Retrospective Cohort Study of Gender Differential in Risk of Multiple Sclerosis in Kuwait

Akhtar, Saeed; Alroughani, Raed; Ahmed, Samar Farouk; Al-Hashel, Jasem

doi:10.1159/000444185

Cited by 7 publications

(4 citation statements)

References 51 publications

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“…Cancer patients which are initially diagnosed and/or treated elsewhere are also referred to KCCC for further follow-up. Health care at all levels is provided free of charge by the government to the nationals, whereas, migrant residents have to pay nominal fee to avail medical services [ 16 , 17 ].…”

Section: Methods and Participantsmentioning

confidence: 99%

Diet, obesity and colorectal carcinoma risk: results from a national cancer registry-based middle-eastern study

Alsheridah

Akhtar

2018

BMC Cancer

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BackgroundCancer of colon and rectum (colorectal) is one of the most common cancers worldwide. There is a scarcity of published data on the risk factors for colorectal cancer (CRC) from the Middle-Eastern countries specifically in Kuwait. Therefore, this matched case-control study sought to examine the risk factors associated with CRC in Kuwait.MethodsOne hundred and three histopathologically confirmed colorectal cancer cases were recruited from Kuwait Cancer Control Centre Registry. Two hundred and six controls matched with cases (2:1 ratio) on age, gender and nationality were selected from medical, ophthalmology, orthopedic and/ or surgical out-patient clinics at three main general hospitals in Kuwait. A structured questionnaire was used to collect the data from cases and controls through face-to-face interview. Adjusted matched odds ratios (mORadj) and their 95% confidence intervals (CI) were estimated using a multivariable conditional logistic regression model.ResultsMultivariable conditional logistic regression model showed that cases were 4.3 times more likely to have had attainted obesity (BMI ≥ 30) in their lifetime compared to controls (mORadj = 4.3; 95% CI: 1.6–11.4). Compared to controls, cases rarely consumed fruits and vegetable (mORadj = 20.8; 95% CI: 4.4–99.5), tended to consume red meat 2–3 times a week (mORadj = 3.8; 95% CI: 1.6–8.7) or more than 4 times a week (mORadj = 9.4; 95% CI: 2.5–35.4). Reportedly cases compared to controls frequently (nearly every week) suffered from constipation (mORadj = 5.6; 95% CI: 1.9–16.5). However, CRC cases were less likely than controls to have been diagnosed in the past with hypercholesterolemia (mORadj = 0.3; 95% CI: 0.2–0.7) or diabetes mellitus type II (mORadj = 0.4; 95% CI: 0.2–0.8).ConclusionsObesity, excessive red meat consumption and infrequent fruits/vegetables intake were associated with an increased CRC risk. Overcoming identified pitfalls in dietary pattern and maintenance of healthy weight may help minimize CRC risk in Kuwait and perhaps other countries in the region. Further studies on genetic basis in conjunction with life styles and dietary factors may unravel their joint contributions to CRC risk and furnish tools for curtailing CRC risk in this and other similar populations.

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Section: Methods and Participantsmentioning

confidence: 99%

Diet, obesity and colorectal carcinoma risk: results from a national cancer registry-based middle-eastern study

Alsheridah

Akhtar

2018

BMC Cancer

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“…Globally, the estimated number of people with MS has increased from 2.1 million in 2008 to 2.3 million in 2013 [4], with higher prevalence in females [1]. Also, in Kuwait the sex ratio (female: male) of 1.9 among MS cases has been reported [5,6]. The precise etiology of MS continues to be undefined.…”

Section: Introductionmentioning

confidence: 99%

A matched case-control study of risk factors associated with multiple sclerosis in Kuwait

2020

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Background: Genetic and environmental factors seem to have etiologic roles in multiple sclerosis (MS). Kuwait is regarded as medium to high risk country for MS. However, there is a paucity of published data on the risk factors for MS in Kuwait. Therefore, this matched case-control study examined the association between various factors including family history, stressful life events, exposure to tobacco smoke, vaccination history, comorbidities and MS risk in Kuwait. Methods: Confirmed 110 MS cases and age (± 5 years), gender and nationality matched controls (1:1) were enrolled. A pre-tested structured questionnaire was used to collect the data through face-to-face interviews both from cases and controls. Conditional logistic regression was used to analyze the data. Results: Among both cases and controls, majority were Kuwaiti (82.7%), and female (76.4%). Multivariable model showed that cases compared to controls were significantly more likely to have had a family history of MS (adjusted matched odds ratio (mOR adj ) = 5.1; 95% CI: 2.1-12.4; p < 0.001) or less likely to have been vaccinated against influenza A and B viruses before MS onset (mOR adj = 0.4; 95% CI: 0.2-0.8; p = 0.010). None of the other variables considered were significantly related to MS status in this study. Conclusions: Family history of MS had significantly direct, whereas, vaccination against influenza A and B viruses had inverse associations with MS status. Future studies may contemplate to verify the observed results.

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“…Non-nationals constitute about 68% of the population and resultantly 80% of the labor force comprises migrants. Majority of the migrants are men with a low educational attainment [9-11]. Among nationals, the male and female literacy rates (defined as individuals aged 10 years or more and who can read and write) are 98.5 and 91.2%, respectively, with a gender ratio (male: female) of 1.04 at birth [12].…”

Section: Methodsmentioning

confidence: 99%

Age-Period-Cohort Modeling of Multiple Sclerosis Incidence Rates in Kuwait: 1980–2014

Akhtar¹,

Al-Abkal

Al-Hashel

et al. 2017

Neuroepidemiology

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Background: Multiple sclerosis (MS) is a complex immune-mediated disorder of the central nervous system with undefined etiology. Genetic predisposition and environmental factors play an imperative role in MS causation and its sustained increasing burden worldwide. This study examined the age, period, and cohort effects on MS incidence rates in Kuwait. Methods: In this retrospective cohort study, data on MS cases diagnosed between January 1, 1980 and December 31, 2014 and registered in National MS Registry and reference population were obtained. Age-period-cohort (APC) analysis was conducted using a loglinear Poisson regression model to supplement the descriptive and graphical presentation. Descriptive statistics were complemented with APC parameters’ estimates including net drift, local drift, age at onset curve, and longitudinal age trend. Age effect was presented as incidence rates (per 10⁵ person-years), whereas period and cohort effects were presented as adjusted relative rates. Results: A total of 1,131 cases were diagnosed in 1,385,923 person-years. Overall age-standardized MS incidence rate was 64.5 (95% CI 52.4–79.8). An estimated annual percentage change revealed 7.4% annual increase in MS incidence rate during the study period (Net drift = 7.4%; 95% CI 4.1–10.8%). APC “fitted” age-at-onset curve showed a bimodal pattern with peaked incidence rates at 20–24 years and 45–49 years of age. Compared with the referent period (1980–1984) and cohort (1970–1974), MS incidence rates progressively and significantly (p < 0.001) increased during subsequent time periods and in successive cohorts. Results of APC analysis are descriptive in nature and specific etiological hypotheses were not evaluated. However, the findings of this study substantiated the notion of multiplicity of genetic and/or environmental risk factors’ contributions. Conclusion: A substantial increase in MS incidence rates was recorded, which significantly varied in all 3 temporal dimensions during the study period. Future studies may contemplate biological basis for recorded temporal increase in MS risk.

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Retrospective Cohort Study of Gender Differential in Risk of Multiple Sclerosis in Kuwait

Cited by 7 publications

References 51 publications

Diet, obesity and colorectal carcinoma risk: results from a national cancer registry-based middle-eastern study

Diet, obesity and colorectal carcinoma risk: results from a national cancer registry-based middle-eastern study

A matched case-control study of risk factors associated with multiple sclerosis in Kuwait

Age-Period-Cohort Modeling of Multiple Sclerosis Incidence Rates in Kuwait: 1980–2014

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