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Mult Scler. 2016 Jan;22(1):104-11. doi: 10.1177/1352458515579444. Epub 2015 May 26.

Level of education and multiple sclerosis risk after adjustment for known risk factors: The EnvIMS study.

Author information

1
Department of Global Public Health and Primary Care, University of Bergen, Norway/The Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Norway kjetil.bjornevik@igs.uib.no.
2
Department of Global Public Health and Primary Care, University of Bergen, Norway/The Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Norway.
3
The Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Norway/The KG Jebsen Centre for MS-Research, Department of Clinical Medicine, University of Bergen, Norway.
4
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway/Department of Neurology, Akershus University Hospital, Norway.
5
Department of Clinical Neurology, University of Tromsø, Norway/Centre for Clinical Research and Education, University Hospital of North Norway, Norway.
6
Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Canada.
7
Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Canada/Research Institute of the McGill University Health Centre, Canada.
8
Department of Global Public Health and Primary Care, University of Bergen, Norway/Department of Clinical and Experimental Medicine, University of Sassari, Italy/Division of Medicine, McGill University, Canada.

Abstract

BACKGROUND:

Several recent studies have found a higher risk of multiple sclerosis (MS) among people with a low level of education. This has been suggested to reflect an effect of smoking and lower vitamin D status in the social class associated with lower levels of education.

OBJECTIVE:

The objective of this paper is to investigate the association between level of education and MS risk adjusting for the known risk factors smoking, infectious mononucleosis, indicators of vitamin D levels and body size.

METHODS:

Within the case-control study on Environmental Factors In MS (EnvIMS), 953 MS patients and 1717 healthy controls from Norway reported educational level and history of exposure to putative environmental risk factors.

RESULTS:

Higher level of education were associated with decreased MS risk (p trend = 0.001) with an OR of 0.53 (95% CI 0.41-0.68) when comparing those with the highest and lowest level of education. This association was only moderately reduced after adjusting for known risk factors (OR 0.61, 95% CI 0.44-0.83). The estimates remained similar when cases with disease onset before age 28 were excluded.

CONCLUSION:

These findings suggest that factors related to lower socioeconomic status other than established risk factors are associated with MS risk.

KEYWORDS:

Multiple sclerosis; education; environmental risk factors; socioeconomic status

PMID:
26014605
PMCID:
PMC4702243
DOI:
10.1177/1352458515579444
[Indexed for MEDLINE]
Free PMC Article

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