Title
Assessment of comorbidity burden in persons with multiple sclerosis: observational study based on Belgrade population registry data
Creator
Marić, Gorica, 1987-, 23535975
Copyright date
2020
Object Links
Select license
Autorstvo-Nekomercijalno-Bez prerade 3.0 Srbija (CC BY-NC-ND 3.0)
License description
Dozvoljavate samo preuzimanje i distribuciju dela, ako/dok se pravilno naznačava ime autora, bez ikakvih promena dela i bez prava komercijalnog korišćenja dela. Ova licenca je najstroža CC licenca. Osnovni opis Licence: http://creativecommons.org/licenses/by-nc-nd/3.0/rs/deed.sr_LATN. Sadržaj ugovora u celini: http://creativecommons.org/licenses/by-nc-nd/3.0/rs/legalcode.sr-Latn
Language
English
Cobiss-ID
Theses Type
Doktorska disertacija
description
Datum odbrane: 26.02.2021.
Other responsibilities
mentor
Pekmezović, Tatjana, 1964-, 12668519
komentor
Lalić, Katarina, 1962-, 12598119
komentor
Mesaroš, Šarlota, 1967-, 36937063
član komisije
Drulović, Jelena, 1960-, 12542823
član komisije
Kisić-Tepavčević, Darija, 1975-, 12892519
član komisije
Pugliatti, Maura, 70534665
Academic Expertise
Medicinske nauke
University
Univerzitet u Beogradu
Faculty
Medicinski fakultet
Alternative title
Procena opterećenja komorbiditetima kod osoba sa multiplom sklerozom: opservaciona studija zasnovana na podacima populacionog registra Beograda
Publisher
[G. Maric]
Format
75 str.
description
Medicine - Epidemiology / Medicina
- Epidemiologija
Abstract (en)
Introduction: Comorbidity is one of major patients’ characteristics relevant to the clinical presentation and management of multiple sclerosis (MS).
Aims: To estimate the prevalence of comorbidities in MS patients in Belgrade, Serbia, based on population-based registry data with special emphasis on cardiovascular disorders (CVD); and to determine their effects on MS course.
Methods: Observational studies were perfomed at the Clinic of Neurology and Clinic of Endocrinology, diabetes and metabolic disorders, Clinical Center of Serbia, in the period 2016-2019. The Belgrade population MS registry was used as a source of data.
Results: The most prevalent groups of comorbidities were psychiatric (20.59%) and CVD (15.23%) and most prevalent single comorbidities were depression (11.82%) and hypertension (11.41%). Progression index was significantly associated with the number of comorbidities (p<0.001). MS patients treated with disease-modifying therapies had a higher risk of comorbidity occurrence compared to those untreated (p=0.001). MS patients had a higher prevalence of insulin resistance (64.1%) compared to healthy individuals (30.8%), (p=0.008), and glucose level at 120’ during oral glucose tolerance test was independently associated with MS. Expanded Disability Status Scale (EDSS) score, physical activity, body mass index and type 2 diabetes comorbidity explained 48% of the variance in difference between chronological and vascular age in MS patients. EDSS score and MS phenotype were independent predictors of occurrence of CVD comorbidity, coronary artery disease and type 2 diabetes.
Conclusion: Our findings implicate need for screening and early adequate management of different comorbidities in MS patients, having in mind its involvement in range of adverse outcomes in MS.
Abstract (sr)
Uvod: Komorbiditeti predstavljaju jednu od ključnih karakteristika relevantnih za kliničku prezentaciju i ishod osoba sa multiplom sklerozom (MS).
Cilj: Odrediti prevalenciju različitih grupa komorbiditeta kod osoba sa MS u populaciji Beograda, Srbija, sa posebnim osvrtom na kardiovaskularne bolesti (KVB) na osnovu podataka populacionog MS registra Beograda, kao i njihov uticaj na tok MS.
Metod: Opservacione studije su sprovedene na Klinici za neurologiju i Klinici za endokrinologiju, dijabetes i bolesti metabolizma, Kliničkog centra Srbije, u periodu 2016-2019. godine. Kao izvor podataka korišćen je populacioni MS registar Beograda.
Rezultati: Najprevalentnije grupe komorbiditeta su bile psihijatrijske bolesti (20,59%) i KVB (15,23%), a najprevalentniji pojedinačni komorbiditeti depresija (11,82%) i hipertenzija (11,41%). Indeks progresije onesposobljenosti je bio statistički značajno povezan sa brojem komorbiditeta (p<0.001). Osobe sa MS na terapiji lekovima koji modifikuju tok bolesti su imale veći rizik za pojavu komorbiditeta u odnosu na nelečene (p=0.001). Kod osoba sa MS je registrovana značajno viša prevalencija insulinske rezistencije (64,1%) u poređenju sa zdravim kontrolama (30,8%), (p=0,008), a nivo glukoze u 120’ oralnog testa tolerancije glukoze bio je nezavisno povezan sa MS. Skor proširene skale neurološke onesposobljenosti (EDSS), fizička aktivnost, indeks telesne mase i prisustvo tip 2 dijabetesa objasnili su 48% varijanse u razlici između hronološkog i vaskularnog uzrasta osoba sa MS. EDSS skor i MS fenotip predstavljaju nezavisne prediktore pojave KVB, koronarne arterijske bolesti i tip 2 dijabetesa kod osoba sa MS.
Zaključak: Naši rezultati upućuju na potrebu za skriningom i ranim i adekvatnim menadžmentom komorbiditeta kod osoba sa MS, posebno imajući u vidu njihov uticaj na veliki broj neželjenih ishoda u MS.
Authors Key words
multiple sclerosis, comorbidity, prevalence, cardiovascular diseases, diabetes, insulin resistance, vascular age, population-based MS registry
Authors Key words
multipla skleroza, komorbiditeti, prevalencija, kardiovaskularne bolesti, dijabetes, insulinska rezistencija, vaskularna starost, populacioni MS registar
Classification
616.832-004.2(497.11)(043.3)
Type
Tekst
Abstract (en)
Introduction: Comorbidity is one of major patients’ characteristics relevant to the clinical presentation and management of multiple sclerosis (MS).
Aims: To estimate the prevalence of comorbidities in MS patients in Belgrade, Serbia, based on population-based registry data with special emphasis on cardiovascular disorders (CVD); and to determine their effects on MS course.
Methods: Observational studies were perfomed at the Clinic of Neurology and Clinic of Endocrinology, diabetes and metabolic disorders, Clinical Center of Serbia, in the period 2016-2019. The Belgrade population MS registry was used as a source of data.
Results: The most prevalent groups of comorbidities were psychiatric (20.59%) and CVD (15.23%) and most prevalent single comorbidities were depression (11.82%) and hypertension (11.41%). Progression index was significantly associated with the number of comorbidities (p<0.001). MS patients treated with disease-modifying therapies had a higher risk of comorbidity occurrence compared to those untreated (p=0.001). MS patients had a higher prevalence of insulin resistance (64.1%) compared to healthy individuals (30.8%), (p=0.008), and glucose level at 120’ during oral glucose tolerance test was independently associated with MS. Expanded Disability Status Scale (EDSS) score, physical activity, body mass index and type 2 diabetes comorbidity explained 48% of the variance in difference between chronological and vascular age in MS patients. EDSS score and MS phenotype were independent predictors of occurrence of CVD comorbidity, coronary artery disease and type 2 diabetes.
Conclusion: Our findings implicate need for screening and early adequate management of different comorbidities in MS patients, having in mind its involvement in range of adverse outcomes in MS.
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