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Seasonal variation in multiple sclerosis relapse

机译：多发性硬化复发的季节性变化

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摘要

Relapses are a characteristic clinical feature of multiple sclerosis (MS), but an appreciation of factors that cause them remains elusive. In this study, we have examined seasonal variation of relapse in a large population-based MS cohort and correlated observed patterns with age, sex, disease course, and climatic factors. Relapse data were recorded prospectively in 2076 patients between 2005 and 2014. 3902 events were recorded in 1158 patients (range 0-24). There was significant seasonal variation in relapse rates (p < 0.0001) and this was associated with monthly hours of sunshine (odds ratio OR 1.08, p = 0.02). Relapse rates were highest in patients under the age of 30 (OR 1.42, p = 0.0005) and decreased with age. There was no evidence of different relapse rates for males compared to females (OR 0.90, p = 0.19). Identification of potentially modifiable environmental factors associated with temporal variation in relapse rates may allow alteration of risk on a population basis and alteration of outcome of established disease once established. Future epidemiological studies should examine dynamic environmental factors with serial prospective measurements and biological sampling. Significant seasonal differences in relapse rates highlight the importance of environmental factors in disease expression and should be taken into account when planning clinical trials in which relapse frequency is an outcome. In addition, identification of potentially modifiable factors associated with this variation may offer unique opportunities for alteration of risk of relapse and long-term outcome on a population level, and suggest putative biological mechanisms for relapse initiation.
机译：复发是多发性硬化（MS）的特征临床特征，但对导致它们仍然难以捉摸的因素的欣赏。在这项研究中，我们研究了大量基于人群的MS队列复发的季节性变化和具有年龄，性别，疾病课程和气候因素的相关观测模式。在2005年至2014年期间，在2076名患者中预先记录复发数据。1158名患者（范围0-24）记录了3902个事件。复发速率存在显着的季节性变化（P <0.0001），这与月度阳光（差距或1.08，P = 0.02）相关。在30岁以下（或1.42，P = 0.0005）的患者中复发率最高，随着年龄的增长而降低。与女性（或0.90，P = 0.19）相比，雄性的不同复发速率没有证据。识别与复发率的时间变化相关的潜在可修改的环境因素可能允许在人口基础上改变风险，并确定既定疾病的成果的改变。未来的流行病学研究应该检查具有连续前瞻性测量和生物取样的动态环境因素。复发率的显着季节性差异突出了环境因素在疾病表达中的重要性，并且在规划复发频率是结果的临床试验时，应考虑到。此外，鉴定与这种变异相关的潜在可修改的因素可以提供独特的机会，以改变群体水平的复发和长期结果的风险，并提出复发启动的推定生物学机制。

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  • 来源
    《Journal of neurology》 |2017年第6期|共9页
  • 作者

    Harding Katharine; Tilling Kate; MacIver Claire; Willis Mark; Joseph Fady; Ingram Gillian; Hirst Claire; Wardle Mark; Pickersgill Trevor; Ben-Shlomo Yoav; Robertson Neil;

  • 作者单位

    Cardiff Univ Univ Hosp Wales Inst Psychol Med &

    Clin Neurosci Heath Pk Cardiff CF14 4XW S Glam;

    Sch Social &

    Community Med Canynge Hall 39 Whatley Rd Bristol BS8 2PS Avon England;

    Cardiff Univ Univ Hosp Wales Inst Psychol Med &

    Clin Neurosci Heath Pk Cardiff CF14 4XW S Glam;

    Cardiff Univ Univ Hosp Wales Inst Psychol Med &

    Clin Neurosci Heath Pk Cardiff CF14 4XW S Glam;

    Royal Gwent Hosp Dept Neurol Cardiff Rd Newport NP20 2UB Gwent Wales;

    Univ Hosp Wales Dept Neurol Helen Durham Ctr Neuroinflammatory Dis Heath Pk Cardiff CF14 4XW S;

    Univ Hosp Wales Dept Neurol Helen Durham Ctr Neuroinflammatory Dis Heath Pk Cardiff CF14 4XW S;

    Univ Hosp Wales Dept Neurol Helen Durham Ctr Neuroinflammatory Dis Heath Pk Cardiff CF14 4XW S;

    Univ Hosp Wales Dept Neurol Helen Durham Ctr Neuroinflammatory Dis Heath Pk Cardiff CF14 4XW S;

    Sch Social &

    Community Med Canynge Hall 39 Whatley Rd Bristol BS8 2PS Avon England;

    Cardiff Univ Univ Hosp Wales Inst Psychol Med &

    Clin Neurosci Heath Pk Cardiff CF14 4XW S Glam;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 神经病学;
  • 关键词

    Multiple sclerosis; Epidemiology; Relapses; Seasonal;

    机译：多发性硬化;流行病学;复发;季节性的;

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