Comorbidity and cardiovascular risk factors in multiple sclerosis.

Abstract

Background and objectives: Cardiovascular diseases (CVD) and their risk factors supposedly occur frequently in patients with multiple sclerosis (pwMS). We investigated prevalence of comorbidity particularly CVD among pwMS.

Methods: Two cohorts from Tehran and Isfahan were investigated retrospectively with longitudinal follow up and were invited to participate prospectively with measurement of biomedical parameters including determination of metabolic syndrome (MetS), and insulin resistance (IR). The 10-year office-based Framingham risk score (FRS) was calculated.

Results: Out of 856 pwMS 329 (38.4%) had at least one comorbidity and 97 (11.3%) had > 2 diseases, i.e., multiple comorbidity. PwMS and comorbidity were older (p < 0.0001) and had higher age at MS onset (p < 0.0001) compared to the non-comorbidity group. The prevalence of comorbidity increased from 24.0% at age 15-29 years to 37.3% at 30-49 and to 52.6% at 50-76 years (p < 0.0001) and was associated with odds of EDSS ≥ 4. FRS was for men 7.1 (4.2, 10.5) and for women 2.0 (1.3, 3.4). Of 255 with prospective blood testing, 35 (13.7%) had MetS, and 106 (41.6%) had IR.

Conclusion: A high prevalence of comorbidity, associated with disability and high FRS was observed in pwMS. Our data suggest that MetS and IR occur frequently in this population.