Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden/Department of Translational Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden/Centre for Pharmacoepidemiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
Mult Scler. 2021 Feb;27(2):268-280. doi: 10.1177/1352458520910497. Epub 2020 Mar 12.
People with multiple sclerosis (pwMS) have increased comorbid disease (CMD) risk. Most previous studies have not considered overall CMD burden.
To describe lifetime CMD burden among pwMS.
PwMS identified using Swedish registers between 1968 and 2012 ( = 25,476) were matched by sex, age, and county of residence with general-population comparators ( = 251,170). Prevalence, prevalence ratios (PRs), survival functions, and hazard ratios by MS status, age, and time period compared seven CMD: autoimmune, cardiovascular, depression, diabetes, respiratory, renal, and seizures.
The magnitude of the PRs for each CMD and age group decreased across time, with higher PRs in earlier time periods. Before 1990, younger age groups had higher PRs, and after 1990, older age groups had higher PRs. Male pwMS had higher burden compared with females. Overall, renal, respiratory, and seizures had the highest PRs. Before 2001, 50% of pwMS received a first/additional CMD diagnosis 20 years prior to people without MS, which reduced to 4 years after 2001. PwMS had four times higher rates of first/additional diagnoses in earlier time periods, which reduced to less than two times higher in recent time periods compared to people without MS.
Swedish pwMS have increased CMD burden compared with the general population, but this has reduced over time.
多发性硬化症（pwMS）患者合并症（CMD）风险增加。大多数既往研究未考虑整体 CMD 负担。
描述 pwMS 的终生 CMD 负担。
1968 年至 2012 年间，通过瑞典登记处识别出的 pwMS（n=25476），按性别、年龄和居住地与一般人群对照（n=251170）进行匹配。比较了七种 CMD 的患病率、患病率比（PR）、生存函数和 MS 状态、年龄和时间段的风险比：自身免疫性疾病、心血管疾病、抑郁、糖尿病、呼吸系统疾病、肾脏疾病和癫痫。
每种 CMD 和年龄组的 PR 随着时间的推移而降低，早期时间点的 PR 更高。1990 年之前，年龄较小的组 PR 更高，1990 年之后，年龄较大的组 PR 更高。男性 pwMS 的负担高于女性。总体而言，肾脏疾病、呼吸系统疾病和癫痫的 PR 最高。2001 年之前，50%的 pwMS 在 MS 发病前 20 年被诊断出首次/附加 CMD，而在 2001 年之后，这一比例减少到 4 年。与无 MS 人群相比，pwMS 在早期时间段的首次/附加诊断率高四倍，而在最近时间段的诊断率则低至不到两倍。
与一般人群相比，瑞典 pwMS 的 CMD 负担增加，但随着时间的推移有所减轻。
