An Ecologic Study of Geographical Variation in Multiple Sclerosis Risk in Central Sardinia, Italy

Montomoli, Cristina; Allemani, Claudia; Solinas, Giuliana; Motta, G.; Bernardinelli, Luisa; Clemente, Susana; Murgia, B.; Ticca, Anna; Musu, Luigina; Piras, Maria Luisa; Ferrai, Raffaela; Caria, A.; Sanna, Sonia; Porcu, O.

doi:10.1159/000059522

Cited by 27 publications

(23 citation statements)

References 20 publications

(31 reference statements)

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“…Ï R = s/q (risk ratio to general population = risk for R-degree relative/risk in general population). 1 See reference [10]. Table 3 shows age-adjusted risks and risk ratios Ï R for different degrees of MS relatives.…”

Section: Resultsmentioning

confidence: 99%

“…Malaria was also the reason for selecting some human leucocyte antigen alleles [8] and possibly some ancestral haplotypes which are particularly frequent in Sardinia but not in other parts of the world [9]. A high prevalence of MS (157/100,000 inhabitants, 103/ 100,000 inhabitants) and a high proportion of MS cases in the young age groups are reported in Sardinia, in particular in the Nuoro province and in the north-western part of the island [10,11]. An association between the ancestral haplotype A30B18DR3 and MS was also observed [12].…”

Section: Study Populationmentioning

confidence: 99%

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Risk for Relatives of Patients with Multiple Sclerosis in Central Sardinia, Italy

Prokopenko

Montomoli²,

Ferrai³

et al. 2003

Neuroepidemiology

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Multiple sclerosis (MS) is a chronic, inflammatory, disabling disease of the central nervous system, known for its complex interplay between genetic and environmental factors. We used life table techniques to calculate age-adjusted recurrence risks for different categories of relatives of MS patients from Central Sardinia (Italy), a genetically homogeneous, stable population with a high degree of consanguinity. We included 313 probands and a total of 12,717 relatives in the analysis. The overall age-adjusted recurrence risk for relatives of MS probands is 1.90% [95% confidence interval (CI): 1.57–2.30]. The age-adjusted recurrence risk in parents was 1.26% (95% CI 0.60–2.63), in children 2.33% (95% CI 0.09–5.56), in sibs 4.76% (95% CI 3.57–6.32), in second-degree relatives 0.72% (95% CI 0.42–1.22), and in third-degree relatives 1.79% (95% CI 1.27–2.51). The sex of the probands (male) and of the relatives (female), and the number of affected relatives in the family significantly increase the risk of MS in relatives.

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Section: Resultsmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

Risk for Relatives of Patients with Multiple Sclerosis in Central Sardinia, Italy

Prokopenko

Montomoli²,

Ferrai³

et al. 2003

Neuroepidemiology

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“…New evidence has been reported that increased sun exposure during ages 6-15 y is associated with a decreased risk of multiple sclerosis (Van der Mei et al, 2003). Interestingly, the prevalence of MS among Sardinians presents evidence against the latitude gradient theory (Pugliatti et al, 2001) and could be explained by a high susceptibility of the population to MS (Montomoli et al, 2002).…”

Section: Ms and Vitamin Dmentioning

confidence: 99%

Multiple sclerosis and vitamin D: an update

et al. 2004

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MS is a chronic, immune-mediated inflammatory and neurodegenerative disease of the central nervous system (CNS), with an etiology that is not yet fully understood. The prevalence of MS is highest where environmental supplies of vitamin D are lowest. It is well recognized that the active hormonal form of vitamin D, 1,25-dihydroxyvitamin D (1,25-(OH) 2 D), is a natural immunoregulator with anti-inflammatory action. The mechanism by which vitamin D nutrition is thought to influence MS involves paracrine or autocrine metabolism of 25OHD by cells expressing the enzyme 1a-OHase in peripheral tissues involved in immune and neural function. Administration of the active metabolite 1,25-(OH) 2 D in mice and rats with experimental allergic encephalomyelitis (EAE, an animal model of MS) not only prevented, but also reduced disease activity. 1,25-(OH) 2 D alters dendritic cell and T-cell function and regulates macrophages in EAE. Interestingly, 1,25-(OH) 2 D is thought to be operating on CNS constituent cells as well. Vitamin D deficiency is caused by insufficient sunlight exposure or low dietary vitamin D 3 intake. Subtle defects in vitamin D metabolism, including genetic polymorphisms related to vitamin D, might possibly be involved as well. Optimal 25OHD serum concentrations, throughout the year, may be beneficial for patients with MS, both to obtain immune-mediated suppression of disease activity, and also to decrease disease-related complications, including increased bone resorption, fractures, and muscle weakness.

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“…In recent years the Bayesian methodology has been strongly encouraged as an alternative to the frequentist approach when dealing with epidemio-logical data [13][14][15] and Bayesian mapping could be a better key to modeling the geographical distribution of a disease [16][17][18][19] .…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and Geographical Variation of Myasthenia Gravis in the Province of Pavia, Italy

et al. 2012

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Background and Aims: Previous studies have reported a prevalence estimate of myasthenia gravis (MG) from 7.7 to 11.1 per 100,000 inhabitants in Europe. Moreover, the study of the geographical distribution of MG should be useful to generate specific hypotheses. The aims are to estimate MG prevalence and to investigate its geographical variation in a delimited area in Northern Italy. Methods: The primary source of data was the MG database of the Neurological Institute of Pavia and all other sources of case collection in and outside the province. We adopted a Bayesian approach to analyze MG geographical variation within the finest geographical grid. Results: We identified 119 live MG prevalent cases resident in the province of Pavia on December 31, 2008. The overall crude prevalence was 24 per 100,000 inhabitants. The Bayesian analysis identified a small cluster of higher MG prevalence in the northern area of the province. Conclusions: The estimated MG prevalence sets the province of Pavia among the high-risk areas. The identification of high/low MG risk areas deserves further investigation of genetic and environmental factors possibly related to a major risk of the disease in that area.

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An Ecologic Study of Geographical Variation in Multiple Sclerosis Risk in Central Sardinia, Italy

Cited by 27 publications

References 20 publications

Risk for Relatives of Patients with Multiple Sclerosis in Central Sardinia, Italy

Risk for Relatives of Patients with Multiple Sclerosis in Central Sardinia, Italy

Multiple sclerosis and vitamin D: an update

Epidemiology and Geographical Variation of Myasthenia Gravis in the Province of Pavia, Italy

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