Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark; Hammel Neurorehabilitation Centre and University Research Clinic, Voldbyvej 15, 8450 Hammel, Denmark.
Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark.
Mult Scler Relat Disord. 2020 May;40:101968. doi: 10.1016/j.msard.2020.101968. Epub 2020 Jan 26.
Multiple sclerosis (MS) onset is commonly observed in adults aged 20-50 years of age. The incidence rate of MS-onset after age 50, late-onset MS, has increased along with the observed overall increase in MS incidence rate in the past 60 years. In general, the aetiology of MS is largely acknowledged to involve a complex interrelation of environmental and modifiable lifestyle risk factors in genetically susceptible individuals. Smoking is an established risk factor, while the role of the diet in the aetiology of MS remains inconclusive. However, even less is known about the role of diet and smoking in the aetiology of late-onset MS as this subgroup of patients has not gained much attention in the scientific literature. Therefore, the objective of this study was to investigate the association between diet quality and the hazards of late-onset MS diagnosis in relation to smoking habits, thus attempting to identify high-risk individuals.
The study was a prospective cohort study based on the Danish cohort Diet, Cancer and Health including middle-aged individuals (50-64 years) born and residing in Denmark. Cox' proportional hazards models were used to estimate the hazard ratios (HR) for tertiles of diet quality, assessed by means of the Alternative Healthy Eating Index-2010. Information on time-at-risk and diagnosis of MS was collected based on linked information from the Danish Civil Registration System and Danish National Patient Registry. Additionally, a stratified analysis according to smoking status (current smokers, former smokers and never smokers) was conducted while adjusting for sex.
A total of 56,867 individuals were followed for a median of 20.4 years. During follow-up, 124 individuals were diagnosed with late-onset MS. No statistically significant association was found between diet quality at baseline and the hazard of MS diagnosis in adjusted analyses (HR highest vs lowest diet quality tertile: 0.79; 95%CI: 0.49-1.27, Test for trend: p = 0.22). Smoking status did not modify the association.
In this cohort of middle-aged Danes, diet quality was neither statistically significantly associated with the hazards of late-onset MS diagnosis in the entire sample, nor in sub-groups of current smokers, former smokers or never smokers.
多发性硬化症（MS）的发病通常见于 20-50 岁的成年人。随着过去 60 年来 MS 发病率的整体增加，50 岁以后发病的多发性硬化症（即晚发性 MS）的发病率也有所增加。一般来说，MS 的病因很大程度上被认为涉及环境和可改变的生活方式风险因素在遗传易感个体中的复杂相互作用。吸烟是一个已确定的危险因素，而饮食在 MS 发病机制中的作用仍不确定。然而，由于该亚组患者在科学文献中并未受到太多关注，因此，关于饮食和吸烟在晚发性 MS 发病机制中的作用知之甚少。因此，本研究的目的是调查饮食质量与吸烟习惯与晚发性 MS 诊断风险之间的关联，从而试图确定高危个体。
这是一项基于丹麦队列饮食、癌症和健康研究的前瞻性队列研究，该研究纳入了丹麦出生并居住的中年人群（50-64 岁）。使用 Cox 比例风险模型来估计饮食质量的 tertiles 与 MS 诊断风险的危害比（HR），通过替代健康饮食指数-2010 进行评估。通过丹麦民事登记系统和丹麦国家患者登记处的链接信息收集与时间风险和 MS 诊断相关的信息。此外，根据吸烟状况（当前吸烟者、曾经吸烟者和从不吸烟者）进行分层分析，同时调整性别因素。
共有 56867 人随访中位数为 20.4 年。随访期间，有 124 人被诊断为晚发性 MS。在调整分析中，基线时的饮食质量与 MS 诊断的风险之间没有统计学上显著的关联（最高 tertile 与最低 tertile 相比的 HR：0.79；95%CI：0.49-1.27，趋势检验：p=0.22）。吸烟状况也没有改变这种关联。
在这项丹麦中年人群的队列研究中，饮食质量与整个样本中晚发性 MS 诊断风险之间既没有统计学显著关联，也没有与当前吸烟者、曾经吸烟者或从不吸烟者的亚组之间存在关联。
