A Clinical Comparison Of Gender Difference In Multiple Sclerosis

Objective:Multiple Sclerosis (MS) is a kind of autoimmune disease characaterized by demyelination throughtout the white matter of central nervous system. Incidence of MS in females is significantly higher than that in males, and clinical manifestation of the disease is influenced by gender. Previous studies on gender issue of MS were mostly based on European and American populations, while few concerned Asian patients. Current study retrospectively compared the gender difference in clinical features of Chinese MS patients.Methods:94patients who were diagnosed as definite Multiple Sclerosis and hospitalized in the department of neurology of Second Affiliated Hospital of Zhejiang University School of Medicine between January2008and March2013were included, with33males and61females. Data were collected and compared between males and females on ages of onset, intervals between two relapses of RRMS, symptoms, locations of MRI lesions, cerebrospinal fluid (CSF) IgG indexes, and the CSF/serum albumin ratios, which indicated the integrity of blood-brain barrier.Results:The mean age of onset of MS and average intervals between two relapses of RRMS show no gender difference. More females reported abnormal sensations (82.0%) than males (60.6%)(x2=5.139, P=0.023). They were at a higher risk of having numbness (80.3%v.s60.6%)(x2=4.267, P=0.039) as well as pain (27.9%v.s9.1%) (χ2=4.508, P=0.034). Lower limb paralysis also happened more frequently in females than in males (68.9%v.s45.5%)(χ2=4.912, P=0.027). Concerning MRI lesions, the risk to find cerebellum lesions was higher in males (27.3%) than in females (13.1%), while the opposite trend was found in midbrain lesions (male:6.1%v.s female:21.3%). Both reached marginal significance (χ2=2.898, P=0.089; x2=3.714, P=0.054; respectively). The rate of female patients having cervical lesions were significantly higher than that of male patients (63.9%v.s33.3%)(χ2=8.054, P=0.005). No gender difference were found in CSF IgG index and CSF/Serum Albumin ratio, but the avarage serum IgG was higher in females (13.58±4.74g/L) than in males (10.87±3.13g/L)(t=2.614, P=0.011).Conclusion:Gender difference exists in Chinese MS patients. Females are at a higher risk to have abnormal sensation, lower limb paralysis, and cervical lesions than males. There is also a trend that more females show midbrain lesions while more males show cerebellum lesions. Serum IgG is higher in females than in males.