Makkawi Seraj, Aljabri Ammar, Bin Lajdam Ghassan, Albakistani Ammar, Aljohani Abdulrahman, Labban Suhail, Felemban Razaz
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
Front Neurol. 2022 Mar 14;13:862120. doi: 10.3389/fneur.2022.862120. eCollection 2022.
Multiple sclerosis (MS) is becoming a global subject of study in which some demographic variations are thought to be correlated with its activity. Relapsing-remitting multiple sclerosis (RRMS) is the most common demyelinating disorder, characterized by periods of exacerbating attacks, followed by partial or complete remission. Several factors might play a role in disease progression and relapse frequency, such as vitamin D, ultraviolet B radiation, estrogen levels, smoking, obesity, and unhealthy lifestyles. In this study, we identified the relationship between seasonal variation and relapse rate and correlated the latter with sex, age, and vitamin D levels in patients with RRMS in Jeddah, Saudi Arabia. We retrospectively collected data from 182 RRMS patients between 2016 and 2021. A total of 219 relapses were documented in 106 patients (58.2 %). The relapse per patient ratio showed a sinusoidal pattern, peaking in January at a rate of 0.49 and troughed in June at a rate of 0.18. There was no difference in relapse rates between men and women ( =0.280). There was a significant negative correlation between vitamin D levels and relapse rate ( = -0.312, =0.024). Therefore, the relapse rate was higher during the winter and was correlated with low vitamin D levels. However, relapses are likely multifactorial, and more population-based studies are needed to understand the role of environmental variables in MS exacerbation. A better understanding of this relationship will allow for improved treatment and possibly better prevention of relapse.
多发性硬化症（MS）正成为一个全球性的研究课题，人们认为某些人口统计学差异与其活动相关。复发缓解型多发性硬化症（RRMS）是最常见的脱髓鞘疾病，其特征是发作加剧期，随后是部分或完全缓解期。几个因素可能在疾病进展和复发频率中起作用，如维生素D、紫外线B辐射、雌激素水平、吸烟、肥胖和不健康的生活方式。在本研究中，我们确定了沙特阿拉伯吉达RRMS患者的季节变化与复发率之间的关系，并将后者与性别、年龄和维生素D水平相关联。我们回顾性收集了2016年至2021年间182例RRMS患者的数据。106例患者（58.2%）共记录到219次复发。每位患者的复发率呈正弦模式，1月份达到峰值，为0.49，6月份降至谷底，为0.18。男性和女性的复发率没有差异（=0.280）。维生素D水平与复发率之间存在显著负相关（=-0.312，=0.024）。因此，冬季复发率较高，且与低维生素D水平相关。然而，复发可能是多因素的，需要更多基于人群的研究来了解环境变量在MS加重中的作用。更好地理解这种关系将有助于改善治疗，并可能更好地预防复发。
