Article, 2024
Sex ratio and age of onset in AQP4 antibody-associated NMOSD: a review and meta-analysis
Journal of Neurology,
ISSN
1432-1459,
0340-5354,
Pages 1-19,
10.1007/s00415-024-12452-8
Contributors
Arnett, Simon V
(Corresponding author)
[1]
[2]
Chew, Sin Hong
0000-0002-4697-5415
[1]
[2]
Leitner, Unnah
0000-0001-8914-9941
[2]
Hor, Jyh Yung
[3]
Paul, Friedemann
0000-0002-6378-0070
[4]
[5]
Yeaman, Michael R
0000-0002-9468-5252
[6]
[7]
[8]
Levy, Michael
0000-0002-7969-8346
[9]
[10]
Weinshenker, Brian Gary
0000-0001-5806-6203
[11]
Banwell, Brenda Louise
[12]
[13]
Fujihara, Kazuo
0000-0002-3096-4156
[14]
Abboud, Hesham
0000-0001-5346-8254
[15]
[16]
Dujmovic-Basuroski, Irena
0000-0002-5179-1901
[17]
Arrambide, Georgina
0000-0002-2657-5510
[18]
Neubrand, Veronika E
0000-0002-3793-8487
[19]
Quan, Chao
0000-0003-1040-3930
[20]
Melamed, Esther
[21]
Palace, Jacqueline A
[22]
[23]
Sun, Jing
0000-0002-0097-2438
[2]
[24]
Asgari, Nasrin
0000-0001-8551-0947
[25]
[26]
Broadley, Simon A
[1]
[2]
Affiliations
- [1]
Gold Coast Hospital
[NORA names:
Australia; Oceania; OECD];
- [2]
Griffith University
[NORA names:
Australia; Oceania; OECD];
- [3]
Hospital Pulau Pinang
[NORA names:
Malaysia; Asia, South];
- [4]
Cluster of Excellence "NeuroCure"
[NORA names:
Germany; Europe, EU; OECD];
- [5]
Max Delbrück Center for Molecular Medicine
[NORA names:
Germany; Europe, EU; OECD];
(... more)
- [6]
Harbor–UCLA Medical Center
[NORA names:
United States; America, North; OECD];
- [7]
The Lundquist Institute
[NORA names:
United States; America, North; OECD];
- [8]
University of California, Los Angeles
[NORA names:
United States; America, North; OECD];
- [9]
Harvard University
[NORA names:
United States; America, North; OECD];
- [10]
Massachusetts General Hospital
[NORA names:
United States; America, North; OECD];
- [11]
University of Virginia
[NORA names:
United States; America, North; OECD];
- [12]
Children's Hospital of Philadelphia
[NORA names:
United States; America, North; OECD];
- [13]
University of Pennsylvania
[NORA names:
United States; America, North; OECD];
- [14]
Fukushima Medical University
[NORA names:
Japan; Asia, East; OECD];
- [15]
Case Western Reserve University
[NORA names:
United States; America, North; OECD];
- [16]
University Hospitals Cleveland Medical Center
[NORA names:
United States; America, North; OECD];
- [17]
University of North Carolina at Chapel Hill
[NORA names:
United States; America, North; OECD];
- [18]
Neurology-Neuroimmunology Department, Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Catalonia, Spain
[NORA names:
Spain; Europe, EU; OECD];
- [19]
University of Granada
[NORA names:
Spain; Europe, EU; OECD];
- [20]
Huashan Hospital
[NORA names:
China; Asia, East];
- [21]
The University of Texas at Austin
[NORA names:
United States; America, North; OECD];
- [22]
John Radcliffe Hospital
[NORA names:
United Kingdom; Europe, Non-EU; OECD];
- [23]
University of Oxford
[NORA names:
United Kingdom; Europe, Non-EU; OECD];
- [24]
Charles Sturt University
[NORA names:
Australia; Oceania; OECD];
- [25]
Næstved, Slagelse and Ringsted Hospitals
[NORA names:
Region Zealand;
Hospital; Denmark; Europe, EU; Nordic; OECD];
- [26]
University of Southern Denmark
[NORA names:
SDU University of Southern Denmark;
University; Denmark; Europe, EU; Nordic; OECD]
(less)
Abstract
BackgroundAquaporin-4 (AQP4) antibody-associated neuromyelitis optica spectrum disorder (NMOSD) is an antibody-mediated inflammatory disease of the central nervous system. We have undertaken a systematic review and meta-analysis to ascertain the sex ratio and mean age of onset for AQP4 antibody associated NMOSD. We have also explored factors that impact on these demographic data.MethodsA systematic search of databases was conducted according to the PRISMA guidelines. Articles reporting sex distribution and age of onset for AQP4 antibody-associated NMSOD were reviewed. An initially inclusive approach involving exploration with regression meta-analysis was followed by an analysis of just AQP4 antibody positive cases.ResultsA total of 528 articles were screened to yield 89 articles covering 19,415 individuals from 88 population samples. The female:male sex ratio was significantly influenced by the proportion of AQP4 antibody positive cases in the samples studied (p < 0.001). For AQP4 antibody-positive cases the overall estimate of the sex ratio was 8.89 (95% CI 7.78–10.15). For paediatric populations the estimate was 5.68 (95% CI 4.01–8.03) and for late-onset cases, it was 5.48 (95% CI 4.10–7.33). The mean age of onset was significantly associated with the mean life expectancy of the population sampled (p < 0.001). The mean age of onset for AQP4 antibody-positive cases in long-lived populations was 41.7 years versus 33.3 years in the remainder.ConclusionsThe female:male sex ratio and the mean age of onset of AQP4 antibody-associated NMOSD are significantly higher than MS. The sex ratio increases with the proportion of cases that are positive for AQP4 antibodies and the mean age of onset increases with population life expectancy.
Keywords
AQP4,
AQP4 antibody,
BackgroundAquaporin-4,
ConclusionsThe,
MS,
MethodsA,
MethodsA systematic search,
NMSOD,
PRISMA,
PRISMA guidelines,
age,
analysis,
antibodies,
antibody positive cases,
antibody-mediated inflammatory disease,
antibody-positive cases,
article,
cases,
central nervous system,
data,
database,
demographic data,
disease,
disorders,
distribution,
estimation,
expectations,
exploration,
factors,
female:male sex ratio,
females,
guidelines,
increase,
individuals,
inflammatory diseases,
late-onset cases,
life expectancy,
male sex ratio,
mean life expectancy,
meta-analysis,
nervous system,
neuromyelitis optica spectrum disorder,
paediatric population,
population,
population life expectancy,
population sample,
positive cases,
proportion,
proportion of cases,
ratio,
regression,
regression meta-analysis,
review,
samples,
search,
sex,
sex distribution,
sex ratio,
spectrum disorder,
system,
systematic review,
systematic search,
years
Funders
Data Provider: Digital Science