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多发性硬化症在多样化英国队列中的预诊断特征:一个嵌套的病例控制研究

Pooja Tank¹, Benjamin M Jacobs^1,2, Jonathan Bestwick¹

¹Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom.

Annals of clinical and translational neurology

|September 24, 2025

概括

多发性硬化症 (MS) 的前兆症状或早期症状在英国不同的人群中始终出现. 这些预诊断症状为早期识别MS提供了潜在的可能性,无论健康的社会决定因素如何.

科学领域:

神经学神经学
流行病学流行病学
公共卫生公共卫生

背景情况:

多发性硬化症 (MS) 诊断通常是随着一段时间的非特异性症状,称为"MS前".
以前对多发性硬化预症的描述主要涉及社会经济上同质的群体.
健康的社会决定因素对MS诊断前症状表现的影响仍然未得到充分研究.

研究的目的:

调查诊断前症状与多发性硬化症 (MS) 风险之间的关联.
检查这些关联是否因健康的不同社会决定因素而有所不同,包括性别,种族,贫困和地理位置.
通过对多样化人群进行前期症状分析,评估早期识别多发性硬化症的潜力.

主要方法:

使用Aurum数据库的临床实践研究数据链接 (CPRD) 进行了一项回顾性,基于人群的嵌套病例对照研究.
采用多变量逻辑回归模型来评估病例和匹配的对照中预诊断症状和MS风险之间的关联.
使用统计相互作用和分层模型来确定症状关联是否因健康的社会决定因素而有所不同.

主要成果:

该研究包括15029例多发性硬化病例和81027例对照病例.
在诊断前五年,MS病例的自主,认知,神经,疼痛和精神症状比对照人群更高.
观察到的前性症状和MS风险之间的关联在性别,种族,贫困和地理位置的各层次上是一致的,没有发现统计学上显著的相互作用.

结论:

在一个多样化的英国队列中,前兆症状与多发性硬化症 (MS) 风险增加之间存在一致的关系.
没有发现任何特定的前性症状关联是特定种族,性别或社会经济群体的独特特征.
这些发现支持了预诊断症状代表了早期识别多发性硬化症的宝贵机会的概念.

关键词:

剥夺是一种剥夺.多样性的多样性多样性的多样性民族身份民族身份性别性别性别性别性别多发性硬化症多发性硬化症这是一个prodrome,一个prodrome.

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