Li Yanfei, Jia Yanjie
Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Neurol. 2025 Jul 28;16:1619479. doi: 10.3389/fneur.2025.1619479. eCollection 2025.
Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is an inflammatory demyelinating disease with a high risk of recurrence and progressive disability, and it is crucial to find sensitive and reliable biomarkers for prognosis and the early prediction of relapse. In the study we investigated whether serum homocysteine (Hcy) levels are associated with a poor prognosis or risk of relapse in patients with first-attack MOGAD.
We enrolled patients diagnosed as having first-attack MOGAD between January 2019 and December 2024 in this retrospective study. Clinical data and initial Expanded Disability Status Scale (EDSS) scores were collected and analyzed. Clinical outcomes were measured using the final EDSS score and relapse events. We used logistic regression models and Cox regression analysis to determine the association between Hcy levels and clinical recovery and relapse.
Seventy patients (female, = 36; male, = 34) with first-attack MOGAD were included in this study. The final EDSS scores ( = 0.015) and relapse rates ( = 0.039) were higher in the high Hcy group than in the normal Hcy group. Multivariate analysis results indicated that Hcy levels [odds ratio (OR) 1.126; 95% confidence interval (CI) 1.005-1.261, = 0.04] and the initial EDSS scores (OR 2.017, 95% CI 1.266-3.214, = 0.003) were independent risk factors for predicting poor recovery. Kaplan-Meier survival analysis showed that Hcy levels were a predictor of relapse in patients with MOGAD (log-rank test = 0.029). The results of the multivariate Cox proportional hazards model indicated that Hcy levels [hazard ratio (HR) 1.088, 95% CI 1.020-1.161, = 0.011] were related to MOGAD relapse.
We identified Hcy levels as an independent risk factor for predicting poor clinical recovery in patients with first-attack MOGAD. Hcy levels were also significantly associated with the relapse of MOGAD.
髓鞘少突胶质细胞糖蛋白抗体病（MOGAD）是一种炎症性脱髓鞘疾病，复发风险高且有逐渐残疾的风险，因此找到用于预后评估和复发早期预测的敏感且可靠的生物标志物至关重要。在本研究中，我们调查了首次发作的MOGAD患者血清同型半胱氨酸（Hcy）水平是否与预后不良或复发风险相关。
在这项回顾性研究中，我们纳入了2019年1月至2024年12月期间被诊断为首次发作MOGAD的患者。收集并分析临床数据和初始扩展残疾状态量表（EDSS）评分。使用最终EDSS评分和复发事件来衡量临床结局。我们使用逻辑回归模型和Cox回归分析来确定Hcy水平与临床恢复和复发之间的关联。
本研究纳入了70例首次发作的MOGAD患者（女性36例；男性34例）。高Hcy组的最终EDSS评分（P = 0.015）和复发率（P = 0.039）均高于正常Hcy组。多变量分析结果表明，Hcy水平[比值比（OR）1.126；95%置信区间（CI）1.005 - 1.261，P = 0.04]和初始EDSS评分（OR 2.017，95% CI 1.266 - 3.214，P = 0.003）是预测恢复不良的独立危险因素。Kaplan - Meier生存分析表明，Hcy水平是MOGAD患者复发的预测指标（对数秩检验P = 0.029）。多变量Cox比例风险模型的结果表明，Hcy水平[风险比（HR）1.088，95% CI 1.020 - 1.161，P = 0.011]与MOGAD复发相关。
我们确定Hcy水平是预测首次发作MOGAD患者临床恢复不良的独立危险因素。Hcy水平也与MOGAD的复发显著相关。
