Wayra Citlali Paz-Ballesteros1, Eric Alejandro Monterrubio-Flores2, José de Jesús Flores-Rivera3, Teresa Corona-Vázquez4, Carlos Hernández-Girón5. 1. Escuela de Salud Pública, Instituto Nacional de Salud Pública, Cuernavaca, México. 2. Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México. 3. Departamento de Enfermedades Desmielinizantes, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México. 4. Departamento de Neurología, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México. 5. Centro de Investigación sobre Salud de la Población, Instituto Nacional de Salud Pública, Cuernavaca, México. Electronic address: chernand@correo.insp.mx.
Abstract
BACKGROUND: The rate at which disability progresses in multiple sclerosis (MS), and its severity, have been associated with modifiable lifestyle habits. OBJECTIVE: To investigate the risk of disability progression in MS patients according to tobacco and alcohol consumption and to the presence of overweight. METHODS: This was a follow-up of MS cases from a concluded case-control study (National Institute of Neurology and Neurosurgery, Mexico 2010-2013). The evolution in EDSS (Expanded Disability Scale Score) units was followed through a medical record review. Kaplan Meier statistics and multivariate Cox regression analysis were performed. RESULTS: Of 181 cases, 63.5% were women and 82.5% had relapsing remitting MS. Study duration was 19.95 ± 15.24 months. The disease progressed faster in daily smokers than in non-smokers (p = 0.0168). In overweight patients, disability progressed faster than in normal weight patients (p = 0.0249). Ex-consumers of alcohol had lower risk of progression than current consumers (HR = 0.33 CI 95% = 0.14-0.83, p = 0.019) and both daily and ex-smokers presented higher risk of progression than non-smokers (HR = 2.32 CI 95% = 1.14-4.72, p = 0.020 and HR = 3.56, CI 95% = 1.21-10.46, p = 0.021). Stratifying by gender, the effects of smoking and overweight were only found in men. CONCLUSIONS: Smoking is associated with rapid disability progression in MS. Our results suggest that cessation of tobacco and alcohol consumption could be clinically beneficial. Although there is association between overweight and disability progression in men, a further exploration of gender differences is necessary to corroborate this finding.
BACKGROUND: The rate at which disability progresses in multiple sclerosis (MS), and its severity, have been associated with modifiable lifestyle habits. OBJECTIVE: To investigate the risk of disability progression in MS patients according to tobacco and alcohol consumption and to the presence of overweight. METHODS: This was a follow-up of MS cases from a concluded case-control study (National Institute of Neurology and Neurosurgery, Mexico 2010-2013). The evolution in EDSS (Expanded Disability Scale Score) units was followed through a medical record review. Kaplan Meier statistics and multivariate Cox regression analysis were performed. RESULTS: Of 181 cases, 63.5% were women and 82.5% had relapsing remitting MS. Study duration was 19.95 ± 15.24 months. The disease progressed faster in daily smokers than in non-smokers (p = 0.0168). In overweight patients, disability progressed faster than in normal weight patients (p = 0.0249). Ex-consumers of alcohol had lower risk of progression than current consumers (HR = 0.33 CI 95% = 0.14-0.83, p = 0.019) and both daily and ex-smokers presented higher risk of progression than non-smokers (HR = 2.32 CI 95% = 1.14-4.72, p = 0.020 and HR = 3.56, CI 95% = 1.21-10.46, p = 0.021). Stratifying by gender, the effects of smoking and overweight were only found in men. CONCLUSIONS: Smoking is associated with rapid disability progression in MS. Our results suggest that cessation of tobacco and alcohol consumption could be clinically beneficial. Although there is association between overweight and disability progression in men, a further exploration of gender differences is necessary to corroborate this finding.
Authors: Angeliki G Filippatou; Jeffrey Lambe; Elias S Sotirchos; Kathryn C Fitzgerald; Andrew Aston; Olwen C Murphy; Nicole Pellegrini; Nicholas Fioravante; Hunter Risher; Esther Ogbuokiri; Ohemaa Kwakyi; Brandon Toliver; Simidele Davis; Nicholas Luciano; Ciprian Crainiceanu; Jerry L Prince; Ellen M Mowry; Peter A Calabresi; Shiv Saidha Journal: Mult Scler Date: 2020-04-16 Impact factor: 6.312
Authors: Kamilah Castro; Achilles Ntranos; Mario Amatruda; Maria Petracca; Peter Kosa; Emily Y Chen; Johannes Morstein; Dirk Trauner; Corey T Watson; Michael A Kiebish; Bibiana Bielekova; Matilde Inglese; Ilana Katz Sand; Patrizia Casaccia Journal: EBioMedicine Date: 2019-04-10 Impact factor: 8.143
Authors: Jeremy Hobart; Amy Bowen; George Pepper; Harriet Crofts; Lucy Eberhard; Thomas Berger; Alexey Boyko; Cavit Boz; Helmut Butzkueven; Elisabeth Gulowsen Celius; Jelena Drulovic; José Flores; Dana Horáková; Christine Lebrun-Frénay; Ruth Ann Marrie; James Overell; Fredrik Piehl; Peter Vestergaard Rasmussen; Maria José Sá; Carmen-Adella Sîrbu; Eli Skromne; Øivind Torkildsen; Vincent van Pesch; Timothy Vollmer; Magd Zakaria; Tjalf Ziemssen; Gavin Giovannoni Journal: Mult Scler Date: 2018-11-01 Impact factor: 6.312