Incidence of multiple sclerosis in multiple racial and ethnic groups
Incidence of multiple sclerosis in multiple racial and ethnic groups
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DOI：
10.1212/wnl.0b013e3182918cc2
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发表时间：
2013-05-01
期刊：
影响因子：
9.9
通讯作者：
Zhang, Jian L.
中科院分区：
文献类型：
--
作者：
Langer-Gould, Annette;Brara, Sonu M.;Zhang, Jian L.
目的：为了确定多发性硬化症（MS）的发病率是否因种族/民族而异，在一个多种族，人口为基础的cohols.Methods：我们进行了一项回顾性队列研究，超过900万人年的观察，从多种族，社区居民的凯撒永久南加州健康计划的成员，从2008年1月1日至2010年12月31日。MS的发病率和风险比比较发病率之间的种族/族裔groups.Results泊松回归计算：我们确定了496例新诊断的MS谁符合麦当劳标准。诊断时的平均年龄为41.6岁（范围8.6-78.3岁），70.2%为女性。黑人（79.3%）的女性优势比白色、西班牙裔和亚裔MS患者（分别为67.8%、68.1%和69.2%; p = 0.03）更明显。MS的发病率在黑人中较高（10.2，95%置信区间[CI] 8.4-12.4; p < 0.0001），西班牙裔更低（2.9，95% CI 2.4-3.5; p < 0.0001）和亚洲人（1.4，95% CI 0.7-2.4; p < 0.0001）比白人（6.9，95% CI 6.1-7.8）。黑人妇女有较高的风险MS（风险比1.59，95%CI 1.27-1.99; P = 0.0005），而黑人男性有类似的风险MS（风险比1.04，95%CI = 0.67-1.57）相比white.Conclusions：我们的研究结果不支持被广泛接受的断言，即黑人MS的风险低于白人。对我们的研究结果的一个可能的解释是，肤色较深的人维生素D水平较低，从而增加了MS的风险，但这不能解释为什么西班牙裔和亚洲人患MS的风险低于白人，或者为什么黑人患MS的风险仅在女性中发现。神经病学（R）2013;80：1734-1739
Objective: To determine whether the incidence of multiple sclerosis (MS) varies by race/ethnicity in a multiethnic, population-based cohort.Methods: We conducted a retrospective cohort study of more than 9 million person-years of observation from the multiethnic, community-dwelling members of Kaiser Permanente Southern California health plan from January 1, 2008 to December 31, 2010. Incidence of MS and risk ratios comparing incidence rates between racial/ethnic groups were calculated using Poisson regression.Results: We identified 496 patients newly diagnosed with MS who met McDonald criteria. The average age at diagnosis was 41.6 years (range 8.6-78.3 years) and 70.2% were women. The female preponderance was more pronounced among black (79.3%) than white, Hispanic, and Asian individuals with MS (67.8%, 68.1%, and 69.2%, respectively; p = 0.03). The incidence of MS was higher in blacks (10.2, 95% confidence interval [CI] 8.4-12.4; p < 0.0001) and lower in Hispanics (2.9, 95% CI 2.4-3.5; p < 0.0001) and Asians (1.4, 95% CI 0.7-2.4; p < 0.0001) than whites (6.9, 95% CI 6.1-7.8). Black women had a higher risk of MS (risk ratio 1.59, 95% CI 1.27-1.99; p = 0.0005) whereas black men had a similar risk of MS (risk ratio 1.04, 95% CI = 0.67-1.57) compared with whites.Conclusions: Our findings do not support the widely accepted assertion that blacks have a lower risk of MS than whites. A possible explanation for our findings is that people with darker skin tones have lower vitamin D levels and thereby an increased risk of MS, but this would not explain why Hispanics and Asians have a lower risk of MS than whites or why the higher risk of MS among blacks was found only among women. Neurology (R) 2013;80:1734-1739