Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Clinic of Neurology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Mult Scler Relat Disord. 2024 Feb;82:105392. doi: 10.1016/j.msard.2023.105392. Epub 2023 Dec 19.
Multiple sclerosis (MS) is an immune-mediated disease that affects the central nervous system, which most likely results from the interplay between environmental and genetic factors. The aim of our study was to assess the effect of breastfeeding on the risk of developing familial multiple sclerosis (fMS) in persons with positive MS history, being the first such investigation performed in fMS cohort.
A case-control study based on the Belgrade population MS Registry was conducted. Cases for the sporadic MS (sMS) control group were randomly selected from the Registry, and matched with individuals with fMS at a ratio of 1:1. Spouses of the persons with fMS were included as a healthy control (HC) group. A specific questionnaire that was previously validated was used to obtain the data. To evaluate risk factors associated with breastfeeding for fMS occurrence compared with sMS and HC, multinomial regression analysis was performed to compute the relative risk ratios (RRR) along with 95% confidence intervals (95% CI). The analysis was afterwards repeated, stratified by sex. Both models were adjusted for potential confounding factors.
A total of 393 participants were included in our case-control study, 131 per group. There were more individuals who were exclusively breastfed longer than six months in the sMS group compared to fMS group (RRR 2.01, 95% CI 1.22-3.32). After stratification by sex, exclusive breastfeeding was shown to be a protective factor for fMS only in male population, for individuals breastfed ≥4 months. The results of both the main and stratified analysis remained robust after adjustment.
Our study findings indicate that breastfeeding reduces the risk of MS in infants with family history of the disease, although this protective effect may be limited to the male population. Further investigation into the differences in risk factors between fMS and sMS is warranted to gain a more comprehensive understanding of the disease.
多发性硬化症（MS）是一种影响中枢神经系统的免疫介导性疾病，它很可能是由环境和遗传因素相互作用引起的。我们的研究目的是评估母乳喂养对有 MS 家族史的个体患家族性多发性硬化症（fMS）的风险的影响，这是在 fMS 队列中进行的首次此类研究。
我们进行了一项基于贝尔格莱德人群 MS 登记处的病例对照研究。从登记处随机选择散发性 MS（sMS）对照组的病例，并以 1:1 的比例与 fMS 个体相匹配。fMS 个体的配偶被纳入健康对照组（HC）。使用先前经过验证的特定问卷获取数据。为了评估与 fMS 发生相关的母乳喂养风险因素与 sMS 和 HC 相比，我们进行了多变量回归分析，以计算相对风险比（RRR）及其 95%置信区间（95%CI）。随后，按性别进行了分层分析。两个模型都调整了潜在的混杂因素。
我们的病例对照研究共纳入了 393 名参与者，每组 131 名。sMS 组中，与 fMS 组相比，有更多的个体进行了更长时间（≥6 个月）的纯母乳喂养（RRR 2.01，95%CI 1.22-3.32）。按性别分层后，仅在男性人群中，≥4 个月纯母乳喂养被证明是 fMS 的保护因素。主要和分层分析的结果在调整后仍然稳健。
我们的研究结果表明，母乳喂养可降低有 MS 家族史的婴儿患 MS 的风险，但这种保护作用可能仅限于男性人群。进一步研究 fMS 和 sMS 之间的危险因素差异，有助于更全面地了解该疾病。
