Cardiometabolic Comorbidities in Neuromyelitis Optica Spectrum Disorder: A Systematic Review and Meta-analysis
Oranuch Chuapakdee1, Wattakorn Laohapiboolrattana2, Nonthikorn Theerasuwipakorn3, Abhinbhen Saraya Wasontiwong4
1Chula Neuroscience Center, Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai red cross society, 2Faculty of Medicine, Naresuan University, 3Cardiac center, Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, 4Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Thai Red Cross Emerging Infectious Diseases Health Science Centre, King Chulalongkorn Memorial Hospital
Objective:
To determine the prevalence of cardiometabolic comorbidities in patients with NMOSD compared to controls.
Background:
The prevalence of cardiometabolic comorbidities in neuromyelitis optica spectrum disorder (NMOSD) remains uncertain.
Design/Methods:
PubMed, Scopus, and Cochrane databases were systematically searched from 2006 to April 2026 to identify studies comparing the prevalence of cardiometabolic comorbidities between NMOSD patients and non-NMOSD controls. Pooled odds ratios were estimated using a random-effects model. Pre-specified subgroup analysis was performed by stratification of controls (multiple sclerosis [MS], other demyelinating, and non-demyelinating controls).
Results:
Twelve studies comprising 5,011 NMOSD patients and 13,466 controls were included (mean age 45.3±15.4 years; 71.8% female). Compared to controls, NMOSD patients had higher prevalences of hypertension (26.7% vs. 14.8%; pooled odds ratio [pOR] 1.34; 95%CI 1.05-1.70), type 2 diabetes mellitus (T2DM: 14.0% vs. 6.1%; pOR 1.76; 95%CI 1.39-2.23), Stroke (11.4% vs. 1.3%; pOR 5.58; 95%CI 1.35-23.08), coronary artery disease (CAD: 3.1% vs. 2.2%; pOR 1.81; 95%CI 1.26-2.58), and heart failure (HF: 3.4% vs. 0.8%; pOR 3.72; 95%CI 1.88-7.39), while dyslipidemia (10.6% VS 11.8%) was not significantly different. Regarding subgroup analysis of NMOSD vs. non-demyelinating controls, the prevalences of T2DM (15.1% vs. 6.9%), stroke (11.6% vs. 1.2%), CAD (3.1% vs. 2.2%), and HF (3.3% vs. 0.8%) were significantly higher, while DLP (14.3% vs. 24%) was lower in NMOSD. The prevalence of T2DM (11.2% vs. 5.6%) was higher in NMOSD than in MS, but not significantly different compared to other demyelinating controls. Hypertension and dyslipidemia prevalences were not statistically different between NMOSD and MS/other demyelinating controls. Insufficient data precluded a pooled analysis of stroke, CAD, and HF in MS and other demyelinating controls.
Conclusions:
Cardiometabolic comorbidities, including hypertension, T2DM, stroke, CAD, and HF, are more prevalent in patients with NMOSD than in controls, suggesting that comorbidities screening and management should be incorporated into routine NMOSD care.
Generative AI Usage
No, did not use generative AI in the drafting or editing in this abstract.
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