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Kathryn Continue reading. Comorbidity is emerging as a relevant component of clinical care in people with multiple sclerosis MS. Comorbidities are disorders coexisting with a given disease that are not downstream complications of the primary disease. Both MS risk and prognosis are heterogeneous, and recent research has highlighted the role of comorbidities as a potential contributor to the observed differences in outcomes. Social determinants of health, including socioeconomic status SESenvironmental factors, racial and ethnic identity, and the interplay among these factors may also contribute to the link between MS and comorbid conditions, although data are limited.

Vascular and related comorbidities are overrepresented in people with MS, 2 including hypertension, ischemic Te disease, and, possibly, heart failure, venous thromboembolism, and atrial fibrillation.

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These findings are largely derived from population-based registry studies conducted in Scandinavian countries and Canada. A study including all Danish-born citizens with MS between and showed people with MS had nearly twice the risk for cerebrovascular disease and cardiovascular disease CVD as people of the same sex, age, and region of residence without MS.

In the study from England, lower mortality rates were seen in people with MS who were using lipid-lowering medications statins primarily.

A cross-sectional registry study of North American residents with MS suggests indicators of low SES are associated with increased prevalence of vascular and Effect comorbidities eg, hypertension and hypercholesterolemia. Similar to CVD comorbidity, closely related metabolic comorbidities including obesity, diabetes, insulin resistance, and dyslipidemia are also overrepresented in people with MS. Excess adiposity has Depressin consistently identified as a risk factor for MS. Some prospective studies show obesity as a risk factor for faster rates of neurodegeneration in people with MS. This potential link between metabolism and autoimmunity has also motivated studies describing anti-inflammatory effects of several antidiabetic medications eg, metformin or pioglitazone on MS outcomes and biomarkers of inflammation.

Comorbid Cancer A comprehensive review suggests people with MS may have a higher risk of meningioma and urinary system cancers and a lower risk of pancreatic, ovarian, prostate, and testicular cancers, although results of individual studies yield inconsistent data.]