Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece.
Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece/Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
Mult Scler. 2020 Apr;26(4):397-404. doi: 10.1177/1352458519872664. Epub 2019 Sep 6.
Multiple sclerosis (MS) is a chronic demyelinating disease that is associated with permanent disability and low quality of life. Development of MS is attributed to a combination of genetic and environmental factors. Genome-wide association studies revealed more than 200 variants that are associated with risk of MS. An umbrella review showed that smoking, history of infectious mononucleosis, and anti-Epstein-Barr virus nuclear antigen (anti-EBNA) immunoglobulin G (IgG) seropositivity are credible risk factors of MS. In the present narrative review, we updated our published umbrella review, showing that body mass index in childhood and adolescence and anti-viral capsid antigen (anti-VCA) IgG seropositivity are additional credible risk factors of MS. In addition, we discuss the findings from Mendelian randomization studies, which present evidence for a potential causal role of serum vitamin D and adulthood body mass index on risk of MS. Finally, we discuss the potential limitations of meta-analyses, umbrella reviews, and Mendelian randomization studies in the search for risk factors of MS.
多发性硬化症（MS）是一种慢性脱髓鞘疾病，与永久性残疾和生活质量低下有关。MS 的发展归因于遗传和环境因素的综合作用。全基因组关联研究揭示了 200 多种与 MS 风险相关的变异。一项伞式综述表明，吸烟、传染性单核细胞增多症史和抗 Epstein-Barr 病毒核抗原（抗-EBNA）免疫球蛋白 G（IgG）阳性是 MS 的可信危险因素。在本次叙述性综述中，我们更新了已发表的伞式综述，表明儿童和青少年时期的体重指数和抗病毒衣壳抗原（抗-VCA）IgG 阳性也是 MS 的额外可信危险因素。此外，我们还讨论了孟德尔随机化研究的结果，这些结果为血清维生素 D 和成年期体重指数对 MS 风险的潜在因果作用提供了证据。最后，我们讨论了在寻找 MS 危险因素的过程中，荟萃分析、伞式综述和孟德尔随机化研究的潜在局限性。
