Higher latitude is significantly associated with an earlier age of disease onset in multiple sclerosis
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu srovnávací studie, časopisecké články, multicentrická studie
PubMed
27810919
DOI
10.1136/jnnp-2016-314013
PII: jnnp-2016-314013
Knihovny.cz E-zdroje
- MeSH
- dospělí MeSH
- genetická predispozice k nemoci genetika MeSH
- genetika MeSH
- kohortové studie MeSH
- lékařská geografie MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- relabující-remitující roztroušená skleróza diagnóza epidemiologie etiologie MeSH
- rizikové faktory MeSH
- roztroušená skleróza diagnóza epidemiologie etiologie MeSH
- ultrafialové záření MeSH
- věk při počátku nemoci MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- srovnávací studie MeSH
- Geografické názvy
- Austrálie MeSH
- Evropa MeSH
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. 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. 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=3.83×10-23). 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=1.56×10-17). 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=1.40×10-265). 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.
Al Zahra Hospital Isfahan University of Medical Sciences Isfahan Iran
Amiri Hospital Kuwait City Kuwait
AORN San Giuseppe Moscati Avellino Avellino Italy
Bombay Hospital Institute of Medical Sciences Mumbai India
Brain and Mind Research Institute Sydney New South Wales Australia
C Mondino National Neurological Institute Pavia Italy
CHUM Hôpital Notre Dame Montreal Canada
CISSS Chaudiere Appalaches Levis Quebec Canada
Cliniques Universitaires Saint Luc Brussels Belgium
Department of Basic Medical Sciences Neuroscience and Sense Organs University of Bari Bari Italy
Department of Medicine Royal Melbourne Hospital University of Melbourne Melbourne Victoria Australia
Department of Neurofarba Section of Neurosciences University of Florence Florence Italy
Department of Neurology Eastern Health Monash University Box Hill Victoria Australia
Department of Neurology Golestan University of Medical Sciences Gorgan Iran
Department of Neurology Mayis University Samsun Turkey
Department of Neuroscience University of Parma Parma Italy
Flinders University and Medical Centre Adelaide South Australia Australia
Geelong Hospital Geelong Victoria Australia
Groene Hart Ziekenhuis Gouda The Netherlands
Hospital de Galdakao Usansolo Galdakao Spain
Hospital Ecoville Curitiba Brazil
Hospital Fernandez Capital Federal Argentina
Hospital Germans Trias 1 Pujol Badalona Spain
Hospital Italiano Buenos Aries Argentina
Hospital Universitario Virgen de Valme Sevilla Spain
Hospital Universitario Virgen Macarena Sevilla Spain
IRCCS Istituto delle Scienze Neurologiche UOSI Riabilitazione Sclerosi Multipla Bologna Italy
Liverpool Hospital Liverpool New South Wales Australia
Menzies Institute for Medical Research University of Tasmania Hobart Tasmania Australia
Neuro Rive Sud Hôpital Charles LeMoyne Quebec Quebec Canada
Neurology Unit ASUR Marche AV 3 Macerata Italy
Ospedali Riuniti di Salerno Salerno Italy
St Andrew's Place Brisbane Australia
St Vincent's Hospital Melbourne Victoria Australia
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