Ethnic and Socioeconomic Associations with Multiple Sclerosis Risk.
Adult
Asian People
/ statistics & numerical data
Black People
/ statistics & numerical data
Case-Control Studies
Economic Status
/ statistics & numerical data
England
/ epidemiology
Female
Humans
Infectious Mononucleosis
/ epidemiology
Male
Middle Aged
Multiple Sclerosis
/ epidemiology
Obesity
/ epidemiology
Odds Ratio
Overweight
/ epidemiology
Risk Factors
Smoking
/ epidemiology
Social Class
White People
/ statistics & numerical data
Journal
Annals of neurology
ISSN: 1531-8249
Titre abrégé: Ann Neurol
Pays: United States
ID NLM: 7707449
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
08
10
2019
revised:
21
01
2020
accepted:
21
01
2020
pubmed:
25
1
2020
medline:
28
7
2020
entrez:
25
1
2020
Statut:
ppublish
Résumé
Epidemiological research in multiple sclerosis (MS) has mainly been performed in socioeconomically and ethnically limited populations; influences on MS risk have not been studied in prospectively collected non-White populations. We set out to study the influence of previously described MS risk factors in an ethnically diverse population. A nested case-control study was created using primary care records of >1 million individuals, >50% of whom identify as Black, Asian, and Minority Ethnic (BAME). MS cases were compared to an age- and sex-matched control cohort (1:4), and to a large unmatched cohort. Odds ratios (ORs) of disease were determined according to exposure of interest, and a multivariate model including all exposures was created. Potential pairwise interactions were considered where both indicated a significant effect. A total of 1,344 confirmed MS cases were included. MS OR in blacks aged <40 years was 1.15 (95% confidence interval [CI] = 0.81-1.62) compared to whites. MS odds in BAME current (OR = 1.71, 95% CI = 1.24-2.31) and ex-smokers (OR = 2.83, 95% CI = 2.14-3.72) were considerably higher than in Whites (OR = 1.09, 95% CI = 0.88-1.34; OR = 1.44, 95% CI = 1.19-1.74, respectively). Prior infectious mononucleosis was associated with increased odds of MS in Blacks (OR = 4.94, 95% CI = 1.23-17.89). An increase in MS odds was seen in the least-deprived quintile (OR = 2.46, 95% CI = 1.40-4.24), but no effect across deprived quintiles was seen. This cohort provides novel data on factors potentially driving MS susceptibility in a diverse population, one-third of whom live in poverty. Environmental exposures have differential risk across ethnicity. ANN NEUROL 2020;87:599-608.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
599-608Informations de copyright
© 2020 American Neurological Association.
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