Phenome-wide examination of comorbidity burden and multiple sclerosis disease severity.

Adult Boston / epidemiology British Columbia / epidemiology Cohort Studies Comorbidity Female Genetic Association Studies / methods Genome-Wide Association Study Humans Male Middle Aged Multiple Sclerosis / epidemiology Phenotype Severity of Illness Index Young Adult

Journal

Neurology(R) neuroimmunology & neuroinflammation
ISSN: 2332-7812
Titre abrégé: Neurol Neuroimmunol Neuroinflamm
Pays: United States
ID NLM: 101636388

Informations de publication

Date de publication:
11 2020
Historique:
received: 02 03 2020
accepted: 17 06 2020
entrez: 21 8 2020
pubmed: 21 8 2020
medline: 5 10 2021
Statut: epublish

Résumé

We assessed the comorbidity burden associated with multiple sclerosis (MS) severity by performing a phenome-wide association study (PheWAS). We conducted a PheWAS in 2 independent cohorts: a discovery (Boston, United States; 1993-2014) and extension cohort (British Columbia, Canada; 1991-2008). We included adults with MS, ≥1 Expanded Disability Status Scale (EDSS) score, and ≥1 The discovery and extension cohorts included 3,439 and 4,876 participants, respectively. After Bonferroni correction and covariate adjustments, a higher MSSS was associated with 37 coexisting conditions in the discovery cohort. Subsequently, 16 conditions, including genitourinary, infectious, metabolic, epilepsy, and movement disorders, met the reporting criteria, reaching the Bonferroni threshold of significance with the same direction of effect in the discovery and extension cohort. Notably, benign neoplasm of the skin was inversely associated with the MSSS. The phenome-wide approach enabled a systematic interrogation of the comorbidity burden and highlighted clinically relevant medical conditions associated with MS severity (beyond MS-specific consequences) and defines a roadmap for comprehensive investigation of comorbidities in chronic neurologic diseases. Further prospective investigation of the bidirectional relationship between disability and comorbidities could inform the individualized patient management.

Identifiants

DOI: 10.1212/NXI.0000000000000864 PMID: 32817202 PMC: PMC7673286
pubmed: 32817202
pii: 7/6/e864
doi: 10.1212/NXI.0000000000000864
pmc: PMC7673286
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : NINDS NIH HHS
ID : R01 NS098023
Pays : United States
Organisme : CIHR
Pays : Canada

Informations de copyright

Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

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Auteurs

Tingting Zhang (T)

From the Department of Health Services (T.Z.), Policy and Practice, Brown University, Providence, RI; Department of Biostatistics (M.G., T. Cai), Harvard T. H. Chan School of Public Health, Boston, MA; Department of Medicine (Neurology) (F.Z., R.C., H.T.), and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada; Department of Neurology (B.H., T. Chitnis, H.W., P.D.J., Z.X.), Brigham and Women's Hospital, Boston, MA; Department of Neurology (P.D.J.), Columbia University, New York, NY; and Department of Neurology (Z.X.), University of Pittsburgh, PA.

Matthew Goodman (M)

From the Department of Health Services (T.Z.), Policy and Practice, Brown University, Providence, RI; Department of Biostatistics (M.G., T. Cai), Harvard T. H. Chan School of Public Health, Boston, MA; Department of Medicine (Neurology) (F.Z., R.C., H.T.), and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada; Department of Neurology (B.H., T. Chitnis, H.W., P.D.J., Z.X.), Brigham and Women's Hospital, Boston, MA; Department of Neurology (P.D.J.), Columbia University, New York, NY; and Department of Neurology (Z.X.), University of Pittsburgh, PA.

Feng Zhu (F)

From the Department of Health Services (T.Z.), Policy and Practice, Brown University, Providence, RI; Department of Biostatistics (M.G., T. Cai), Harvard T. H. Chan School of Public Health, Boston, MA; Department of Medicine (Neurology) (F.Z., R.C., H.T.), and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada; Department of Neurology (B.H., T. Chitnis, H.W., P.D.J., Z.X.), Brigham and Women's Hospital, Boston, MA; Department of Neurology (P.D.J.), Columbia University, New York, NY; and Department of Neurology (Z.X.), University of Pittsburgh, PA.

Brian Healy (B)

From the Department of Health Services (T.Z.), Policy and Practice, Brown University, Providence, RI; Department of Biostatistics (M.G., T. Cai), Harvard T. H. Chan School of Public Health, Boston, MA; Department of Medicine (Neurology) (F.Z., R.C., H.T.), and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada; Department of Neurology (B.H., T. Chitnis, H.W., P.D.J., Z.X.), Brigham and Women's Hospital, Boston, MA; Department of Neurology (P.D.J.), Columbia University, New York, NY; and Department of Neurology (Z.X.), University of Pittsburgh, PA.

Robert Carruthers (R)

From the Department of Health Services (T.Z.), Policy and Practice, Brown University, Providence, RI; Department of Biostatistics (M.G., T. Cai), Harvard T. H. Chan School of Public Health, Boston, MA; Department of Medicine (Neurology) (F.Z., R.C., H.T.), and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada; Department of Neurology (B.H., T. Chitnis, H.W., P.D.J., Z.X.), Brigham and Women's Hospital, Boston, MA; Department of Neurology (P.D.J.), Columbia University, New York, NY; and Department of Neurology (Z.X.), University of Pittsburgh, PA.

Tanuja Chitnis (T)

From the Department of Health Services (T.Z.), Policy and Practice, Brown University, Providence, RI; Department of Biostatistics (M.G., T. Cai), Harvard T. H. Chan School of Public Health, Boston, MA; Department of Medicine (Neurology) (F.Z., R.C., H.T.), and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada; Department of Neurology (B.H., T. Chitnis, H.W., P.D.J., Z.X.), Brigham and Women's Hospital, Boston, MA; Department of Neurology (P.D.J.), Columbia University, New York, NY; and Department of Neurology (Z.X.), University of Pittsburgh, PA.

Howard Weiner (H)

From the Department of Health Services (T.Z.), Policy and Practice, Brown University, Providence, RI; Department of Biostatistics (M.G., T. Cai), Harvard T. H. Chan School of Public Health, Boston, MA; Department of Medicine (Neurology) (F.Z., R.C., H.T.), and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada; Department of Neurology (B.H., T. Chitnis, H.W., P.D.J., Z.X.), Brigham and Women's Hospital, Boston, MA; Department of Neurology (P.D.J.), Columbia University, New York, NY; and Department of Neurology (Z.X.), University of Pittsburgh, PA.

Tianxi Cai (T)

From the Department of Health Services (T.Z.), Policy and Practice, Brown University, Providence, RI; Department of Biostatistics (M.G., T. Cai), Harvard T. H. Chan School of Public Health, Boston, MA; Department of Medicine (Neurology) (F.Z., R.C., H.T.), and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada; Department of Neurology (B.H., T. Chitnis, H.W., P.D.J., Z.X.), Brigham and Women's Hospital, Boston, MA; Department of Neurology (P.D.J.), Columbia University, New York, NY; and Department of Neurology (Z.X.), University of Pittsburgh, PA.

Philip De Jager (P)

From the Department of Health Services (T.Z.), Policy and Practice, Brown University, Providence, RI; Department of Biostatistics (M.G., T. Cai), Harvard T. H. Chan School of Public Health, Boston, MA; Department of Medicine (Neurology) (F.Z., R.C., H.T.), and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada; Department of Neurology (B.H., T. Chitnis, H.W., P.D.J., Z.X.), Brigham and Women's Hospital, Boston, MA; Department of Neurology (P.D.J.), Columbia University, New York, NY; and Department of Neurology (Z.X.), University of Pittsburgh, PA.

Helen Tremlett (H)

From the Department of Health Services (T.Z.), Policy and Practice, Brown University, Providence, RI; Department of Biostatistics (M.G., T. Cai), Harvard T. H. Chan School of Public Health, Boston, MA; Department of Medicine (Neurology) (F.Z., R.C., H.T.), and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada; Department of Neurology (B.H., T. Chitnis, H.W., P.D.J., Z.X.), Brigham and Women's Hospital, Boston, MA; Department of Neurology (P.D.J.), Columbia University, New York, NY; and Department of Neurology (Z.X.), University of Pittsburgh, PA.

Zongqi Xia (Z)

From the Department of Health Services (T.Z.), Policy and Practice, Brown University, Providence, RI; Department of Biostatistics (M.G., T. Cai), Harvard T. H. Chan School of Public Health, Boston, MA; Department of Medicine (Neurology) (F.Z., R.C., H.T.), and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada; Department of Neurology (B.H., T. Chitnis, H.W., P.D.J., Z.X.), Brigham and Women's Hospital, Boston, MA; Department of Neurology (P.D.J.), Columbia University, New York, NY; and Department of Neurology (Z.X.), University of Pittsburgh, PA. zxia1@pitt.edu.
ORCID: 0000-0003-1500-2589

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Phenome-wide examination of comorbidity burden...
questionsmedicales.fr › Régions géographiques › Villes › Boston › Phenome-wide examination of comorbidity burden...
questionsmedicales.fr › Régions géographiques › Amériques › Amérique du Nord › Canada › Colombie-Britannique › Phenome-wide examination of comorbidity burden...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Phenome-wide examination of comorbidity burden...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Facteurs épidémiologiques › Comorbidité › Phenome-wide examination of comorbidity burden...
questionsmedicales.fr › Techniques d'investigation › Techniques génétiques › Études d'associations génétiques › Phenome-wide examination of comorbidity burden...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Épidémiologie moléculaire › Étude d'association pangénomique › Phenome-wide examination of comorbidity burden...
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questionsmedicales.fr › Maladies du système immunitaire › Maladies auto-immunes › Maladies auto-immunes du système nerveux › Maladies démyélinisantes auto-immunes du SNC › Sclérose en plaques › Phenome-wide examination of comorbidity burden...
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