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Nyström, Maria
Publications (2 of 2) Show all publications
Salzer, J., Hallmans, G., Nyström, M., Stenlund, H., Wadell, G. & Sundström, P. (2013). Smoking as a risk factor for multiple sclerosis. Multiple Sclerosis, 19(8), 1022-1027
Open this publication in new window or tab >>Smoking as a risk factor for multiple sclerosis
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2013 (English)In: Multiple Sclerosis, ISSN 1352-4585, E-ISSN 1477-0970, Vol. 19, no 8, p. 1022-1027Article in journal (Refereed) Published
Abstract [en]

Background: Smoking has been associated with an increased risk for multiple sclerosis, but no studies have measured levels of the nicotine metabolite cotinine in prospectively collected samples to assess exposure.

Objective: To investigate the effects of laboratory defined tobacco use on the risk for multiple sclerosis using prospectively collected biobank blood samples.

Methods: Levels of cotinine were measured in n=192 cases, and n=384 matched controls, using an immunoassay. The risk for multiple sclerosis was estimated using matched logistic regression.

Results: Elevated cotinine levels (≥10 ng/ml) were associated with a significantly increased risk for multiple sclerosis, (odds ratio, OR 1.5, 95% confidence interval, CI 1.0–2.1). This association was only present in young individuals (below median age at blood sampling, <26.4 years), (OR 2.2, 95% CI 1.3–3.8).

Conclusions: This study confirms that smoking is a risk factor for multiple sclerosis. It has the advantage of using analyses of cotinine levels in samples that were collected several years before disease onset, thus excluding any risk for recall bias and minimising the risk for reversed causation. Our results also suggest that the smoking related immunological events that contribute to the development of multiple sclerosis occur early in life.

Place, publisher, year, edition, pages
Sage Publications, 2013
Keywords
Multiple sclerosis, case control study, risk factors in epidemiology, smoking
National Category
Neurology
Research subject
Epidemiology
Identifiers
urn:nbn:se:umu:diva-63742 (URN)10.1177/1352458512470862 (DOI)000327373300008 ()23257617 (PubMedID)
Note

First published online December 20th, 2012.

Available from: 2013-01-11 Created: 2013-01-07 Last updated: 2018-06-08Bibliographically approved
Salzer, J., Hallmans, G., Nyström, M., Stenlund, H., Wadell, G. & Sundström, P. (2013). Vitamin A and systemic inflammation as protective factors in multiple sclerosis. Multiple Sclerosis, 19(8), 1046-1051
Open this publication in new window or tab >>Vitamin A and systemic inflammation as protective factors in multiple sclerosis
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2013 (English)In: Multiple Sclerosis, ISSN 1352-4585, E-ISSN 1477-0970, Vol. 19, no 8, p. 1046-1051Article in journal (Refereed) Published
Abstract [en]

Background: Vitamin A is important for the immune system, and might suppress inflammatory activity in multiple sclerosis (MS).

Objectives: We aimed to examine if vitamin A levels were associated with MS risk in samples collected prospectively and during gestation.

Methods: We measured Retinol Binding Protein (RBP – a surrogate marker for vitamin A) and high-sensitivity C-reactive protein (hs-CRP) levels, in (1) prospectively collected biobank blood samples from MS cases and controls, and (2) gestational samples where the offspring had later developed MS, and gestational control samples. The risk of MS was calculated using matched multivariable logistic regression adjusted for confounders.

Results: In prospective samples, RBP levels within the second quintile (vs. the first) were associated with a lower MS risk (OR = 0.38, 95% CI 0.19–0.74). No effect on MS risk in the offspring by gestational RBP levels was found. In young subjects hs-CRP levels ≥10 mg/l in prospective samples were associated with a lower MS risk (OR = 0.36, 95% CI 0.14–0.95).

Conclusions: Our results suggest that sub-optimal vitamin A levels may be associated with MS risk. The association between hs-CRP levels and MS risk in young subjects may support the role of the hygiene hypothesis in MS aetiology. 

Place, publisher, year, edition, pages
Sage Publications, 2013
Keywords
Multiple sclerosis, case-control study, risk factors in epidemiology, vitamin a, retinol, c-reactive protein, CRP, hygiene hypothesis
National Category
Neurology
Research subject
Epidemiology
Identifiers
urn:nbn:se:umu:diva-64211 (URN)10.1177/1352458512472752 (DOI)000327373300011 ()23334316 (PubMedID)
Available from: 2013-01-21 Created: 2013-01-21 Last updated: 2018-06-08Bibliographically approved
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