Hedström A K, Adams C, Shao X, Schaefer C, Olsson T, Barcellos L F, Alfredsson L
Department of Clinical Neuroscience, Karolinska Institutet, Sweden.
Genetic Epidemiology and Genomics Lab, School of Public Health, University of California, USA.
Mult Scler J Exp Transl Clin. 2020 Jun 1;6(2):2055217320928101. doi: 10.1177/2055217320928101. eCollection 2020 Apr-Jun.
Breastfeeding as an infant appears protective against later development of some autoimmune diseases, but research into its influence on multiple sclerosis (MS) risk has yielded inconclusive results.
We investigated the possible impact of breastfeeding on MS risk.
We used two population-based case-control studies comprising 3670 cases and 6737 matched controls. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for association between MS and exposure to prolonged breastfeeding (4 months or longer) versus reduced breastfeeding (less than 4 months). A meta-analysis of case-control studies that assessed the impact of breastfeeding on MS risk among women and men was conducted.
Prolonged breastfeeding was associated with reduced MS risk among men (OR 0.7, 95% CI 0.5-0.9) but not among women (OR 0.9, 95% CI 0.8-1.1). Among men, a synergistic effect was observed between carrier status and reduced breastfeeding.
Findings from the current study add to accumulating evidence that breastfeeding may be a modifiable protective factor for reducing the risk of MS in offspring. When possible, mothers should be supported to breastfeed their infants; however, the mechanism of a sex-specific biologic effect of breastfeeding on MS risk is unclear.
婴儿期母乳喂养似乎对某些自身免疫性疾病的后期发展具有保护作用，但关于其对多发性硬化症（MS）风险影响的研究结果尚无定论。
我们调查了母乳喂养对MS风险的可能影响。
我们使用了两项基于人群的病例对照研究，包括3670例病例和6737例匹配对照。采用逻辑回归来估计MS与长期母乳喂养（4个月或更长时间）与减少母乳喂养（少于4个月）之间关联的比值比（OR）和95%置信区间（CI）。对评估母乳喂养对男性和女性MS风险影响的病例对照研究进行了荟萃分析。
长期母乳喂养与男性MS风险降低相关（OR 0.7，95%CI 0.5 - 0.9），但与女性无关（OR 0.9，95%CI 0.8 - 1.1）。在男性中，观察到携带者状态与减少母乳喂养之间存在协同效应。
本研究结果进一步证明，母乳喂养可能是降低后代MS风险的一个可改变的保护因素。应尽可能支持母亲母乳喂养婴儿；然而，母乳喂养对MS风险的性别特异性生物学效应机制尚不清楚。
