Differing trends in the incidence of vascular comorbidity in MS and the general population.
Differing trends in the incidence of vascular comorbidity in MS and the general population.
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DOI：
10.1212/cpj.0000000000000230
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发表时间：
2016-04
期刊：
影响因子：
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通讯作者：
CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis
中科院分区：
文献类型：
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作者：
Marrie RA;Fisk J;Tremlett H;Wolfson C;Warren S;Blanchard J;Patten SB;CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis
虽然血管合并症的不良影响越来越多地认识到多发性硬化症（MS），这些条件的流行病学仍然知之甚少。使用基于人口的管理数据，我们确定了44，452名加拿大MS患者和220，849名年龄，性别和地理位置匹配的对照组。我们应用经过验证的定义来估计1995年至2005年糖尿病、高血压、高脂血症和缺血性心脏病（IHD）的发病率。在MS病例中，31，757例（71.4%）为女性受试者，索引日期时的平均（SD）年龄为43.8（13.7）岁。随着时间的推移，MS人群中糖尿病的年龄标准化发病率（每年的发病率比[IRR] 1.06; 95%置信区间[CI] 1.03-1.08）比匹配人群（每年的IRR 1.02; 95% CI 1.01-1.03）增加更多。两个人群中高脂血症、高血压和IHD的年龄标准化发病率的时间趋势相似。在20-44岁的受试者中，MS人群的IHD发生率较高（IRR 1.59; 95% CI 1.19-2.11）。MS人群中IHD发生率的增加在60岁及以上人群中减弱（IRR 1.01; 95% CI 0.97-1.06）。MS人群中糖尿病、高血压和高脂血症的发病率正在上升。需要系统地预防和治疗这些疾病的方案。
Although the adverse effects of vascular comorbidities are increasingly recognized in multiple sclerosis (MS), the epidemiology of these conditions remains poorly understood. Using population-based administrative data, we identified 44,452 Canadians with MS and 220,849 age-, sex- and geographically matched controls. We applied validated definitions to estimate the incidence of diabetes, hypertension, hyperlipidemia, and ischemic heart disease (IHD) from 1995 to 2005. Of the MS cases, 31,757 (71.4%) were in female participants, with a mean (SD) age at the index date of 43.8 (13.7) years. Over time, the age-standardized incidence of diabetes rose more in the MS population (incidence rate ratio [IRR] per year 1.06; 95% confidence interval [CI] 1.03–1.08) than in the matched population (IRR per year 1.02; 95% CI 1.01–1.03). Temporal trends in the age-standardized incidence of hyperlipidemia, hypertension, and IHD were similar in both populations. Among those aged 20–44 years, the incidence of IHD was higher in the MS population (IRR 1.59; 95% CI 1.19–2.11). The increased incidence of IHD in the MS population was attenuated among those aged 60 years and older (IRR 1.01; 95% CI 0.97–1.06). The incidence rates of diabetes, hypertension, and hyperlipidemia are rising within the MS population. Programs to systematically prevent and treat these conditions are needed.