Ethnic and Socioeconomic Associations with Multiple Sclerosis Risk

Abstract

Objective Epidemiological research in multiple sclerosis (MS) has mainly been performed in socioeconomically and ethnically limited populations; influences on MS risk have not been studied in prospectively collected non‐White populations. We set out to study the influence of previously described MS risk factors in an ethnically diverse population. Methods A nested case–control study was created using primary care records of >1 million individuals, >50% of whom identify as Black, Asian, and Minority Ethnic (BAME). MS cases were compared to an age‐ and sex‐matched control cohort (1:4), and to a large unmatched cohort. Odds ratios (ORs) of disease were determined according to exposure of interest, and a multivariate model including all exposures was created. Potential pairwise interactions were considered where both indicated a significant effect. Results A total of 1,344 confirmed MS cases were included. MS OR in blacks aged <40 years was 1.15 (95% confidence interval [CI] = 0.81–1.62) compared to whites. MS odds in BAME current (OR = 1.71, 95% CI = 1.24–2.31) and ex‐smokers (OR = 2.83, 95% CI = 2.14–3.72) were considerably higher than in Whites (OR = 1.09, 95% CI = 0.88–1.34; OR = 1.44, 95% CI = 1.19–1.74, respectively). Prior infectious mononucleosis was associated with increased odds of MS in Blacks (OR = 4.94, 95% CI = 1.23–17.89). An increase in MS odds was seen in the least‐deprived quintile (OR = 2.46, 95% CI = 1.40–4.24), but no effect across deprived quintiles was seen. Interpretation This cohort provides novel data on factors potentially driving MS susceptibility in a diverse population, one‐third of whom live in poverty. Environmental exposures have differential risk across ethnicity. ANN NEUROL 2020;87:599–608

Epidemiology of Epstein-Barr virus infection and infectious mononucleosis in the United Kingdom

“…Demographic details for all participants within the database were extracted, including self-declared ethnicity according to ONS codes at GP registration. Demographic details were defined as previously described [16]. Age was defined at age data extraction (1st February 2018), and deprivation according to IMD raw scores for each lower layer super output area (LSOA).…”

Association of Infectious Mononucleosis in Childhood and Adolescence With Risk for a Subsequent Multiple Sclerosis Diagnosis Among Siblings

“…Genome-wide association studies have found that loci in the human leukocyte antigen (HLA) region, such as HLA-DRB1 and HLA-DQA1 genes, are associated with both MS risk and elevated anti-EBNA IgG levels. [4][5][6] The possibility of confounding is suggested by studies showing that the increased MS risk associated with IM decreased in magnitude 7 or became statistically nonsignificant 8 after controlling for potential confounders, including genetic ancestry and HLA-DRB1*1501 carrier status. However, few studies have extensively addressed measured and unmeasured shared familial genetic and environmental factors as potential confounders that may be associated with both IM and MS.…”

Assessment of Racial/Ethnic Disparities in Volumetric MRI Correlates of Clinical Disability in Multiple Sclerosis: A Preliminary Study

“…4 Multiple observational studies suggest that Hispanics with MS present at a younger age and demonstrate faster disability accumulation compared to their Caucasian counterparts of European ancestry. 5,6 However, in contrast to a burgeoning literature on racial disparities between African Americans and Caucasians with MS, there is a paucity of data on racial and ethnic variability in Hispanic populations.…”