Department of Neurology & Experimental Neurology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117, Germany.
BMC Neurol. 2011 Oct 6;11:123. doi: 10.1186/1471-2377-11-123.
Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS) with increasing incidence mainly in high-income countries. One explanation of this phenomenon may be a higher prevalence of allergic and autoimmune diseases in industrialized countries as a consequence of otherwise beneficial advances in sanitation (hygiene hypothesis). We investigated environmental factors in early childhood associated with MS.
A case-control study was performed of 245 MS patients and 296 population-based controls in Berlin. The study participants completed a standardized questionnaire on environmental factors in childhood and youth, including aspects of personal and community hygiene. Multivariable logistic regression analysis was performed to investigate factors in childhood and youth associated with the occurrence of MS.
Mean age was 46 years (range, 20-80) in the MS group and 42 years (range 18-80) in the control group, of which 73.9% in the MS and 61.5% in the control group were female. The multivariable analysis showed that having at least two older siblings (OR 0.54; p = 0.05, for individuals with two older siblings compared to individuals without older siblings), attending a day-care center (OR 0.5; p = 0.004) and growing up in an urban center with more than 100, 000 inhabitants (OR 0.43; p = 0.009) were factors independently associated with a lower chance for MS.
The hygiene hypothesis may play a role in the occurrence of MS and could explain disease distribution and increasing incidence.
多发性硬化症（MS）是一种中枢神经系统（CNS）的慢性炎症性脱髓鞘疾病，发病率不断上升，主要发生在高收入国家。这种现象的一个解释可能是由于卫生条件的改善（卫生假说），工业化国家中过敏和自身免疫性疾病的患病率更高。我们研究了与 MS 相关的儿童早期环境因素。
对柏林的 245 名 MS 患者和 296 名基于人群的对照进行了病例对照研究。研究参与者完成了一份关于儿童和青年时期环境因素的标准化问卷，包括个人和社区卫生的各个方面。采用多变量逻辑回归分析来研究与 MS 发生相关的儿童和青年时期的因素。
MS 组的平均年龄为 46 岁（范围，20-80 岁），对照组为 42 岁（范围，18-80 岁），其中 73.9%的 MS 患者和 61.5%的对照组患者为女性。多变量分析显示，有两个或更多年长的兄弟姐妹（OR 0.54；p = 0.05，与没有年长兄弟姐妹的个体相比，有两个或更多年长兄弟姐妹的个体）、参加日托中心（OR 0.5；p = 0.004）和在人口超过 10 万的城市中心长大（OR 0.43；p = 0.009）是与 MS 发生几率降低相关的独立因素。
卫生假说可能在 MS 的发生中起作用，并可以解释疾病的分布和发病率的增加。
