本研究量化了 MS 患者中各种并发症、代谢综合征 (MS) 相关危险因素和合并症的纵向经济负担。这项回顾性研究利用了 2013 年全国健康访谈调查和 2012-2021 年国家健康访谈调查的关联数据国家健康保险研究数据库，用于识别 MS 个体及其特征。每种并发症的发生率计算为研究期间并发症事件的数量除以随访期间的总人年数。使用广义估计方程模型分析并发症的医疗费用，以确定调整患者特征后并发症的费用影响。对缺失率较高的变量（即死亡原因、体重指数）进行了敏感性分析。在超过 8.28 (±1.35) 年随访的 837 名 MS 个体中，最常见的并发症是微血管疾病（发病率肾病/视网膜病/神经病：每100人年有6.49/2.64/2.08起事件），其次是心血管疾病（2.47）、周围血管疾病（2.01）和癌症（1.53）。死亡是成本最高的事件（每人事件年成本：16,429 美元），癌症是成本最高的并发症（非 MS 和 MS 相关癌症为 9,127-11,083 美元）。患上非 MS/MS 相关的癌症、心血管疾病和肥胖相关的医疗状况会使年度费用增加 273% (95% CI: 181-397%)/175% (105-269%)、159% (118-分别为 207%) 和 140% (84-214%)。微血管疾病对年度费用的影响最小（即肾病/神经病/视网膜病分别增加 27% [17-39%]/27% [11-46%]/24% [11-37%]）。现有合并症会使每年的费用增加 20%（骨关节炎）至 108%（抑郁症）。病态肥胖（即体重指数 ≥ 35 kg/m2）使每年的费用增加 58% (30-91%)。昂贵的并发症（即心血管疾病、外周血管疾病、癌症）、MS-相关危险因素（即病态肥胖）和合并症（即抑郁症）凸显了早期干预以预防多发性硬化症及其进展的迫切需要。本研究报告的综合成本估算可以促进经济分析的参数化，以确定对这些患者具有成本效益的干预措施。© 2024。作者。

This study quantifies the longitudinal economic burden for a wide spectrum of incident complications, metabolic syndrome (MS)-related risk factors, and comorbidities in patients with MS.This retrospective study utilized linked data from the 2013 National Health Interview Survey and the 2012-2021 National Health Insurance Research Database to identify MS individuals and their characteristics. The incidence rate of each complication was calculated as the number of complication events in the study period divided by the total person-years during follow-up. The healthcare costs of complications were analyzed using a generalized estimating equation model to determine the cost impact of complications after adjustment for patients' characteristics. Sensitivity analyses on variables with high missing rates (i.e., cause of death, body mass index) were performed.Among 837 identified MS individuals over 8.28 (± 1.35) years of follow-up, the most frequent complications were microvascular diseases (incidence rate for nephropathy/retinopathy/neuropathy: 6.49/2.64/2.08 events per 100 person-years), followed by cardiovascular diseases (2.47), peripheral vascular diseases (2.01), and cancers (1.53). Death was the costliest event (event-year cost per person: USD 16,429) and cancers were the most expensive complications (USD 9,127-11,083 for non-MS- and MS-related cancers). Developing non-MS/MS-related cancers, cardiovascular diseases, and obesity-related medical conditions increased annual costs by 273% (95% CI: 181-397%)/175% (105-269%), 159% (118-207%), and 140% (84-214%), respectively. Microvascular diseases had the lowest cost impact on annual costs (i.e., 27% [17-39%]/27% [11-46%]/24% [11-37%] increases for nephropathy/neuropathy/retinopathy, respectively). Having existing comorbidities increased annual costs by 20% (osteoarthritis) to 108% (depression). Having morbid obesity (i.e., body mass index ≥ 35 kg/m2) increased annual costs by 58% (30-91%).The economic burden from costly incident complications (i.e., cardiovascular diseases, peripheral vascular diseases, cancers), MS-related risk factors (i.e., morbid obesity), and comorbidities (i.e., depression) highlight the urgent need for early intervention to prevent MS and its progression. The comprehensive cost estimates reported in this study can facilitate the parameterization of economic analyses to identify cost-effective interventions for these patients.© 2024. The Author(s).