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Differences in Cardiometabolic Comorbidities Between Black and White Persons Living With Multiple Sclerosis

Published:October 30, 2021DOI:https://doi.org/10.1016/j.apmr.2021.10.011

      Abstract

      Objective

      To determine differences in obesity, type 2 diabetes, and hypertension in Black patients compared with White patients with multiple sclerosis (MS).

      Design

      Cross-sectional database review.

      Setting

      Large academic medical center research records database.

      Participants

      A total of 3191 patient cases (N=3191; 77% female, 34% Black) identified by MS diagnosis within the medical record.

      Interventions

      Not applicable.

      Main Outcome Measures

      Diagnosis codes for type 2 diabetes and hypertension. Body mass index (BMI), race, age, and sex were collected. Analysis of variance (continuous variables) and chi-square analyses (categorical variables) were conducted to determine differences in obesity, diabetes, and hypertension between race and sex. Logistic regression was conducted to determine odds ratios (ORs) of developing diabetes and hypertension based on race, sex, BMI, and age.

      Results

      Black patients were more than twice as likely to be diagnosed as having diabetes (OR, 2.15 [95% CI, 1.70-2.72]; P<.0001) or hypertension (OR, 2.44 [95% CI, 2.05-2.91], P<.0001) compared with White patients. Sex did not present a greater likelihood of being diagnosed as having diabetes; however, men were 1.22 times more likely be diagnosed as having hypertension compared with women (95% CI, 1.01-1.49; P=.0439). Increased age and BMI were also significantly associated with likelihood of diagnosis of diabetes and hypertension (age: diabetes OR, 1.05 [95% CI, 1.04-1.06], P<.0001; hypertension OR, 1.06 [95% CI, 1.05-1.06], P<.0001; BMI: diabetes obese vs normal: OR, 2.11 [95% CI, 1.43-3.11], P=.0002; hypertension: obese vs normal: OR, 1.72 [95% CI, 1.39-2.13], P<.0001).

      Conclusions

      Black patients with MS are significantly more likely to have cardiometabolic conditions than White patients. These conditions have been associated with poorer health outcomes for people with MS and may have some effect on the differences in MS disease course reported in Black patients.

      Keywords

      List of abbreviations:

      BMI (body mass index), ICD-9 (International Classification of Diseases, Ninth Revision), ICD-10 (International Classification of Diseases, Tenth Revision), i2b2 (Informatics for Integrating Biology and the Bedside), MS (multiple sclerosis), OR (odds ratio), UAB (University of Alabama at Birmingham), US (United States)
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