Perwieniec Jakub, Podwójcic Krzysztof, Maluchnik Michał, Szeląg Mateusz, Walkiewicz Dorota, Zakrzewski Michał, Droździkowska Amelia, Kamiński Bogumił, Zasybska Adriana, Wnuk Marcin, Słowik Agnieszka, Rejdak Konrad
Department of Analysis and Strategy, Ministry of Health of the Republic of Poland, 00-952 Warsaw, Poland.
Institute of Labour and Social Studies, 01-022 Warsaw, Poland.
J Clin Med. 2021 Aug 26;10(17):3821. doi: 10.3390/jcm10173821.
Increasing evidence supports the observation that multiple sclerosis (MS) has a preclinical period, with various prodromal signs and symptoms more frequently represented in patients with confirmed MS many years later. Considering the apparent gender differences in the incidence and clinical course of MS, it remains unclear whether it could be reflected in prodromal symptom features. This study aimed to compare a broad spectrum of prodromal signs and symptoms between males and females in the 7-year period before the definite diagnosis of MS. Data came from the central register of the national payer of services, financed under the public healthcare system in Poland. They covered a 7-year period of patient health record claims, from 2009 to 2016. The following groups of symptoms were significant with women: musculoskeletal ( < 0.001), ophthalmic ( < 0.001), laryngological ( < 0.001), digestive system ( < 0.001), urinary tract ( < 0.001), mental ( < 0.001), cardiovascular ( < 0.001), complaints and headaches ( < 0.001). There was also a weak correlation with head injuries ( = 0.03) while dermatological and reproductive system complaints did not appear to be significant ( < 0.05). For males, the following groups of symptoms were significant: musculoskeletal ( < 0.001), ophthalmic ( < 0.001), laryngological ( = 0.007), cardiovascular system symptoms ( < 0.001), and headaches ( < 0.001). Interestingly, reproductive system problems were overrepresented in the male population ( = 0.008). There was no significant correlation with MS risk for dermatological, digestive, urinary, and mental complaints. Similarly, head injuries were not significant. Our results shed more light on well-known differences in the epidemiological and clinical characteristics between sexes in multiple sclerosis, and show differences in prodromal complaints before MS onset.
越来越多的证据支持这样一种观点,即多发性硬化症(MS)存在临床前期,多年后确诊为MS的患者中更频繁地出现各种前驱症状和体征。考虑到MS发病率和临床病程中明显的性别差异,目前尚不清楚这是否会在前驱症状特征中得到体现。本研究旨在比较MS确诊前7年男性和女性的一系列前驱症状和体征。数据来自波兰公共医疗系统资助的国家服务支付方中央登记处。数据涵盖了2009年至2016年患者健康记录索赔的7年期间。对女性而言,以下几组症状具有显著性:肌肉骨骼(<0.001)、眼科(<0.001)、喉科(<0.001)、消化系统(<0.001)、泌尿系统(<0.001)、精神(<0.001)、心血管(<0.001)、主诉和头痛(<0.001)。头部受伤也存在微弱相关性(=0.03),而皮肤和生殖系统主诉似乎不具有显著性(<0.05)。对男性而言,以下几组症状具有显著性:肌肉骨骼(<0.001)、眼科(<0.001)、喉科(=0.007)、心血管系统症状(<0.001)和头痛(<0.001)。有趣的是,生殖系统问题在男性人群中更为常见(=0.008)。皮肤、消化、泌尿和精神主诉与MS风险无显著相关性。同样,头部受伤也不具有显著性。我们的研究结果进一步揭示了多发性硬化症在流行病学和临床特征方面众所周知的性别差异,并显示了MS发病前前驱主诉的差异。