Cho Eun Bin, Yeo Yohwan, Jung Jin Hyung, Jeong Su-Min, Han Kyung-do, Shin Dong Wook, Min Ju-Hong
Department of Neurology, College of Medicine, Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, South Korea.
Department of Neurology, Gyeongsang National University Changwon Hospital, Changwon, South Korea.
J Neurol Neurosurg Psychiatry. 2022 Aug 26. doi: 10.1136/jnnp-2022-329628.
People with multiple sclerosis (MS) are more likely to develop stroke than those without. However, little is known about the association between neuromyelitis optica spectrum disorder (NMOSD) and the risk of stroke. We aimed to estimate the risk of stroke in patients with MS and NMOSD in South Korea.
Data from the Korean National Health Insurance between January 2010 and December 2017 were analysed. A total of 1541/1687 adult patients with MS/NMOSD, who were free of stroke were included. Matched controls were selected based on age, sex and the presence of hypertension, diabetes mellitus and dyslipidaemia.
The risk of developing stroke was 2.78 times higher (adjusted HR (aHR), 95% CI 1.91 to 4.05) in patients with MS compared with controls matched by age, sex, hypertension, diabetes mellitus and dyslipidaemia. The risk of stroke in NMOSD was also higher than that in matched controls (aHR=1.69, 95% CI 1.10 to 2.61) and not statistically different from that of MS (p=0.216). The patients with MS had a higher risk for either of ischaemic or haemorrhagic stroke (HR=2.63 and 2.93, respectively), whereas those with NMOSD had a higher risk for ischaemic stroke (HR=1.60) with marginal statistical significance.
The risk of stroke is increased in patients with MS and NMOSD and seemed comparable between the two conditions. This is the first study that estimates the risk of stroke in patients with MS and NMOSD within the same population.
与未患多发性硬化症（MS）的人相比，MS患者发生中风的可能性更高。然而，关于视神经脊髓炎谱系障碍（NMOSD）与中风风险之间的关联却知之甚少。我们旨在评估韩国MS和NMOSD患者的中风风险。
分析了2010年1月至2017年12月期间韩国国民健康保险的数据。共纳入了1541/1687例无中风的成年MS/NMOSD患者。根据年龄、性别以及是否存在高血压、糖尿病和血脂异常选择匹配的对照组。
与年龄、性别、高血压、糖尿病和血脂异常匹配的对照组相比，MS患者发生中风的风险高2.78倍（调整后风险比（aHR），95%置信区间1.91至4.05）。NMOSD患者的中风风险也高于匹配的对照组（aHR = 1.69，95%置信区间1.10至2.61），且与MS患者的中风风险无统计学差异（p = 0.216）。MS患者发生缺血性或出血性中风的风险均较高（风险比分别为2.63和2.93），而NMOSD患者发生缺血性中风的风险较高（风险比 = 1.60），具有边缘统计学意义。
MS和NMOSD患者的中风风险增加，且两种疾病的风险似乎相当。这是第一项在同一人群中评估MS和NMOSD患者中风风险的研究。
