OBJECTIVE To determine if vascular risk factor (VRF), that is, smoking, arterial hypertension (HT), dyslipidaemia and diabetes, have an effect on multiple sclerosis (MS) pathology as measured by MS typical brain lesions, we have compared brain MRIs from patients with MS with and without VRF age-matched and sex-matched. METHODS Brain MRIs from five centres were scored for the presence of Dawson's fingers (DF) and juxtacortical lesions (JCL). A regression model was built to predict the effect of each individual VRF on DF and JCL, considering age and disease duration. RESULTS 92 MS cases without VRF and 106 MS with one or more VRF (80 ever-smokers, 43 hypertensives, 25 dyslipidaemics and 10 diabetics) were included. Ever-smoking associated with a higher burden of DF (Exp(B)=1.29, 95% CI 1.10 to 1.51, p<0.01) and JCL (Exp(B)=1.38, 95% CI 1.21 to 1.57, p<0.01). No other VRF had an impact on DF. Dyslipidaemia associated with increased JCL (Exp(B)=1.30, 95% CI 1.10 to 1.56, p<0.01) but HT did not associate with any of the outcomes. CONCLUSIONS Individual VRF appear to affect MS-specific lesions differently. An increase in MS lesions was mainly seen in smokers; however, this VRF is most likely to be present from onset of MS, and other VRF effects may be partly mitigated by treatment. Our findings support that treating VRF and cessation of smoking may be important in the management of MS.

中文翻译：

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不同血管危险因素对多发性硬化症中白质脑病变的不同影响。

目的为了确定血管危险因素（VRF），即吸烟，动脉高压（HT），血脂异常和糖尿病是否对多发性硬化症（MS）病理有影响，以MS典型的脑部病变为指标，我们比较了患有和不患有VRF的MS患者的年龄匹配和性别匹配。方法对五个中心的脑MRI进行评分，以评估道森氏手指（DF）和皮层皮损（JCL）的存在。考虑到年龄和疾病持续时间，建立了回归模型来预测每个VRF对DF和JCL的影响。结果包括92例无VRF的MS病例和106例有一种或多种VRF的MS患者（80例经常吸烟者，43例高血压，25例血脂异常和10例糖尿病患者）。经常吸烟与DF（Exp（B）= 1.29，95％CI 1.10至1.51，p <0.01）和JCL（Exp（B）= 1.38，95％CI 1。21至1.57，p <0.01）。没有其他VRF对DF产生影响。与JCL升高相关的血脂异常（Exp（B）= 1.30，95％CI 1.10至1.56，p <0.01），但HT与任何预后无关。结论个体VRF似乎对MS特异性病变的影响不同。MS损害的增加主要见于吸烟者；但是，这种VRF最有可能在MS发作后出现，其他VRF效应可能会通过治疗得到部分缓解。我们的发现支持治疗VRF和戒烟可能对MS的治疗很重要。MS损害的增加主要见于吸烟者；但是，这种VRF最有可能在MS发作后出现，其他VRF效应可能会通过治疗得到部分缓解。我们的发现支持治疗VRF和戒烟可能对MS的治疗很重要。MS病变的增加主要见于吸烟者。但是，这种VRF最有可能在MS发作后出现，其他VRF效应可能会通过治疗得到部分缓解。我们的发现支持治疗VRF和戒烟可能对MS的治疗很重要。