Risk Factors Associated with Multiple Sclerosis: A Case-Control Study in Damascus, Syria

Abstract

Objectives. To assess the probable risk factors associated with Multiple sclerosis among Syrian patients in the city of Damascus. Method. In a case-control study conducted from May to September 2020, 140 MS patients and 140 healthy controls were selected from two main hospitals in Damascus. Data regarding risk factors associated with MS was collected via a structured questionnaire and complementary laboratory tests. The statistical analysis was carried out by the SPSS Statistical Software Version 26. Results. Factors such as smoking, family history of MS, migraine, and vitamin D deficiency were associated with a higher risk of developing MS: Smoking ( OR = 2.275 95% CI (1.348-3.841) P = 0.002 ). Family history of MS ( OR = 3.970 95% CI (1.807-8.719) P ≤ 0.001 ). Migraine ( OR = 3.011 95% CI (1.345-6.741) P = 0.005 ). Vitamin D deficiency ( OR = 4.778 95% CI (2.863-7.972) P ≤ 0.001 ). However, factors such as diabetes, hypertension, a surgical history of appendectomy, tonsillectomy, and being the first-born in a family were statistically irrelevant: Diabetes ( OR = 0.652 95% CI (0.226-1.882) P = 0.426 ). Hypertension ( OR = 1.445 95% CI (0.724-2.885) P = 0.295 ) Appendectomy ( OR = 1.269 95% CI (0.486-3.317) P = 0.626 ) Tonsillectomy ( OR = 1.280 95% CI (0.576-2.843) P = 0.544 ). First-born Child ( OR = 0.933 95% CI (0.558-1.562) P = 0.793 ). Conclusion. Our study suggests that smoking, vitamin D deficiency, family history of MS, and migraine are probable risk factors for multiple sclerosis. Therefore, engaging in outdoor activities and maintaining a healthy diet—for females in particular—is highly recommended.

Analysis of shared underlying mechanism in neurodegenerative disease

“…Therefore, animal models should incorporate high-risk environmental effects in studies. High-risk factors in AD include hypertension and diabetes, for ALS include smoking and hypermetabolism disorders, and for MS include smoking and obesity ( Silva et al, 2019 ; Tsai et al, 2019 ; Taan et al, 2021 ). By combining genetic and risk factor into an animal model, conclusions drawn may provide greater transability in clinical trial than generated with a genetic model alone.…”

Relationship between medical history and multiple sclerosis: A-case-control study

“…However, we were unable to take into account major variables such as vitamin D deficiency and particular HLA due to the high cost and lack of access to a normal population group. [49,50] Our study was not tailored to any particular factor or medical history, but rather focused on exploring the factors most associated with MS development, which could lead to an overestimation of our results. Therefore, it is recommended that future studies hone in on the factors with the strongest association to MS occurrence in order to modify its progression.…”

Association of adverse childhood experiences with adulthood multiple sclerosis: A systematic review of observational studies

“…However, the exact etiology of MS is yet to be identified (Handel et al., 2010; Shaw et al., 2017). Several early‐life exposures, such as pediatric optic neuritis (Waldman et al., 2011), low vitamin D status (Taan et al., 2021), frequent migraine (Taan et al., 2021), smoking (Taan et al., 2021), infections during childhood (Shaygannejad et al., 2016), and childhood obesity (Gianfrancesco et al., 2014), are recorded as predictors of late‐life MS development or discerned to be linked with several manifestations of adulthood MS (Figure 1).…”

“…However, the exact etiology of MS is yet to be identified (Handel et al, 2010;Shaw et al, 2017). Several early-life exposures, such as pediatric optic neuritis (Waldman et al, 2011), low vitamin D status (Taan et al, 2021), frequent migraine (Taan et al, 2021), smoking (Taan et al, 2021), infections during childhood (Shaygannejad et al, 2016), and childhood obesity (Gianfrancesco et al, 2014), are recorded as predictors of late-life MS development or discerned to be linked with several manifestations of adulthood MS (Figure 1). Childhood trauma, abuse, neglect, and other forms of adverse childhood experiences (ACEs) lead to severe stress very early in a child's life, and individuals with these experiences are found to be at high risks for MS development in later life (Spitzer et al, 2012).…”