the epidemiology of multiple sclerosis in scotland inferences from hospital admissions多发性硬化症的流行病学从住院在苏格兰的推论.pdf

The Epidemiology of Multiple Sclerosis in Scotland: Inferences from Hospital Admissions 1,2 3 1,2 1,2 1,2 Adam E. Handel , Lynne Jarvis , Ryan McLaughlin , Anastasia Fries , George C. Ebers , Sreeram V. Ramagopalan1,2* 1 Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom, 2 Department of Clinical Neurology, University of Oxford, Oxford, United Kingdom, 3 National Health Service Scotland, Edinburgh, United Kingdom Abstract Background: Multiple sclerosis (MS) is a neurological disorder with a highly characteristic disease distribution. Prevalence and incidence in general increase with increasing distance from the equator. Similarly the female to male sex ratio increases with increasing latitude. Multiple possible risk factors have been hypothesised for this epidemiological trend, including human leukocyte antigen allele frequencies, ultraviolet exposure and subsequent vitamin D levels, smoking and Epstein- Barr virus. In this study we undertook a study of medical records across Scotland on an NHS health board level of resolution to examine the epidemiology of MS in this region. Methods and Results: We calculated the number and rate of patient-linked hospital admissions throughout Scotland between 1997 and 2009 from the Scottish Morbidity Records. We used weighted-regression to examine correlations between these measures of MS, and latitude and smoking prevalence. We found a highly significant relationship between MS patient-linked admissions and latitude (r weighted by standard error (rsw) = 0.75, p = 0.002). There was no significant relationship between smoking prevalence and MS patient-linked admissions.