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二次进展性多发性硬化症中的心血管风险因素:MS-STAT2随机对照试验的横截面分析

Thomas Williams¹, Nevin John^1,2, Alberto Calvi¹

¹Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.

European journal of neurology

|June 15, 2023

概括

心血管风险加快了二级渐进性多发性硬化症 (SPMS) 中的大脑缩. 管理可修改的风险因素可能有助于保持脑容量,并减缓SPMS患者的残疾进展.

科学领域:

神经学神经学
心脏病学心脏病学
放射学放射学是一门学科.

背景情况:

心血管风险 (CVR) 越来越多地与多发性硬化症 (MS) 的残疾进展有关.
这种风险在二次渐进性多发性硬化 (SPMS) 中特别高,这是一个可以使用验证得分量化CVR的阶段.
了解可修改的CVR对大脑结构的影响对于SPMS管理至关重要.

研究的目的:

研究SPMS患者可修改心血管风险,大脑缩和残疾之间的横截面关联.
使用磁共振成像 (MRI) 量化过早实现的CVR和大脑体积之间的关系.

主要方法:

利用了218名参加MS-STAT2试验与SPMS的参与者的数据.
使用QRISK3软件计算复合CVR得分,以年表达过早的CVR.
使用多个线性回归来确定CVR,大脑体积和认知表现之间的关联.

主要成果:

过早实现的每一年的CVR与正常化全脑体积的2.7毫升下降有关 (p=0.006).
观察到最强的关联是皮质灰质体积,每年减少1.6毫升 (p=0.003).
较高的CVR与较差的语言工作记忆相关;体重指数和血清脂质比率与大脑体积和认知功能有显著的关系.

结论:

过早达到的心血管风险与SPMS中正常化大脑体积的减少显著相关.
这些发现凸显了可修改的心血管因素对SPMS患者大脑健康的潜在影响.
需要进一步的纵向分析来确认CVR是否预测SPMS的未来疾病恶化.

关键词:

心血管疾病的风险.伴随性疾病发生率.多发性硬化症多发性硬化症渐进的多发性硬化症.二次进展性多发性硬化症.

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