Maric Gorica D, Pekmezovic Tatjana D, Mesaros Sarlota T, Tamas Olivera S, Ivanovic Jovana B, Martinovic Vanja N, Andabaka Marko M, Jovanovic Aleksa Lj, Veselinovic Nikola D, Kisic-Tepavcevic Darija B, Drulovic Jelena S
Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Department of the CNS Immune-Mediated Disorders, Clinic of Neurology, Clinical Center of Serbia, Belgrade, Serbia.
Neurol Sci. 2021 May;42(5):1887-1893. doi: 10.1007/s10072-020-04727-5. Epub 2020 Sep 22.
Comorbidities occur frequently in persons with multiple sclerosis (MS). The aim of the present study was to determine the prevalence of the most common comorbidities in the population of MS patients in Belgrade, Serbia.
Data on diagnosed and fully documented comorbidities were taken from the Belgrade MS population registry. The list of explored comorbidities included cardiovascular, malignant, and autoimmune diseases; psychiatric disorders; epilepsy; and type 2 diabetes. In the data analysis, crude, age- and gender-specific, and age-adjusted prevalence was calculated. Additionally, comorbidities were analyzed in patients with various MS phenotypes.
The most prevalent group of comorbidities were psychiatric (prevalence (Prev) = 20.59%, 95% CI 19.10-22.17) and cardiovascular comorbidities (Prev = 15.23%, 95% CI 13.93-16.63). The most prevalent single comorbidities were depression (Prev = 11.82%, 95% CI 10.64-13.11) and hypertension (Prev = 11.41%, 95% CI 10.25-12.68). Type 2 diabetes was significantly more prevalent in patients with primary progressive MS compared with the patients with relapsing-remitting and secondary progressive MS (p < 0.001). We found statistically significant positive correlation between number of comorbidities and progression index (p < 0.001). Patients treated with disease-modifying therapies (DMTs) had significantly higher risk of developing comorbidity, after treatment initiation, compared with those who were untreated (p = 0.001).
Our study demonstrated high prevalence of comorbidities in persons with MS, with psychiatric and cardiovascular diseases being the most common. Furthermore, our findings confirmed the association of comorbidities with progression of disability and emphasized their role in treatment decision-making in MS.
合并症在多发性硬化症（MS）患者中频繁出现。本研究的目的是确定塞尔维亚贝尔格莱德MS患者群体中最常见合并症的患病率。
已诊断且有完整记录的合并症数据取自贝尔格莱德MS人群登记处。所探究的合并症列表包括心血管疾病、恶性疾病和自身免疫性疾病；精神障碍；癫痫；以及2型糖尿病。在数据分析中，计算了粗患病率、年龄和性别特异性患病率以及年龄调整患病率。此外，还对不同MS表型的患者的合并症进行了分析。
最常见的合并症类别是精神疾病（患病率（Prev）=20.59%，95%置信区间19.10 - 22.17）和心血管合并症（Prev = 15.23%，95%置信区间13.93 - 16.63）。最常见的单一合并症是抑郁症（Prev = 11.82%，95%置信区间10.64 - 13.11）和高血压（Prev = 11.41%，95%置信区间10.25 - 12.68）。与复发缓解型和继发进展型MS患者相比，原发性进展型MS患者的2型糖尿病患病率显著更高（p < 0.001）。我们发现合并症数量与进展指数之间存在统计学上显著的正相关（p < 0.001）。与未接受治疗的患者相比，接受疾病修正治疗（DMTs）的患者在开始治疗后发生合并症的风险显著更高（p = 0.001）。
我们的研究表明MS患者中合并症的患病率很高，其中精神疾病和心血管疾病最为常见。此外，我们的研究结果证实了合并症与残疾进展之间的关联，并强调了它们在MS治疗决策中的作用。
