肌肉减少症与多发性硬化症残疾的关系。

The relation of sarcopenia and disability in multiple sclerosis.

机构信息

NMR Research Unit, Queen Square Multiple Sclerosis Centre, University College London Institute of Neurology, United Kingdom; Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Austria.

NMR Research Unit, Queen Square Multiple Sclerosis Centre, University College London Institute of Neurology, United Kingdom.

出版信息

Mult Scler Relat Disord. 2023 Sep;77:104855. doi: 10.1016/j.msard.2023.104855. Epub 2023 Jul 3.

DOI:10.1016/j.msard.2023.104855

PMID:37442077

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11752834/

Abstract

BACKGROUND

The relation of sarcopenia and disability in MS is unknown.

OBJECTIVE

To investigate the relation of temporal muscle thickness (TMT) and disability.

METHODS

A cohort of 132 people who presented with a clinically isolated syndrome (CIS) suggestive of MS at a mean age of 30.0 years, were prospectively followed clinically and with MRI over 30-years. TMT and expanded disability status scale (EDSS) were assessed at baseline, one- five- ten- fourteen- twenty- and thirty-year follow-up.

RESULTS

At 30-years, 27 participants remained classified as having had a CIS, 34 converted to relapsing remitting MS, 26 to secondary progressive MS, and 16 had died due to MS. Using linear mixed effect models with subject nested in time, greater annualized TMT-thinning was seen in individuals who developed MS (-0.04 mm/a, 95%CI: -0.07 to -0.01, p = 0.023). In those who converted to MS, a thinner TMT was reached at 14- (p = 0.008), 20- (p = 0.002) and 30-years (p< 0.001). TMT was negatively correlated with EDSS at 20-years (R=-0.18, p = 0.032) and 30-years (R-0.244, p = 0.005). Longitudinally, TMT at earlier timepoints was not predictive for 30-year clinical outcomes.

CONCLUSION

TMT thinning is accelerated in MS and correlated with disability in later disease stages, but is not predictive of future disability.

摘要

背景

肌少症与多发性硬化症（MS）残疾之间的关系尚不清楚。

目的

研究颞肌厚度（TMT）与残疾之间的关系。

方法

对 132 名在平均年龄为 30.0 岁时出现临床孤立综合征（CIS）的患者进行前瞻性队列研究，这些患者的 CIS 提示 MS，随访时间长达 30 年。在基线、1 年、5 年、10 年、14 年和 20 年时评估 TMT 和扩展残疾状况量表（EDSS）。

结果

30 年后，27 名参与者仍被归类为患有 CIS，34 名患者转变为复发缓解型 MS，26 名患者转变为继发进展型 MS，16 名患者因 MS 死亡。使用具有嵌套在时间中的受试者的线性混合效应模型，在发展为 MS 的个体中，TMT 的年平均变薄速度更快（-0.04mm/a，95%CI：-0.07 至-0.01，p=0.023）。在转换为 MS 的患者中，14 年（p=0.008）、20 年（p=0.002）和 30 年（p<0.001）时 TMT 变薄更明显。TMT 与 20 年（R=-0.18，p=0.032）和 30 年（R-0.244，p=0.005）的 EDSS 呈负相关。纵向研究表明，早期 TMT 并不能预测 30 年的临床结局。