男性青春期后期近视与随后的多发性硬化症

Myopia in late adolescence and subsequent multiple sclerosis among men.

作者信息

Hiyoshi Ayako, Hawkes Christopher H, Neffendorf James E, Olsson Tomas, Giovannoni Gavin, Montgomery Scott

机构信息

Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Campus USÖ, Södra Grev Rosengatan 30, Örebro 703 62, Sweden; Department of Public Health Sciences, Stockholm University, Stockholm SE-106 91, Sweden; Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom.

Neuroimmunology Unit, Blizard Institute, Queen Mary, University of London, UK.

出版信息

Mult Scler Relat Disord. 2023 Mar;71:104577. doi: 10.1016/j.msard.2023.104577. Epub 2023 Feb 15.

DOI:10.1016/j.msard.2023.104577

PMID:36863085

Abstract

BACKGROUND

Risk factors such as low vitamin D level has been implicated in the etiology of multiple sclerosis (MS) and may be relevant to myopia, such that there may be an association between myopia and MS.

METHODS

Using linked Swedish national register data, we conducted a cohort study of men who were born in Sweden between 1950 and 1992, lived in Sweden between 1990 and 2018, and enrolled in military conscription assessment (n = 1,847,754). Myopia was defined based on the spherical equivalent refraction measured at conscription assessment, around age 18 years. Multiple sclerosis was identified using the Patient Register. Cox regression produced hazard ratios (HR) with 95% confidence intervals (95% CI), with adjustment for demographic and childhood socioeconomic characteristics and residential region. Due to changes in the assessment of refractive error, the analysis was stratified into two groups by the year of conscription assessment: 1969-1997 and 1997-2010.

RESULTS

Among 1,559,859 individuals during a maximum of 48 years of follow-up from age 20 to 68 years (44,715,603 person-years), there were 3,134 MS events, and the incidence rate 7.0 (95% CI [6.8, 7.3] per 100,000 person-years). Among individuals with conscription assessments during 1997-2010, there were 380 MS events. There was no evidence of an association between myopia and MS, with HR 1.09 (95% CI 0.83, 1.43). Among individuals who underwent conscription assessment in 1969-1997, there were 2754 MS events. After adjusting for all covariates, there was no evidence of an association between myopia and MS (HR 0.99 [95% CI 0.91, 1.09]).

CONCLUSION

Myopia in late adolescence is not associated with a subsequent raised risk of MS and thus there does not appear to be important shared risk factors.

摘要

背景

低维生素D水平等风险因素已被认为与多发性硬化症（MS）的病因有关，并且可能与近视相关，因此近视与MS之间可能存在关联。

方法

利用瑞典国家关联登记数据，我们对1950年至1992年在瑞典出生、1990年至2018年居住在瑞典且参加过征兵评估的男性进行了一项队列研究（n = 1,847,754）。近视根据征兵评估时（约18岁）测量的等效球镜度来定义。使用患者登记册确定多发性硬化症。Cox回归得出风险比（HR）及95%置信区间（95%CI），并对人口统计学和儿童期社会经济特征以及居住地区进行了调整。由于屈光不正评估方法的变化，分析按征兵评估年份分为两组：1969 - 1997年和1997 - 2010年。

结果

在1,559,859名个体中，从20岁到68岁进行了最长48年的随访（44,715,603人年），有3134例MS事件，发病率为每10万人年7.0（95%CI[6.8, 7.3]）。在1997 - 2010年进行征兵评估的个体中，有380例MS事件。没有证据表明近视与MS之间存在关联，HR为1.09（95%CI 0.83, 1.43）。在1969 - 1997年接受征兵评估的个体中，有2754例MS事件。在对所有协变量进行调整后，没有证据表明近视与MS之间存在关联（HR 0.99[95%CI 0.91, 1.09]）。