Institute of Environmental Medicine and Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Neuroimmunology Unit, Department of Clinical Neuroscience and Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden.
Mult Scler. 2021 Jul;27(8):1293-1296. doi: 10.1177/1352458520968803. Epub 2020 Nov 10.
Studies using cotinine levels to define smokers have generally failed to detect an association between smoking and multiple sclerosis (MS). Using a Swedish population-based case-control study, we show that associations in relation to MS risk and progression differ considerably depending on how smoking is measured. The risk of conversion into secondary progressive disease was increased among smokers when self-reported smoking history, but not presumed cotinine levels, was used to define smokers. Defining smoking by cotinine levels without distinguishing between different sources of nicotine may lead to severely biased estimates of the association between smoking and both MS risk and progression.
使用可替宁水平来定义吸烟者的研究通常未能发现吸烟与多发性硬化症（MS）之间的关联。使用基于瑞典人群的病例对照研究，我们表明，与 MS 风险和进展相关的关联因吸烟的测量方式而异。当使用自我报告的吸烟史而不是推测的可替宁水平来定义吸烟者时，吸烟者转化为继发性进行性疾病的风险增加。如果不区分尼古丁的不同来源，仅凭可替宁水平定义吸烟，可能会导致对吸烟与 MS 风险和进展之间关联的严重偏差估计。
