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社会经济因素和生殖因素在多发性硬化症风险中的作用。

Role of socio-economic and reproductive factors in the risk of multiple sclerosis.

作者信息

Magyari M

机构信息

Danish Multiple Sclerosis Centre, Department of Neurology, University of Copenhagen, Copenhagen, Denmark.

Danish Multiple Sclerosis Registry, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

出版信息

Acta Neurol Scand. 2015;132(199):20-3. doi: 10.1111/ane.12426.

Abstract

The incidence of multiple sclerosis is increasing in Danish women. Their risk of developing multiple sclerosis has more than doubled in 25 years while it has remained virtually unchanged for men. The explanation for these epidemiological changes should be sought in the environment as they are too rapid to be explained by gene alterations. We investigated the effect of numerous biological social physical and chemical environmental exposures in different periods of life. These data were available from population-based registries and were used in a case-control approach. This study database included all multiple sclerosis cases (n = 1403) from the Danish MS Registry with clinical onset between 2000 and 2004 as well as 35,045 controls drawn by random from the Danish Civil Registration System and matched by sex year of birth and residential municipality at the reference year. Having newborn children reduced the risk of multiple sclerosis (MS) in women but not in men. Childbirths reduced the risk of MS by about 46% during the following 5 years. Even pregnancies terminated early had a protective effect on the risk of developing MS suggesting a temporary immunosuppression during pregnancy. Our data on social behaviour regarding educational level income and relationship stability did not indicate reverse causality. A greater likelihood to be exposed to common infections did not show any effect on the risk of MS neither in puberty nor in adulthood. Socio-economic status and lifestyle expressed in educational level and sanitary conditions in youth were not associated with the risk of MS.

摘要

丹麦女性多发性硬化症的发病率正在上升。在25年里,她们患多发性硬化症的风险增加了一倍多,而男性的风险几乎没有变化。这些流行病学变化的原因应从环境中寻找,因为其变化太快,无法用基因改变来解释。我们调查了在生命不同阶段众多生物、社会、物理和化学环境暴露的影响。这些数据来自基于人群的登记处,并用于病例对照研究。该研究数据库包括丹麦多发性硬化症登记处所有临床发病于2000年至2004年的多发性硬化症病例(n = 1403),以及从丹麦民事登记系统随机抽取的35,045名对照,这些对照按性别、出生年份和参考年份的居住市镇进行匹配。生育降低了女性而非男性患多发性硬化症(MS)的风险。分娩后5年内,多发性硬化症的风险降低了约46%。即使是早期终止妊娠也对患多发性硬化症的风险有保护作用,这表明怀孕期间存在暂时的免疫抑制。我们关于教育水平、收入和关系稳定性等社会行为的数据并未表明存在反向因果关系。在青春期或成年期,更易接触常见感染对多发性硬化症的风险没有任何影响。以教育水平和青年时期卫生条件表示的社会经济地位和生活方式与多发性硬化症的风险无关。

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