Vascular function in multiple sclerosis: Systematic review with meta-analysis

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders Pub Date : 2024-09-22 DOI:10.1016/j.msard.2024.105902

Peixuan Zheng, Noah G. DuBose, Sydney R. DeJonge, Brenda Jeng, Brooks A. Hibner, Robert W. Motl

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引用次数: 0

Abstract

Background

Vascular comorbidities are prevalent in persons with multiple sclerosis (MS), yet less is known about underlying vascular function (VF). We performed a systematic review with meta-analysis of studies that compared VF in persons with MS and healthy controls and examined factors that may moderate the difference in vascular outcomes between groups.

Methods

We conducted a systematic search using PubMed/MEDLINE, CINAHL, and Embase from inception through March 2024. The search identified studies that included comparisons of VF between MS and controls on a range of function and structure outcomes (e.g., pulse wave velocity, augmentation index, arterial diameter, intima-media thickness, flow-mediated dilation). Effect sizes were calculated as standardized mean differences (SMD) using Hedge's g with a positive effect indicating worse VF in MS than controls. The meta-analysis involved a multilevel random effects model with follow-up moderator analyses.

Results

Fourteen studies met the inclusion criteria and yielded 49 effect sizes for meta-analysis. The MS subjects (N = 614) were predominantly female (72.0 %), with mean ages ranging from 29.9 to 54.4 years. There was a moderate difference in VF between persons with MS and healthy controls (SMD [95 % CI] = 0.56 [0.08, 1.03]; p = 0.02), and the effects were heterogenous (Q₄₈=634.5, p < 0.01; I²=94.39 %). There was a greater difference in arterial stiffness between MS and controls (0.78 [0.21, 1.36], p = 0.008), but not in other arterial structure or function outcomes (p > 0.05). No significant moderators were detected (p > 0.05).

Conclusions

The cumulative evidence supports that persons with MS have worse VF, notably greater arterial stiffness, than healthy controls. Such findings support future research on the cause, consequences, and management of arterial stiffness among persons with MS.

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多发性硬化症的血管功能：系统回顾与荟萃分析

背景多发性硬化症（MS）患者普遍存在血管并发症，但对其潜在的血管功能（VF）却知之甚少。我们对比较多发性硬化症患者和健康对照者血管功能的研究进行了系统回顾和荟萃分析，并研究了可能缓和组间血管结果差异的因素。该搜索确定了包括多发性硬化症和对照组之间在一系列功能和结构结果（如脉搏波速度、增强指数、动脉直径、内膜中层厚度、血流介导的扩张）方面的 VF 比较的研究。效应大小以标准化均值差异（SMD）计算，采用赫氏 g，正效应表示多发性硬化症患者的 VF 比对照组差。荟萃分析采用了多层次随机效应模型，并进行了随访调节因子分析。结果14项研究符合纳入标准，并产生了49个效应大小用于荟萃分析。多发性硬化症受试者（N = 614）主要为女性（72.0%），平均年龄为 29.9 岁至 54.4 岁。多发性硬化症患者与健康对照组之间的 VF 存在中度差异（SMD [95 % CI] = 0.56 [0.08, 1.03]；P = 0.02），效应具有异质性（Q48=634.5，P < 0.01；I2=94.39 %）。多发性硬化症患者与对照组之间的动脉僵硬度差异较大（0.78 [0.21, 1.36]，p = 0.008），但其他动脉结构或功能结果差异不大（p > 0.05）。结论累积的证据表明，与健康对照组相比，多发性硬化症患者的 VF 更差，尤其是动脉僵化程度更高。这些发现支持未来对多发性硬化症患者动脉僵化的原因、后果和管理进行研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.