Body size and the risk of multiple sclerosis in Norway and Italy: The EnvIMS study

Abstract

Background:

Obesity may be a risk factor for developing multiple sclerosis (MS).

Objective:

We examined if body size influences the risk of MS in a population-based, case control study.

Methods:

A total of 953 cases and 1717 controls from Norway and 707 cases and 1333 controls from Italy reported their body size by choosing a silhouette 1 to 9 (largest) every fifth year from age 5 to 30 and at time of study. The body size-related MS risk was defined by odds ratios (ORs) in logistic regression analyses adjusting for age, smoking and outdoor activity.

Results:

In Norway a large body size (silhouettes 6–9) compared to silhouette 3 increased the risk of MS, especially at age 25 (OR 2.21; 95% CI 1.09–4.46 for men and OR 1.43; 95% CI 0.90–2.27 for women). When comparing silhouette 9 to 1, we found a significant dose-response from age 10 until age 30 peaking at age 25 (sex-adjusted OR 2.83; 95% CI 1.68–4.78). The association was present for at least 15 years prior to disease onset. No significant associations were found in Italy.

Conclusions:

Obesity from childhood until young adulthood is a likely risk factor for MS with a seemingly stronger effect in Norway than in Italy.

Keywords

Multiple sclerosis body size obesity epidemiology vitamin D case control studies body mass index

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References

Wynia

Middel

van Dijk

. The impact of disabilities on quality of life in people with multiple sclerosis. Mult Scler 2008; 14: 972–980.

Nortvedt

Riise

Myhr

. Quality of life in multiple sclerosis: Measuring the disease effects more broadly. Neurology 1999; 53: 1098–1103.

Handel

Giovannoni

Ebers

. Environmental factors and their timing in adult-onset multiple sclerosis. Nat Rev Neurol 2010; 6: 156–166.

Lin

Charlesworth

van der Mei

. The genetics of multiple sclerosis. Pract Neurol 2012; 12: 279–288.

Ascherio

Munger

Simon

. Vitamin D and multiple sclerosis. Lancet Neurol 2010; 9: 599–612.

Munger

Levin

Hollis

. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA 2006; 296: 2832–2838.

Goldner

Stoner

Thompson

. Prevalence of vitamin D insufficiency and deficiency in morbidly obese patients: A comparison with non-obese controls. Obes Surg 2008; 18: 145–150.

Konradsen

Lindberg

. Serum 1,25-dihydroxy vitamin D is inversely associated with body mass index. Eur J Nutr 2008; 47: 87–91.

Munger

Chitnis

Ascherio

. Body size and risk of MS in two cohorts of US women. Neurology 2009; 73: 1543–1550.

10.

Hedström

Olsson

Alfredsson

. High body mass index before age 20 is associated with increased risk for multiple sclerosis in both men and women. Mult Scler 2012; 18: 1334–1336.

11.

Langer-Gould

Brara

Beaber

. Childhood obesity and risk of pediatric multiple sclerosis and clinically isolated syndrome. Neurology 2013; 80: 548–552.

12.

Munger

Bentzen

Laursen

. Childhood body mass index and multiple sclerosis risk: A long-term cohort study. Mult Scler 2013; 19: 1323–1329.

13.

Myhr

Grytten

Aarseth

. The Norwegian Multiple Sclerosis Registry and Biobank. Acta Neurol Scand Suppl 2012; 20–23.

14.

Alonso

Hernan

. Temporal trends in the incidence of multiple sclerosis: A systematic review. Neurology 2008; 71: 129–135.

15.

Pugliatti

Casetta

Drulovic

. A questionnaire for multinational case-control studies of environmental risk factors in multiple sclerosis (EnvIMS-Q). Acta Neurol Scand Suppl 2012; 43–50.

16.

Stunkard

Sørensen

Schulsinger

. Use of the Danish Adoption Register for the study of obesity and thinness. Res Publ Assoc Res Nerv Ment Dis 1983; 60: 115–120.

17.

Sorbara

Geliebter

. Body image disturbance in obese outpatients before and after weight loss in relation to race, gender, binge eating, and age of onset of obesity. Int J Eat Disord 2002; 31: 416–423.

18.

Lewis

Cachelin

. Body image, body dissatisfaction, and eating attitudes in midlife and elderly women. Eat Disord 2001; 9: 29–39.

19.

Bulik

Wade

Heath

. Relating body mass index to figural stimuli: Population-based normative data for Caucasians. Int J Obes Relat Metab Disord 2001; 25: 1517–1524.

20.

World Health Organization. WHO global database on body mass index [database], http://www.who.int/gho/ncd/risk_factors/bmi_text/en/ (accessed: 5 August 2012).

21.

Kremer

Campbell

Reinhardt

. Vitamin D status and its relationship to body fat, final height, and peak bone mass in young women. J Clin Endocrinol Metab 2009; 94: 67–73.

22.

Gordon

DePeter

Feldman

. Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med 2004; 158: 531–537.

23.

Wortsman

Matsuoka

Chen

. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 2000; 72: 690–693.

24.

Aleksandrova

Nimptsch

Pischon

. Influence of obesity and related metabolic alterations on colorectal cancer risk. Curr Nutr Rep 2013; 2: 1–9.

25.

Nishimura

Manabe

Nagasaki

. CD8+ effector T cells contribute to macrophage recruitment and adipose tissue inflammation in obesity. Nat Med 2009; 15: 914–920.

26.

Kasper

Shoemaker

. Multiple sclerosis immunology: The healthy immune system vs the MS immune system. Neurology 2010; 74 (Suppl 1): S2–S8.

27.

Gøbel

Jensen

Frøkiaer

. Obesity, inflammation and metabolic syndrome in Danish adolescents. Acta Paediatr 2012; 101: 192–200.

28.

Hedström

Lima Bomfim

Barcellos

. Interaction between adolescent obesity and HLA risk genes in the etiology of multiple sclerosis. Neurology 2014; 82: 865–872.

29.

Correale

Ysrraelit

Gaitan

. Vitamin D-mediated immune regulation in multiple sclerosis. J Neurol Sci 2011; 311: 23–31.

30.

Deluca

Cantorna

. Vitamin D: Its role and uses in immunology. FASEB J 2001; 15: 2579–2585.

31.

Koch

Metz

Agrawal

. Environmental factors and their regulation of immunity in multiple sclerosis. J Neurol Sci 2013; 324: 10–16.

32.

Mai

Chen

Camargo

Jr . Cross-sectional and prospective cohort study of serum 25-hydroxyvitamin D level and obesity in adults: The HUNT Study. Am J Epidemiol 2012; 175: 1029–1036.

33.

Becklund

Severson

Vang

. UV radiation suppresses experimental autoimmune encephalomyelitis independent of vitamin D production. Proc Natl Acad Sci U S A 2010; 107: 6418–6423.

34.

Adami

Bertoldo

Braga

. 25-hydroxy vitamin D levels in healthy premenopausal women: Association with bone turnover markers and bone mineral density. Bone 2009; 45: 423–426.

35.

Pacifico

Anania

Osborn

. Low 25(OH)D3 levels are associated with total adiposity, metabolic syndrome, and hypertension in Caucasian children and adolescents. Eur J Endocrinol 2011; 165: 603–611.

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