Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Eur J Neurol. 2024 Jun;31(6):e16269. doi: 10.1111/ene.16269. Epub 2024 Mar 5.
Higher latitude has been associated with increased occurrence of multiple sclerosis (MS) and with more severe disease. The aim was to study the impact of sun exposure habits on MS disease progression and health-related quality of life.
Patients from a population-based case-control study were categorized based on sun exposure habits at diagnosis and were followed up to 15 years post-diagnosis through the Swedish MS registry (n = 3314) with regard to changes in Expanded Disability Status Scale (EDSS). Linear mixed models were used to analyse long-term changes, while Cox regression models, with 95% confidence intervals, were used to investigate outcomes, including 24-week confirmed diasability worsening, EDSS3, EDSS4, and physical worsening as measured by the physical component of the Multiple Sclerosis Impact Scale 29.
Compared to average sun exposure (median value), low exposure to sunlight was associated with faster EDSS progression, increased risk of confirmed disability worsening (hazard ratio [HR] 1.48, 95% CI 1.21-1.81), increased risk of reaching EDSS 3 (HR 1.35, 95% CI 1.02-1.79), EDSS 4 (HR 1.47, 95% CI 1.01-2.20) and self-reported physical worsening (HR 1.27, 95% CI 1.00-1.62). Significant trends revealed a lower risk of unfavourable outcomes with increasing sun exposure.
Very low levels of sun exposure are associated with worse disease progression and health-related quality of life in patients with MS.
更高的纬度与多发性硬化症（MS）的发生率增加以及更严重的疾病有关。本研究旨在研究阳光暴露习惯对 MS 疾病进展和健康相关生活质量的影响。
根据诊断时的阳光暴露习惯，对来自基于人群的病例对照研究的患者进行分类，并通过瑞典 MS 登记处（n=3314）进行随访，随访时间长达 15 年，以评估扩展残疾状况量表（EDSS）的变化。使用线性混合模型分析长期变化，而使用 Cox 回归模型（95%置信区间）调查结局，包括 24 周确认残疾恶化、EDSS3、EDSS4 和物理恶化，使用多发性硬化症影响量表 29 的物理分量进行测量。
与平均阳光暴露（中位数）相比，低阳光暴露与 EDSS 进展更快相关，确认残疾恶化的风险增加（风险比 [HR] 1.48，95%置信区间 1.21-1.81），达到 EDSS 3（HR 1.35，95%置信区间 1.02-1.79）、EDSS 4（HR 1.47，95%置信区间 1.01-2.20）和自我报告的物理恶化（HR 1.27，95%置信区间 1.00-1.62）的风险增加。随着阳光暴露的增加，不良结局的风险呈下降趋势。
极低水平的阳光暴露与 MS 患者的疾病进展和健康相关生活质量较差相关。
