Sundström P, Nyström L, Hallmans G
Department of Neurology, Umeå University Hospital, Umeå, Sweden.
Eur J Neurol. 2008 Jun;15(6):579-83. doi: 10.1111/j.1468-1331.2008.02122.x.
To estimate the effect of exposure to smoking on the risk for multiple sclerosis (MS), we analyzed nicotine metabolite (cotinine) levels in biobank samples from 109 MS cases and 218 matched referents.
Elevated cotinine levels, even modest elevations, were associated with an increased risk for MS (all other categories versus lowest: OR = 2.9; 95% CI: 1.3-6.3). A similar but non-significant risk increase was observed also in the small subset of individuals with samples collected before the onset of MS (all other categories versus lowest: OR = 2.4; 95% CI: 0.26-21). Elevated cotinine was associated with an increased risk for MS predominantly in women (all other categories versus lowest category: OR = 3.9; 95% CI: 1.3-12), whereas the risk increase in men was smaller and non-significant.
Smoke exposure is associated with a higher risk for MS than previously estimated. There seems to be a threshold effect present in the lower range of cotinine in its relation to MS. Modestly elevated cotinine levels suggestive of passive smoking are associated with an increased risk for MS. Smoke exposure may explain the higher incidence of MS in women. These preliminary findings need to be confirmed in an expanded material of prospectively collected samples.
为评估吸烟暴露对多发性硬化症（MS）风险的影响，我们分析了来自109例MS患者和218例匹配对照者生物样本库样本中的尼古丁代谢物（可替宁）水平。
可替宁水平升高，即使是适度升高，也与MS风险增加相关（所有其他类别与最低类别相比：OR = 2.9；95%CI：1.3 - 6.3）。在MS发病前采集样本的一小部分个体中也观察到了类似但不显著的风险增加（所有其他类别与最低类别相比：OR = 2.4；95%CI：0.26 - 21）。可替宁水平升高主要与女性MS风险增加相关（所有其他类别与最低类别相比：OR = 3.9；95%CI：1.3 - 12），而男性的风险增加较小且不显著。
吸烟暴露与MS风险高于先前估计有关。可替宁与MS的关系在较低范围内似乎存在阈值效应。提示被动吸烟的适度升高的可替宁水平与MS风险增加相关。吸烟暴露可能解释了女性中MS发病率较高的原因。这些初步发现需要在前瞻性收集的样本的扩大材料中得到证实。
