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Higher latitude is significantly associated with an earlier age of disease onset in multiple sclerosis.
- Source :
-
Journal of neurology, neurosurgery, and psychiatry [J Neurol Neurosurg Psychiatry] 2016 Dec; Vol. 87 (12), pp. 1343-1349. Date of Electronic Publication: 2016 Nov 03. - Publication Year :
- 2016
-
Abstract
- Background: Age at onset (AAO) in multiple sclerosis (MS) is an important marker of disease severity and may have prognostic significance. Understanding what factors can influence AAO may shed light on the aetiology of this complex disease, and have applications in the diagnostic process.<br />Methods: The study cohort of 22 162 eligible patients from 21 countries was extracted from the MSBase registry. Only patients with MS aged ≥16 years were included. To reduce heterogeneity, only centres of largely European descent were included for analysis. AAO was defined as the year of the first symptom suggestive of inflammatory central nervous system demyelination. Predictors of AAO were evaluated by linear regression.<br />Results: Compared with those living in lower latitudes (19.0-39.9°), onset of symptoms was 1.9 years earlier for those at higher latitudes (50.0-56.0°) (p=3.83×10 <superscript>-23</superscript> ). A reciprocal relationship was seen for ambient ultraviolet radiation (UVR), with a significantly increasing AAO for patients with MS per each quartile increment of ambient UVR (p=1.56×10 <superscript>-17</superscript> ). We found that the AAO of female patients was ∼5 months earlier than male patients (p=0.002). AAO of progressive-onset patients with MS were ∼9 years later than relapsing-onset patients (p=1.40×10 <superscript>-265</superscript> ).<br />Conclusions: An earlier AAO in higher latitude regions was found in this worldwide European-descent cohort and correlated inversely with variation in latitudinal UVR. These results suggest that environmental factors which act at the population level may significantly influence disease severity characteristics in genetically susceptible populations.<br /> (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)
- Subjects :
- Adolescent
Adult
Age of Onset
Australia
Cohort Studies
Europe
Female
Genetic Predisposition to Disease genetics
Genetics
Geography, Medical
Humans
Male
Multiple Sclerosis diagnosis
Multiple Sclerosis etiology
Multiple Sclerosis, Relapsing-Remitting diagnosis
Multiple Sclerosis, Relapsing-Remitting epidemiology
Multiple Sclerosis, Relapsing-Remitting etiology
Risk Factors
Ultraviolet Rays
Young Adult
Multiple Sclerosis epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1468-330X
- Volume :
- 87
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Journal of neurology, neurosurgery, and psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 27810919
- Full Text :
- https://doi.org/10.1136/jnnp-2016-314013