Hagman Emilia, Putri Resthie R, Danielsson Pernilla, Marcus Claude
Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, S-141 57, Huddinge, Sweden.
Int J Obes (Lond). 2025 Jan 30. doi: 10.1038/s41366-025-01727-3.
Emerging evidence implies a link between high pediatric body mass index (BMI) and an increased risk of multiple sclerosis (MS). However, previous research suggests this association is only present for adolescent obesity and not childhood obesity. The present study aimed to assess the association between pediatric obesity and risk of developing MS, and to investigate if degree of obesity and age at obesity treatment initiation affects the risk. In a subgroup, response to obesity treatment on MS risk was assessed.
In this cohort study, patients aged 2-19 years from the Swedish Childhood Obesity Treatment Register (BORIS), and matched individuals from the general population were followed prospectively. MS was identified through the National Patient Register. Hazard ratios (HR) adjusted for parental MS were calculated.
The study included 21,652 individuals with pediatric obesity and 102,187 general population comparators. The median age at follow-up was 21 (Q1, Q3 18, 25) years. The adjusted HR (95% CI) for developing MS in the pediatric obesity cohort was 2.28 (1.45-3.58). In stratified analyses, obesity class I was not associated with MS, HR = 1.34 (0.64-2.81), while the association between obesity class II and MS was strengthened, HR = 3.42 (1.89-6.19). MS was associated with both childhood obesity, HR = 3.16 (1.12-8.87), and adolescent obesity, HR = 2.12 (1.28-3.51). A decrease in BMI SDS was not associated with lower likelihood of MS, HR = 1.09 (0.92-1.29) per 0.25 BMI SDS unit decrease.
Both childhood and adolescent obesity are associated with an increased risk of MS. Moreover, a dose-response relationship between the degree of obesity and the risk of future MS was indicated, while response to pediatric obesity treatment did not affect the association, highlighting the importance of preventing high degree of obesity early in life.
新出现的证据表明儿童高体重指数（BMI）与多发性硬化症（MS）风险增加之间存在联系。然而，先前的研究表明这种关联仅存在于青少年肥胖中，而不存在于儿童肥胖中。本研究旨在评估儿童肥胖与患MS风险之间的关联，并调查肥胖程度和开始肥胖治疗时的年龄是否会影响风险。在一个亚组中，评估了肥胖治疗对MS风险的反应。
在这项队列研究中，对来自瑞典儿童肥胖治疗登记册（BORIS）的2至19岁患者以及来自普通人群的匹配个体进行了前瞻性随访。通过国家患者登记册确定MS。计算了针对父母患MS情况进行调整的风险比（HR）。
该研究纳入了21,652名患有儿童肥胖的个体和102,187名普通人群对照者。随访时的中位年龄为21岁（第一四分位数，第三四分位数为18岁，25岁）。儿童肥胖队列中患MS的调整后HR（95%置信区间）为2.28（1.45 - 3.58）。在分层分析中，I类肥胖与MS无关联（HR = 1.34，0.64 - 2.81），而II类肥胖与MS之间的关联增强（HR = 3.42，1.89 - 6.19）。MS与儿童肥胖（HR = 3.16，1.12 - 8.87）和青少年肥胖（HR = 2.12，1.28 - 3.51）均有关联。BMI标准差评分（SDS）的降低与MS可能性降低无关，每降低0.25个BMI SDS单位，HR = 1.09（0.92 - 1.29）。
儿童和青少年肥胖均与MS风险增加有关。此外，表明了肥胖程度与未来患MS风险之间存在剂量反应关系，而儿童肥胖治疗的反应并未影响这种关联，突出了在生命早期预防高度肥胖的重要性。
