Multiple sclerosis risk factors contribute to onset heterogeneity
| Autor: | Justin C. Yu, Jinghong Jiangyang, Erica Parrotta, Douglas D. Gunzler, Daniel Ontaneda, Farren B.S. Briggs, Shannon Fu, Mary F. Davis |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Multiple Sclerosis Early Relapse Disease Machine Learning 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Epidemiology medicine Humans Obesity 030212 general & internal medicine Age of Onset Genetic risk Retrospective Studies business.industry Multiple sclerosis Smoking General Medicine Middle Aged medicine.disease Cross-Sectional Studies Neurology Disease Presentation Disease Progression Female Neurology (clinical) Age of onset business 030217 neurology & neurosurgery HLA-DRB1 Chains |
| Zdroj: | Multiple Sclerosis and Related Disorders. 28:11-16 |
| ISSN: | 2211-0348 |
| Popis: | Background The phenotypic presentation of multiple sclerosis (MS) may predict long-term outcomes and little is known about factors contributing to heterogeneity at MS onset. Given temporality, it is likely MS risk factors also influence presentation of the disease near onset. Methods Using a retrospective cross-sectional study of MS cases, we investigated: age of onset (AOO), number of impaired functional domains (NIFDs), time to second relapse (TT2R), and early relapse activity (ERA). Machine learning variable selection was applied to epidemiologic data for each outcome, followed by multivariable regression models. The models were further adjusted for HLA-DRB1*15:01 carrier status and a MS genetic risk score (GRS). The TT2R and ERA analyses were restricted to relapsing remitting MS cases. Results HLA-DRB1*15:01, GRS, and smoking were associated with earlier AOO. Cases who were male, obese, had lower education, or had primary progressive MS were older at onset. For NIFDs, those with relapsing remitting MS and of lower SES had increased NIFDs. Among relapsing remitting cases, those who were older at onset, obese, and had polyfocal presentation had shorter TT2R, while ERA was greater among those younger at onset and who were obese. Conclusion Individual characteristics including age, genetic profiles, obesity, and smoking status contribute to heterogeneity in disease presentation and modulate early disease course evolution. |
| Databáze: | OpenAIRE |
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