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Obes Res Clin Pract. 2014 Sep-Oct;8(5):e435-47. doi: 10.1016/j.orcp.2014.01.002. Epub 2014 Mar 6.

Obesity during childhood and adolescence increases susceptibility to multiple sclerosis after accounting for established genetic and environmental risk factors.

Author information

1
Division of Epidemiology, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, United States.
2
Kaiser Permanente Division of Research, Oakland, CA, United States.
3
Palm Drive Hospital, Sebastopol, CA, United States.
4
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
5
Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
6
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
7
Division of Epidemiology, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, United States; Kaiser Permanente Division of Research, Oakland, CA, United States. Electronic address: lbarcellos@genepi.berkeley.edu.

Abstract

OBJECTIVE:

To investigate the association between obesity and multiple sclerosis (MS) while accounting for established genetic and environmental risk factors.

METHODS:

Participants included members of Kaiser Permanente Medical Care Plan, Northern California Region (KPNC) (1235 MS cases and 697 controls). Logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (95% CI). Body mass index (BMI) or body size was the primary predictor of each model. Both incident and prevalent MS cases were studied.

RESULTS:

In analyses stratified by gender, being overweight at ages 10 and 20 were associated with MS in females (p<0.01). Estimates trended in the same direction for males, but were not significant. BMI in 20s demonstrated a linear relationship with MS (p-trend=9.60×10(-4)), and a twofold risk of MS for females with a BMI≥30kg/m(2) was observed (OR=2.15, 95% CI 1.18, 3.92). Significant associations between BMI in 20s and MS in males were not observed. Multivariate modelling demonstrated that significant associations between BMI or body size with MS in females persisted after adjusting for history of infectious mononucleosis and genetic risk factors, including HLA-DRB1*15:01 and established non-HLA risk alleles.

INTERPRETATION:

Results show that childhood and adolescence obesity confer increased risk of MS in females beyond established heritable and environmental risk factors. Strong evidence for a dose-effect of BMI in 20s and MS was observed. The magnitude of BMI association with MS is as large as other known MS risk factors.

KEYWORDS:

Adolescence; Childhood; Genetics; Multiple sclerosis; Risk factors in epidemiology

PMID:
25263833
PMCID:
PMC4180039
DOI:
10.1016/j.orcp.2014.01.002
[Indexed for MEDLINE]
Free PMC Article

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