目的:慢性合并症在多发性硬化症(PwMS)患者中很常见,从而恶化他们的预后和生活质量,增加疾病负担。本研究的目的是评估托斯卡纳(意大利中部)PwMS中常见合并症的患病率,并将其与普通人群进行比较。
方法:合并症的患病率,包括糖尿病,慢性阻塞性肺疾病(COPD),高血压,中风,心力衰竭(HF),心肌梗死和缺血性心脏病(IHD),在PwMS和居住在托斯卡纳的一般人群中进行了评估,年龄>20岁,使用管理数据。
结果:总计,我们确定了8,274PwMS。其中,34%有至少一种合并症,高血压是最常见的(28.5%)。将PwMS与普通人群进行比较,考虑到整个人群,PwMS有更高的高血压和中风频率,和糖尿病,COPD,和IHD时考虑性别和年龄亚组。这种增加的风险在年轻和中间年龄组尤其明显。多发性硬化症可能是一些合并症的危险因素。在PwMS中,以及在普通人群中,男性慢性病患病率较高,且随年龄增长而增加.
结论:合并症通常与多发性硬化症并存,它们可能对这种复杂的疾病产生影响,从健康,临床,和社会经济观点。因此,慢性合并症的常规筛查应该是临床实践中的关键步骤,以及促进健康的生活方式,以防止发病和减轻他们的负担。
OBJECTIVE: Chronic comorbidities are common in people with multiple sclerosis (PwMS), thus worsening their prognosis and quality of life, and increasing disease burden. The aim of the present
study was to evaluate the prevalence of common comorbidities in PwMS in Tuscany (Central Italy) and to compare it with the general population.
METHODS: The prevalence of comorbidities, including diabetes, chronic obstructive pulmonary disease (COPD), hypertension, stroke, heart failure (HF), cardiac infarction and ischemic heart disease (IHD), was assessed in PwMS and in general population resident in Tuscany, aged > 20 years, using administrative data.
RESULTS: In total, we identified 8,274 PwMS. Among them, 34% had at least one comorbidity, with hypertension being the most common (28.5%). Comparing PwMS with the general population, PwMS had a higher frequency of hypertension and stroke when considering the whole group, and of diabetes, COPD, and IHD when considering sex and age subgroups. This increased risk was especially evident in the young and intermediate age groups, where multiple sclerosis may play an important role as risk factor for some comorbidities. In PwMS, as well as in the general population, prevalence of chronic diseases was higher in males and increased with age.
CONCLUSIONS: Comorbidities frequently coexist with multiple sclerosis and they may have an impact on this complex disease, from the health, clinical, and socioeconomic points of view. Therefore, a routine screening of chronic comorbidities should be a crucial step in clinical practice, as well as the promotion of healthy lifestyles to prevent the onset and to reduce their burden.