Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
Centre for Health Policy School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie Street, Melbourne, VIC, 3053, Australia.
J Neurol. 2021 Feb;268(2):602-612. doi: 10.1007/s00415-020-10194-x. Epub 2020 Sep 3.
Little is known about the change in prevalence of comorbidities during the disease course of people with multiple sclerosis (MS) and whether the prevalences vary by MS onset type.
To calculate the change in prevalence of comorbidities between symptom onset and the time of study, to compare the prevalences of comorbidities with those in the Australian population at the time of study and to examine onset-type differences.
Comorbidity data from 1518 participants of the Australian MS Longitudinal Study and Australian population comparator data (2014-2015 National Health Survey) were used. The change in prevalence between time points and prevalence ratios (PR) at the time of study (crude, age and sex adjusted, and stratified by onset type) was calculated.
Comorbidities were common, and those with the largest increases in prevalence between MS symptom onset and the time of study were depression (+ 26.9%), anxiety (+ 23.1%), hypertension (+ 21.9%), elevated cholesterol (+ 16.3%), osteoarthritis (+ 17.1%), eye diseases (+ 11.6%), osteoporosis (+ 10.9%) and cancer (+ 10.3%). Compared to the general population and after age and sex adjustment, participants had a significantly higher prevalence for 14/19 comorbidities at the time of study. The associations were strongest for anaemia, cancer (both PR > 4.00), anxiety, depression, migraine (all PR > 3.00), psoriasis and epilepsy (both PR > 2.00). No significant differences were seen by onset type.
Comorbidities are common at MS symptom onset and increase with MS duration. Having MS may thus contribute to accrual of comorbidities. This emphasises the importance of optimal screening for and management of comorbidities in early MS and throughout the disease course.
关于多发性硬化症（MS）患者疾病过程中合并症患病率的变化知之甚少，且不同 MS 发病类型的患病率是否存在差异也不得而知。
计算从症状出现到研究时合并症的患病率变化，比较研究时合并症的患病率与当时澳大利亚人群的患病率，并检查发病类型的差异。
使用来自澳大利亚多发性硬化症纵向研究的 1518 名参与者和澳大利亚人群对照数据（2014-2015 年国家健康调查）的合并症数据。计算两个时间点之间的患病率变化和研究时的患病率比值（粗比值、年龄和性别调整比值以及按发病类型分层）。
合并症很常见，从 MS 症状出现到研究时患病率增加最多的是抑郁症（+26.9%）、焦虑症（+23.1%）、高血压（+21.9%）、胆固醇升高（+16.3%）、骨关节炎（+17.1%）、眼部疾病（+11.6%）、骨质疏松症（+10.9%）和癌症（+10.3%）。与一般人群相比，且在年龄和性别调整后，研究时参与者有 14/19 种合并症的患病率显著更高。与贫血、癌症（PR>4.00）、焦虑症、抑郁症、偏头痛（PR>3.00）、银屑病和癫痫（PR>2.00）相关的关联最强。不同发病类型之间未见显著差异。
MS 症状出现时合并症很常见，并随 MS 病程的延长而增加。因此，MS 可能导致合并症的发生。这强调了在早期 MS 和整个疾病过程中对合并症进行最佳筛查和管理的重要性。
