Quantitative effect of sex on disease activity and disability accumulation in multiple sclerosis.
Quantitative effect of sex on disease activity and disability accumulation in multiple sclerosis.
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DOI：
10.1136/jnnp-2022-328994
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发表时间：
2022-07
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--
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量化多发性硬化（MS）活动性和严重程度的性别差异，以及它如何取决于疾病持续时间和临床发作后的时间。自1996年以来，所有接受疾病改善治疗的复发性MS发作的丹麦公民均接受了每年或每半年一次的控制访视，并强制通知丹麦多发性硬化症登记处。男性和女性是通过女性的逆概率进行比较的。复发率和扩展残疾状态量表（EDSS）评分的变化采用加权一般线性模型进行分析，我们采用加权考克斯回归分析不同EDSS终点的男性和女性之间的HR。我们包括3028名男性和6619名女性。加权女性：男性复发率比为1.16（95% CI：1.10至1.22），但50岁后，差异消失。男性EDSS的年增幅为0.07（95% CI：0.05 - 0.08），女性为0.05（95% CI：0.04 - 0.06）; p=0.017。以女性作为参考，达到EDSS 4的HR为1.34（95% CI：1.23至1.45; p<0.001），达到EDSS 6的HR为1.43（95% CI：1.28至1.61; p<0.001）。诊断延迟在性别之间没有显著差异。在绝经年龄之前，女性在复发方面比男性有更多的炎症性疾病活动，这表明性激素可能起作用。男性比女性更容易受到MS的神经退行性成分的影响，特别是在45岁之后。
To quantify sex differences in activity and severity of multiple sclerosis (MS) and how it depends on disease duration and time since clinical onset. All Danish citizens with onset of relapsing MS since 1996 who have received disease-modifying therapy have been followed with annual or biannual control visits with mandatory notification of the Danish Multiple Sclerosis Registry. Men and women were compared by the inverse probability of being female. Relapse rates and changes in the Expanded Disability Status Scale (EDSS) scores were analysed with weighted general linear models, and we used weighted Cox regression for HRs between men and women for different EDSS endpoints. We included 3028 men and 6619 women. The weighted female:male relapse rate ratio was 1.16 (95% CI: 1.10 to 1.22) but after age 50 years, the difference disappeared. The annualised increase in EDSS was 0.07 in men (95% CI: 0.05 to 0.08) and 0.05 in women (95% CI: 0.04 to 0.06); p=0.017. With women as reference, the HR for reaching EDSS 4 was 1.34 (95% CI: 1.23 to 1.45; p<0.001), and for reaching EDSS 6 it was 1.43 (95% CI: 1.28 to 1.61; p<0.001). The diagnostic delay did not differ significantly between the sexes. Women have more inflammatory disease activity in terms of relapses than men up to the age of menopause indicating that sex hormones may play a role. Men are more subject to the neurodegenerative component of MS than women, particularly after the age of 45 years.
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影响因子：
48
作者：
Thompson, Alan J.;Banwell, Brenda L.;Cohen, Jeffrey A.
通讯作者：
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11
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6
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ANDERSEN, O
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Geurts, Jeroen J. G.
影响因子：
7.9
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