Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Department of Clinical Neuroscience, Division of Neurology, Karolinska Institutet Huddinge, Stockholm, Sweden.
Acta Neurol Scand. 2020 Oct;142(4):339-349. doi: 10.1111/ane.13314. Epub 2020 Jul 22.
Risk of multiple sclerosis (MS) is low among first-generation immigrants in Sweden. We aimed to study incident MS in first- and second-generation immigrant groups.
MATERIALS & METHODS: We included adults aged 18 years and older in Sweden in first-generation (n = 6 042 891) and second-generation (n = 4 860 469) sub-studies. MS was defined via two diagnoses in the Swedish National Patient Register. MS risk was estimated by Cox regression, with hazard ratios (HRs) and 95% confidence intervals (CI), in different immigrant groups, using Swedish-born as referents in first-generation sub-study, and individuals with Swedish-born parents in the second-generation. Full models were adjusted for age, geographic residence in Sweden, educational level, marital status, neighborhood socioeconomic status, and co-morbidity.
MS was diagnosed among 10 746 individuals in the first-generation sub-study, (men 3055 and women 7691), and 11 737 in the second-generation sub-study (men 3549 and women 8188) in the period 1998-2015. The annual incidence rate was higher in Swedish-born compared to foreign-born, 11.5 vs 6.3 per 100 000 person-years (age-standardized to the European standard population). Fully adjusted HRs were lower in first-generation immigrant men (HR 0.72, 0.64-0.82) and women (HR 0.67, 0.62-0.73), and in second-generation immigrant men (HR 0.88, 0.79-0.97) and women (HR 0.79; 0.73-0.84). Among first-generation immigrants, lower HRs were found in most groups.
The MS risk was lower in first- and second-generation immigrants compared to Swedish-born or individuals with Swedish-born parents.
在瑞典，第一代移民中多发性硬化症（MS）的风险较低。我们旨在研究第一代和第二代移民群体中多发性硬化症的发病情况。
我们纳入了瑞典第一代（n=6042891 人）和第二代（n=4860469 人）亚研究中年龄在 18 岁及以上的成年人。通过瑞典国家患者登记处的两次诊断来确定 MS。使用第一代亚研究中的瑞典出生者作为参照，以及第二代中具有瑞典出生父母的个体，使用 Cox 回归来估计 MS 风险，计算危险比（HRs）和 95%置信区间（CI）。全模型调整了年龄、在瑞典的地理居住地点、教育程度、婚姻状况、邻里社会经济地位和合并症。
在 1998 年至 2015 年期间，第一代亚研究中诊断出 10746 例 MS（男性 3055 例，女性 7691 例），第二代亚研究中诊断出 11737 例 MS（男性 3549 例，女性 8188 例）。与外国出生者相比，瑞典出生者的年发病率更高，为每 100000 人年 11.5 例比 6.3 例（按欧洲标准人口年龄标准化）。第一代移民男性（HR 0.72，0.64-0.82）和女性（HR 0.67，0.62-0.73），以及第二代移民男性（HR 0.88，0.79-0.97）和女性（HR 0.79；0.73-0.84）的全调整 HR 较低。在第一代移民中，大多数群体的 HR 较低。
与瑞典出生者或具有瑞典出生父母的个体相比，第一代和第二代移民的 MS 风险较低。
