From the Department of Clinical Neuroscience (A.K.H., T.O., I.K., J.H.), Institute of Environmental Medicine (A.K.H., L.A.), Center for Molecular Medicine (T.O., I.K., J.H.), Karolinska Institutet, Stockholm, Sweden; and Centre for Occupational and Environmental Medicine (L.A.), Region Stockholm, Stockholm, Sweden.
Neurol Neuroimmunol Neuroinflamm. 2020 Apr 10;7(3). doi: 10.1212/NXI.0000000000000717. Print 2020 May.
We aimed to investigate the influence of lean and fatty fish consumption on MS risk and to what extent a potential effect may be mediated by vitamin D. We also studied the interplay between fish consumption, sun exposure, , and .
We used 2 population-based case-control studies (6,914 cases and 6,590 controls). Subjects with different fish consumption habits were compared regarding MS risk by calculating ORs with 95% CIs using logistic regression models. The mediation effect of vitamin D on the relationship between fish consumption and MS risk was assessed. Potential interactions between fish consumption, sun exposure, and MS-associated HLA genes were assessed on the additive scale.
Irrespective of sun exposure habits, low fish consumption, including both lean and fatty fish, was associated with increased MS risk (OR 1.2, 95% CI 1.1-1.4) and interacted with the allele (AP 0.3, < 0.0001). The mediation analysis did not support vitamin D as a mediator of the association between fish consumption and MS risk. There was no interaction between fish consumption and sun exposure habits with regard to MS risk.
Low fish consumption and low sun exposure seem to be separate risk factors for MS. Our findings suggest that fish consumption predominantly influences MS risk by other means than by effecting vitamin D status, which is of relevance for prevention, in particular for those with a genetic susceptibility to MS.
我们旨在研究瘦鱼和肥鱼的摄入对多发性硬化症（MS）风险的影响，以及这种潜在影响在多大程度上可以通过维生素 D 来介导。我们还研究了鱼的摄入量、阳光暴露、 以及 之间的相互作用。
我们使用了两项基于人群的病例对照研究（6914 例病例和 6590 例对照）。通过使用逻辑回归模型计算 OR 和 95%CI，比较了具有不同鱼类摄入习惯的受试者患 MS 的风险。评估了维生素 D 对鱼类摄入与 MS 风险之间关系的中介作用。在加性尺度上评估了鱼的摄入量、阳光暴露和与 MS 相关的 HLA 基因之间的潜在相互作用。
无论阳光暴露习惯如何，低鱼类摄入，包括瘦鱼和肥鱼，都与 MS 风险增加相关（OR 1.2，95%CI 1.1-1.4），并与 等位基因（AP 0.3，<0.0001）相互作用。中介分析不支持维生素 D 作为鱼类摄入与 MS 风险之间关联的中介物。在 MS 风险方面，鱼的摄入量与阳光暴露习惯之间没有相互作用。
低鱼类摄入和低阳光暴露似乎是 MS 的独立危险因素。我们的研究结果表明，鱼类摄入主要通过影响维生素 D 状态以外的其他方式影响 MS 风险，这对于预防具有 MS 遗传易感性的人群尤为重要。
