多发性硬化症和视神经脊髓炎谱系疾病患者 2 型糖尿病的患病风险：一项全国性队列研究。
The risk of type 2 diabetes mellitus in multiple sclerosis and neuromyelitis optica spectrum disorder: A nationwide cohort study.
机构信息
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.
Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea.
出版信息
Mult Scler Relat Disord. 2024 May;85:105519. doi: 10.1016/j.msard.2024.105519. Epub 2024 Feb 27.
BACKGROUND AND OBJECTIVES
An association has been suggested between premorbid type 2 diabetes mellitus (T2DM) and the risk of multiple sclerosis (MS). However, little is known about the risk of developing T2DM in MS and neuromyelitis optica spectrum disorder (NMOSD). This study aimed to determine the T2DM risk in patients with MS and NMSOD.
METHODS
The Korean National Health Insurance Service database was analyzed, and 1,801 and 1,721 adults with MS and NMOSD, respectively, who were free of T2DM between January 2010 and December 2017, were included. Matched controls were selected based on age, sex, and the presence of hypertension and dyslipidemia.
RESULTS
The risk of developing T2DM was 1.54 times higher in NMOSD than in the controls (adjusted hazard ratio [aHR], 95 % confidence interval [CI] = 1.20-1.96). However, increased T2DM risk was not observed in MS (aHR = 1.13, 95 % CI = 0.91-1.42). The T2DM risk in patients with NMOSD was higher in those who received steroid treatment (aHR = 1.77, 95 % CI = 1.36-2.30) but not in those who did not (aHR = 0.59, 95 % CI = 0.24-1.43, p for interaction = 0.02).
DISCUSSION
T2DM risk was increased in NMOSD but not in MS. Administering steroid treatment to patients with NMOSD may increase their T2DM risk.
背景与目的
先前的研究表明，2 型糖尿病（T2DM）与多发性硬化症（MS）的发病风险之间存在关联。然而，目前对于 MS 和视神经脊髓炎谱系疾病（NMOSD）患者发生 T2DM 的风险知之甚少。本研究旨在评估 MS 和 NMOSD 患者发生 T2DM 的风险。
方法
本研究利用韩国国家健康保险服务数据库，纳入了 1801 例 MS 患者和 1721 例 NMOSD 患者，这些患者在 2010 年 1 月至 2017 年 12 月期间均无 T2DM 病史。根据年龄、性别、高血压和血脂异常情况，为每位患者匹配了对照组。
结果
与对照组相比，NMOSD 患者发生 T2DM 的风险增加了 54%（调整后的风险比[HR]，95%置信区间[CI]：1.20-1.96）。然而，MS 患者发生 T2DM 的风险并未增加（HR=1.13，95%CI：0.91-1.42）。在 NMOSD 患者中，接受类固醇治疗的患者发生 T2DM 的风险更高（HR=1.77，95%CI：1.36-2.30），而未接受类固醇治疗的患者发生 T2DM 的风险则较低（HR=0.59，95%CI：0.24-1.43，p 交互=0.02）。
讨论
NMOSD 患者发生 T2DM 的风险增加，而 MS 患者则无此风险。类固醇治疗可能会增加 NMOSD 患者发生 T2DM 的风险。
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