Department of Research & Evaluation, Kaiser Permanente of Southern California, Pasadena, USA.
Neurology. 2013 Feb 5;80(6):548-52. doi: 10.1212/WNL.0b013e31828154f3. Epub 2013 Jan 30.
To determine whether childhood obesity is a risk factor for developing pediatric multiple sclerosis (MS) or clinically isolated syndrome (CIS).
Cases were identified through the Kaiser Permanente Southern California (KPSC) pediatric acquired demyelinating diseases cohort between 2004 and 2010. For cases, body mass index (BMI) was obtained prior to symptom onset, for the underlying cohort BMI was obtained through the KPSC Children's health study (n = 913,097). Weight classes of normal weight, overweight, moderate obesity, and extreme obesity were assigned based on BMI specific for age and sex.
We identified 75 newly diagnosed pediatric cases of MS or CIS, the majority of which were in girls (n = 41, 55%), age 11-18 (n = 54, 72%). Obesity was associated with a significantly increased risk of MS/CIS in girls (p = 0.005 for trend) but not in boys (p = 0.93). The adjusted odds ratio and 95% confidence intervals for CIS/MS among girls was 1.58 (0.71-3.50) for overweight compared to normal weight (reference category), 1.78 (0.70-4.49) for moderately obese, and 3.76 (1.54-9.16) for extremely obese. Moderately and extremely obese cases were more likely to present with transverse myelitis compared with normal/overweight children (p = 0.003).
Our findings suggest the childhood obesity epidemic is likely to lead to increased morbidity from MS/CIS, particularly in adolescent girls.
确定儿童肥胖是否是小儿多发性硬化症（MS）或临床孤立综合征（CIS）发展的危险因素。
通过 2004 年至 2010 年期间凯撒永久南加州（KPSC）儿科获得性脱髓鞘疾病队列确定病例。对于病例，在症状发作前获得体重指数（BMI），对于基础队列，通过 KPSC 儿童健康研究（n = 913097）获得 BMI。根据特定年龄和性别的 BMI，将正常体重、超重、中度肥胖和极度肥胖的体重类别分配给儿童。
我们确定了 75 例新诊断的小儿 MS 或 CIS 病例，其中大多数为女孩（n = 41，55%），年龄 11-18 岁（n = 54，72%）。肥胖与 MS/CIS 的风险显著增加相关，在女孩中（趋势 p = 0.005），但在男孩中（p = 0.93）并非如此。与正常体重（参考类别）相比，超重、中度肥胖和极度肥胖的女孩 CIS/MS 的调整后的优势比及其 95%置信区间分别为 1.58（0.71-3.50）、1.78（0.70-4.49）和 3.76（1.54-9.16）。与正常/超重儿童相比，中度和极度肥胖的病例更有可能出现横贯性脊髓炎（p = 0.003）。
我们的发现表明，儿童肥胖的流行可能会导致 MS/CIS 的发病率增加，特别是在青春期女孩中。
