Journal
MULTIPLE SCLEROSIS JOURNAL
Volume 22, Issue 4, Pages 461-469Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/1352458515594040
Keywords
First demyelinating event; multiple sclerosis; gene-environment interaction; population attributable fraction; risk factors
Categories
Funding
- Australian Research Council [100100511]
- National Health and Medical Research Council of Australia
- Australian Research Council
- Multiple Sclerosis Research Australia
- Royal Australasian College of Physicians
- MS Research Australia
- United States National Multiple Sclerosis Society
- Poola Foundation
- Health Research Council of New Zealand
- MS Society of Tasmania
- Bayer Schering Pharma
- Biogen Idec Inc.
Ask authors/readers for more resources
Aim: We examined the combined effect of having multiple key risk factors and the interactions between the key risk factors of multiple sclerosis (MS). Methods: We performed an incident case-control study including cases with a first clinical diagnosis of central nervous system demyelination (FCD) and population-based controls. Results: Compared to those without any risk factors, those with one, two, three, and four or five risk factors had increased odds of being an FCD case of 2.12 (95% confidence interval (CI), 1.11-4.03), 4.31 (95% CI, 2.24-8.31), 7.96 (95% CI, 3.84-16.49), and 21.24 (95% CI, 5.48-82.40), respectively. Only HLA-DR15 and history of infectious mononucleosis interacted significantly on the additive scale (Synergy index, 3.78; p = 0.03). The five key risk factors jointly accounted for 63.8% (95% CI, 43.9-91.4) of FCD onset. High anti-EBNA IgG was another important contributor. Conclusions: A high proportion of FCD onset can be explained by the currently known risk factors, with HLA-DR15, ever smoking and low cumulative sun exposure explaining most. We identified a significant interaction between HLA-DR15 and history of IM in predicting an FCD of CNS demyelination, which together with previous observations suggests that this is a true interaction.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available