Downham Christina, Visser Elizabeth, Vickers Mark, Counsell Carl
Department of Surgery, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, United Kingdom.
Department of Neurology, Ward 205, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, United Kingdom.
Mult Scler Relat Disord. 2017 Oct;17:103-106. doi: 10.1016/j.msard.2017.07.009. Epub 2017 Jul 8.
Infectious mononucleosis (IM) and vitamin D deficiency are both risk factors for multiple sclerosis (MS).
We wished to establish if IM in the winter months when vitamin D levels are low may be a greater risk factor for MS than IM in the summer months.
We identified all patients with MS diagnosed aged 16-60 in a large primary care database in the United Kingdom and matched each by age, sex, general practice and observation period with up to six controls. We identified a coded diagnosis of IM prior to the index date (date of diagnosis). Logistic regression was used to calculate the odds ratio for prior IM exposure in cases versus controls and for winter versus summer exposure in cases and controls with prior IM exposure.
Based on 9247 cases and 55,033 matched controls (246 and 846 with prior IM respectively), IM was associated with the development of MS (OR 1.77, 95%CI 1.53-2.05) but there was no evidence that IM in the winter as opposed to summer was associated with developing MS (OR 1.09, 95%CI 0.72-1.66).
We found no evidence that the season of IM influences the risk of subsequent MS.
传染性单核细胞增多症（IM）和维生素D缺乏都是多发性硬化症（MS）的危险因素。
我们希望确定在维生素D水平较低的冬季发生的IM是否比夏季发生的IM成为MS的更大危险因素。
我们在英国一个大型初级保健数据库中确定了所有16至60岁被诊断为MS的患者，并按年龄、性别、全科医疗和观察期将每位患者与多达6名对照进行匹配。我们在索引日期（诊断日期）之前确定了IM的编码诊断。采用逻辑回归计算病例组与对照组之前IM暴露的比值比，以及有过IM暴露的病例组和对照组中冬季与夏季暴露的比值比。
基于9247例病例和55033名匹配对照（分别有246例和846例有过IM），IM与MS的发生相关（比值比1.77，95%置信区间1.53 - 2.05），但没有证据表明与夏季相比，冬季的IM与MS的发生相关（比值比1.09，95%置信区间0.72 - 1.66）。
我们没有发现证据表明IM发生的季节会影响随后发生MS的风险。
