Environmental Factors and Multiple Sclerosis Severity: A Descriptive Study

International Journal of Environmental Research and Public Health

Daniele Mandia¹  Ottavia E. Ferraro²  Guido Nosari¹  Cristina Montomoli²  Elisabetta Zardini¹ 

[1] Interdepartmental Research Center for Multiple Sclerosis (CRISM), C. Mondino National Neurological Institute, Pavia 27100, Italy; E-Mails:;Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini, 2, Pavia 27100, Italy; E-Mails:

关键词: multiple sclerosis;    environment;    disease severity;    vitamin D;    sunlight exposure;   

DOI  :  10.3390/ijerph110606417

来源: mdpi

【 摘 要 】

Growing evidence suggests that environmental factors play a key role in the onset of multiple sclerosis (MS). This study was conducted to examine whether environmental factors may also be associated with the evolution of the disease. We collected data on smoking habits, sunlight exposure and diet (particularly consumption of vitamin D-rich foods) from a sample of 131 MS patients. We also measured their serum vitamin D concentration. The clinical impact of MS was quantified using the Multiple Sclerosis Severity Score (MSSS); MS was considered “severe” in patients with MSSS ≥ 6, and “mild” in patients with MSSS ≤ 1. The results showed a strong association between serum vitamin D concentration and both sunlight exposure (26.4 ± 11.9 ng/mL vs. 16.5 ± 12.1 ng/mL, p = 0.0004) and a fish-rich diet (23.5 ± 12.1 ng/mL vs. 16.1 ± 12.4 ng/mL, p = 0.005). Patients reporting frequent sunlight exposure had a lower MSSS (2.6 ± 2.4 h vs. 4.6 ± 2.6 h, p < 0.001). The mild MS patients reported much more frequent sunlight exposure (75% mild MS vs. 25% severe MS p = 0.004, Chi square test). A higher serum vitamin D concentration determined a lower risk of developing severe MS, adjusted for sunlight exposure (OR = 0.92 for one unit increase in vitamin D, 95% CI: 0.86–0.97, p = 0.005). A stronger inverse association emerged between frequent sunlight exposure and the risk of severe MS (OR = 0.26, 95% CI: 0.09–0.71, p = 0.009). Our data show that an appropriate diet and adequate expose to sunlight are associated with less aggressive MS.

【 授权许可】

CC BY   
© 2014 by the authors; licensee MDPI, Basel, Switzerland.