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Environmental exposures and the risk of multiple sclerosis in Saudi Arabia.

ABSTRACT: Multiple sclerosis (MS) is the most common non-traumatic condition that leads to disability among young individuals. It is associated with demyelination, inflammation, and neurodegeneration within the central nervous system. Information on risk factors of multiple sclerosis is crucial for the prevention and control of the disease. The aim of this study was to determine risk factors of MS among adults in Saudi Arabia.A matched multicenter case-control study, including 307 MS patients and 307 healthy controls, was conducted in MS clinics and wards in 3 main cities of Saudi Arabia. Age, gender, and hospital were matched. Information on demographics, family history of MS, past medical and family history, sun exposure at different age periods, tobacco use, diet, consanguinity, and coffee consumption was obtained from self-administered questionnaires. ORs and 95% confidence intervals (CIs) were calculated. A conditional logistic regression model was used to control for potential confounding factors.The conditional logistic regression adjusted for age and gender showed that being the first child in the family (Adjusted Odds Ratio (AOR) 1.68, 95% CI: 1.03-2.74), having a family history of MS (AOR 5.83, 95% CI: 2.83-12), eating fast food ?5 times weekly (AOR 2.05, 95% CI: 1.03-4.08), and having had measles (AOR 3.77, 95% CI: 2.05-6.96), were independently associated with an increased risk of MS. In contrast, eating ?5 servings of fruit per week (AOR 0.25, 95% CI: 0.16-0.38), drinking coffee daily (AOR 0.46, 95% CI: 0.31-0.68), and having a high level of sun exposure at the primary school level and university level (AOR 0.57, 95% CI: 0.38-0.85 and AOR 0.48, 95% CI: 0.30-0.76, respectively) were independently associated with a decreased risk of MS.Our study suggested that high levels of sun exposure during primary school and university, consumption of fruits and drinking coffee protect against MS. In contrast, eating fast food was associated with an increased risk of the disease. Encouraging outdoor activity and healthy diets in school, especially for females, is highly recommended.

SUBMITTER: Al Wutayd O

PROVIDER: S-EPMC6006694 | biostudies-other | 2018 Jun

REPOSITORIES: biostudies-other

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Environmental exposures and the risk of multiple sclerosis in Saudi Arabia.

Al Wutayd Osama O Mohamed Ashri Gad AG Saeedi Jameelah J Al Otaibi Hessa H Al Jumah Mohammed M

BMC neurology 20180619 1

<h4>Background</h4>Multiple sclerosis (MS) is the most common non-traumatic condition that leads to disability among young individuals. It is associated with demyelination, inflammation, and neurodegeneration within the central nervous system. Information on risk factors of multiple sclerosis is crucial for the prevention and control of the disease. The aim of this study was to determine risk factors of MS among adults in Saudi Arabia.<h4>Methods</h4>A matched multicenter case-control study, inc ...[more]

PMID: 29914402

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Project description:BackgroundThe outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread and developed as a pandemic threatening global health. Patients with multiple sclerosis (MS)-an autoimmune demyelinating inflammatory disease of the central nervous system (CNS)-are predominantly treated with immunomodulatory/immunosuppressive disease-modifying therapies (DMTs), which can increase the risk of infection. Therefore, there is concern that these patients may have a higher risk of COVID-19. In response to growing concerns of neurologists and patients, this study aimed to determine the prevalence, severity, and possible complications of COVID-19 infection in patients with MS in Saudi Arabia (SA).MethodsIn this prospective cohort study, demographic and clinical data were obtained from patients residing in SA with MS who had a positive result for COVID-19 per reverse transcription-polymerase chain reaction test or viral gene sequencing, using respiratory or plasma samples. Comparison of COVID-19 severity groups was performed using one-way ANOVA or Kruskal-Wallis test for numerical variables and Chi-squared test for categorical variables.ResultsSeventy patients with MS and COVID-19 (71% female) were included in this analysis. Of the 53 (75.7%) patients receiving a DMT at the time of COVID-19 infection, the most frequently used DMTs were fingolimod (25%) and interferon-beta (25%). Nine (13%) patients had MS relapse and were treated with intravenous methylprednisolone in the four weeks before COVID-19 infection. The most common symptoms at the peak of COVID-19 infection were fever (46%), fatigue (37%), and headache (36%). Symptoms lasted for a mean duration of 8.7 days; all symptomatic patients recovered and no deaths were reported. COVID-19 severity was categorized in three groups: asymptomatic (n = 12), mild-not requiring hospitalization (n = 48), and requiring hospitalization (n = 10; two of whom were admitted to the intensive care unit [ICU]). Between the three groups, comparison of age, body mass index , Expanded Disability Severity Score , MS disease duration, and DMT use at the time of infection showed no significant differences. A higher percentage of patients who were admitted to hospital or the ICU (40%; p = 0.026) presented with an MS relapse within the prior four weeks compared with those who were asymptomatic or had a mild infection (both 8.3%).ConclusionThese findings present a reassuring picture regarding COVID-19 infection in patients with MS. However, patients with MS who have had a relapse in the preceding four weeks (requiring glucocorticoid treatment) may have an increased risk of severe COVID-19.

Dataset Information

Environmental exposures and the risk of multiple sclerosis in Saudi Arabia.

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Environmental exposures and the risk of multiple sclerosis in Saudi Arabia.

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