Environmental exposures and the risk of multiple sclerosis in Saudi Arabia

Abstract

BackgroundMultiple sclerosis (MS) is the most common non-traumatic condition that leads to disability among young individuals. It is associated with demyelination, inflammation, and neurodegeneration within the central nervous system. Information on risk factors of multiple sclerosis is crucial for the prevention and control of the disease. The aim of this study was to determine risk factors of MS among adults in Saudi Arabia.MethodsA matched multicenter case-control study, including 307 MS patients and 307 healthy controls, was conducted in MS clinics and wards in 3 main cities of Saudi Arabia. Age, gender, and hospital were matched. Information on demographics, family history of MS, past medical and family history, sun exposure at different age periods, tobacco use, diet, consanguinity, and coffee consumption was obtained from self-administered questionnaires. ORs and 95% confidence intervals (CIs) were calculated. A conditional logistic regression model was used to control for potential confounding factors.ResultsThe conditional logistic regression adjusted for age and gender showed that being the first child in the family (Adjusted Odds Ratio (AOR) 1.68, 95% CI: 1.03–2.74), having a family history of MS (AOR 5.83, 95% CI: 2.83–12), eating fast food ≥5 times weekly (AOR 2.05, 95% CI: 1.03–4.08), and having had measles (AOR 3.77, 95% CI: 2.05–6.96), were independently associated with an increased risk of MS.In contrast, eating ≥5 servings of fruit per week (AOR 0.25, 95% CI: 0.16–0.38), drinking coffee daily (AOR 0.46, 95% CI: 0.31–0.68), and having a high level of sun exposure at the primary school level and university level (AOR 0.57, 95% CI: 0.38–0.85 and AOR 0.48, 95% CI: 0.30–0.76, respectively) were independently associated with a decreased risk of MS.ConclusionsOur study suggested that high levels of sun exposure during primary school and university, consumption of fruits and drinking coffee protect against MS. In contrast, eating fast food was associated with an increased risk of the disease. Encouraging outdoor activity and healthy diets in school, especially for females, is highly recommended.Electronic supplementary materialThe online version of this article (10.1186/s12883-018-1090-8) contains supplementary material, which is available to authorized users.

Fatigue and Self-management among Multiple Sclerosis Patients

“…The socio-demographic and clinical findings of the study revealed that the majority of MS patients were female versus male with Mean ±SD (30.24 ± 12.8), these findings are generally consistent with [21] who reported that 78% of MS patients were female and 22% were male at the peak age is between 20 and 30 years, as well as [22] who stated that MS usually affects women rather than men, between 20 and 40 years and in their most productive years of life. Moreover, [23] mentioned that MS is usually diagnosed in young adults and affects women two to three times as often as men.…”

“…The researchers believes that fatigue in MS increase and worsens with the age as result of its progressive disease course and early self-management strategies on early MS stage in young adult can helps in maintaining good Quality of life and prevent later complications or disability in MS patients. The study result in consistent with [44,45] who explained that age was a significant factor influencing fatigue and strongest predictor of self-management behavior of people with MS. [6,22] added that the majority of MS patients who suffering from fatigue are young adult on their most productive years of life, it can be severe, tends to persist over time and it can lead to MS complications or disability after long period of time. Furthermore [46,47] explained that living with a chronic disease like MS needs to control the disease and limit its progression on early stage , in which young MS individuals play an important role in self-management of the daily effects of the disease on their lives through early control strategy such as self management and changing lifestyle to adjust it.…”

Rising prevalence of multiple sclerosis in Saudi Arabia, a descriptive study

“…11 Qatif Central Hospital, Qatif, Saudi Arabia. 12 King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia. 13 Prince Sultan Military Medical City, Riyadh, Saudi Arabia.…”

“…Other environmental factors such as vitamin D levels, obesity, and certain early childhood exposure to infectious agents, smoking, and certain other modifiable risk factors are associated with increased risk of MS. [9] As per Kurtzke classification, prevalence of MS in the Gulf region is marked as low-risk zone, however recent data have shown marked increased in the prevalence of MS, nearly 31-55 MS per 100,0000 individuals [10]. The increased prevalence in the Gulf region could be associated with change in lifestyle conditions, vitamin D deficiency and parental consanguinity as reported by few studies [11,12]. However, the lack of a central MS registry and long term follow-up epidemiological studies, make it difficult to understand the actual prevalence and associated factors related to the increasing number of MS cases in the region.…”

Rising Prevalence of Multiple Sclerosis in Saudi Arabia, a Descriptive Study

“…(10) The increased prevalence in the Gulf region could be associated with change in lifestyle conditions, vitamin D deficiency and parental consanguinity as reported by few studies. (11,12) However, the lack of a central MS registry and long term follow-up epidemiological studies, make it difficult to understand the actual prevalence and associated factors related to the increasing number of MS cases in the region.…”