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压力大的生活事件与多发性硬化症的风险相关。

Stressful life events are associated with the risk of multiple sclerosis.

作者信息

Jiang X, Olsson T, Hillert J, Kockum I, Alfredsson L

机构信息

Department of Clinical Neuroscience, Karolinska Institute and Centrum for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

出版信息

Eur J Neurol. 2020 Dec;27(12):2539-2548. doi: 10.1111/ene.14458. Epub 2020 Aug 23.

Abstract

BACKGROUND AND PURPOSE

Unexpected stressful life events may alter immune function and affect susceptibility to autoimmune diseases including multiple sclerosis (MS). Current results from epidemiological investigations examining the role of stress in MS remain inconsistent. The aim was to conduct the hitherto largest population-based case-control study on this topic.

METHODS

Extensive questionnaire information collected on lifestyle environmental factors available for 2930 incident MS cases and 6170 controls were used to assess the association of 10 major life events that had occurred before disease onset with the risk of MS by unconditional logistic regressions, adjusting for potential confounders. Stratified analyses were also performed by sex and time.

RESULTS

Compelling evidence was found for a link between major life events and risk of MS - most events significantly increased disease risk by 17%-30%. It was further observed that women were affected to a greater extent than men under certain stressful scenarios, and that most events that happened recently (≤5 years prior to MS onset) had significant effects on MS, indicating a critical window in disease development.

CONCLUSION

Stressful life events may have an adverse effect on the risk of MS. Research into the mechanisms of this observation may give important clues to triggering pathogenetic events in MS.

摘要

背景与目的

意外的生活应激事件可能会改变免疫功能,并影响包括多发性硬化症(MS)在内的自身免疫性疾病的易感性。目前关于应激在MS中作用的流行病学调查结果仍不一致。目的是开展迄今为止关于该主题最大规模的基于人群的病例对照研究。

方法

收集了2930例新发MS病例和6170例对照的广泛问卷信息,内容涉及生活方式和环境因素,通过无条件逻辑回归分析评估疾病发病前发生的10项主要生活事件与MS风险的关联,并对潜在混杂因素进行校正。还按性别和时间进行了分层分析。

结果

发现有力证据表明主要生活事件与MS风险之间存在关联——大多数事件使疾病风险显著增加17%-30%。进一步观察到,在某些应激情况下,女性比男性受影响程度更大,且最近发生的大多数事件(MS发病前≤5年)对MS有显著影响,表明疾病发展存在关键窗口期。

结论

生活应激事件可能对MS风险产生不利影响。对这一观察结果机制的研究可能为MS发病机制事件的触发提供重要线索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ce/7692913/406029c596f0/ENE-27-2539-g001.jpg

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