉内膜中层厚度(CIMT)和高敏C反应蛋白(Hs-CRP)水平。

方法

纳入35例复发缓解型多发性硬化症(RRMS)门诊患者(22例女性和13例男性)以及34例具有相似人口统计学变量的健康对照者(21例女性和13例男性)。记录两组的血细胞计数、胆固醇水平、维生素D和B12、Hs-CRP水平、体重指数(BMI)、吸烟史以及CIMT,患者的扩展残疾状态量表(EDSS)评分和病程。排除有高血压、糖尿病、外周动脉疾病等其他血管疾病病史以及急性复发的患者。

结果

共纳入69名参与者。研究人群的平均年龄为35.8±7.1岁。患者人群的右侧CIMT显著更高(P<0.001)。年龄与右侧CIMT之间斯皮尔曼相关系数为r=0.41,P=0.01。当我们将Hs-CRP与≤3的临界值进行比较时,右侧、左侧及平均CIMT水平无统计学意义(P=0.17;P=0.22;P=0.15)。患者组的平均血清维生素D水平更高,且具有统计学意义(P<0.001)。单因素分析中P<0.2的具有统计学意义因素进一步纳入多变量模型。

结论

多发性硬化症患者的CIMT似乎受疾病本身和年龄的影响。因此,CIMT可能比Hs-CRP更能反映亚临床动脉粥样硬化的易感性。仍需要在大量多发性硬化症人群中进行进一步研究。

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