Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Republic of Korea; Department of Neuropsychiatry, Uijeongbu St. Mary's Hospital, Gyeonggi-do, Republic of Korea.
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Bundang-gu, Seongnam, Republic of Korea.
Sci Total Environ. 2020 Jun 10;720:137565. doi: 10.1016/j.scitotenv.2020.137565. Epub 2020 Feb 25.
Although multiple sclerosis (MS) has been the leading cause of neurologically-induced disability in young adults, risk factors for the relapse and acute aggravation of MS remain unclear. A few studies have suggested a possible role of temperature changes on the relapse and acute aggravation of MS. We investigated the association between short-term exposure to wide diurnal temperature ranges (DTRs) and acute exacerbation of MS requiring an emergency department (ED) visit. A total of 1265 patients visited EDs for acute aggravation of MS as the primary disease in Seoul between 2008 and 2014 from the national emergency database. We conducted a conditional logistic regression analysis of the time-stratified case-crossover design to compare DTRs on the ED visit days for MS and those on control days matched according to the day of the week, month, and year. We examined possible associations with other temperature-related variables (ambient temperature, between-day temperature change, and sunlight hours). Short-term exposure to wide DTRs immediately increased the risk of ED visits for MS. Especially, 2-day average (lag0-1) DTR levels on the day of and one day prior to ED visits exhibited the strongest association (an 8.81% [95% CI: 3.46%-14.44%] change in the odds ratio per 1 °C increase in the DTR). Other temperature-related variables were not associated with MS aggravation. Our results suggest that exposure to wider DTR may increase the risk of acute exacerbation of MS. Given the increasing societal burden of MS and the increasing temperature variability due to climate change, further studies are required.
虽然多发性硬化症 (MS) 一直是导致年轻人神经功能障碍的主要原因，但 MS 复发和急性加重的风险因素仍不清楚。一些研究表明，温度变化可能与 MS 的复发和急性加重有关。我们研究了短期暴露于较大日温差 (DTR) 与需要急诊就诊 (ED) 的 MS 急性加重之间的关系。在 2008 年至 2014 年间，从全国急诊数据库中，我们共收集了 1265 名因 MS 急性加重而在首尔急诊就诊的患者。我们采用时间分层病例交叉设计进行条件逻辑回归分析，比较了 MS 就诊日的 DTR 与根据周、月和年匹配的对照日的 DTR。我们检查了与其他与温度相关的变量（环境温度、日温差和日照时间）的可能关联。短期暴露于较大的 DTR 会立即增加 MS 患者 ED 就诊的风险。特别是 ED 就诊日及其前一天的 2 天平均 (lag0-1) DTR 水平与 ED 就诊风险相关性最强（DTR 每升高 1°C，比值比增加 8.81%[95%CI：3.46%-14.44%]）。其他与温度相关的变量与 MS 加重无关。我们的结果表明，暴露于更大的 DTR 可能会增加 MS 急性加重的风险。鉴于 MS 的社会负担不断增加以及气候变化导致的温度变异性增加，需要进一步研究。
