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Population attributable fractions and joint effects of key risk factors for multiple sclerosis


van der Mei, IAF and Lucas, RM and Taylor, BV and Valery, PC and Dwyer, T and Kilpatrick, TJ and Pender, MP and Williams, D and Chapman, C and Otahal, P and Ponsonby, AL, Population attributable fractions and joint effects of key risk factors for multiple sclerosis, Multiple Sclerosis Journal, 22, (4) pp. 461-469. ISSN 1352-4585 (2016) [Refereed Article]

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The Author(s), 2015. Reprints and permissions: journalsPermissions.nav

DOI: doi:10.1177/1352458515594040


Aim: We examined the combined effect of having multiple key risk factors and the interactions between the key risk factors of multiple sclerosis (MS).

Methods: We performed an incident case-control study including cases with a first clinical diagnosis of central nervous system demyelination (FCD) and population-based controls.

Results: Compared to those without any risk factors, those with one, two, three, and four or five risk factors had increased odds of being an FCD case of 2.12 (95% confidence interval (CI), 1.114.03), 4.31 (95% CI, 2.248.31), 7.96 (95% CI, 3.8416.49), and 21.24 (95% CI, 5.4882.40), respectively. Only HLA-DR15 and history of infectious mononucleosis interacted significantly on the additive scale (Synergy index, 3.78; p = 0.03). The five key risk factors jointly accounted for 63.8% (95% CI, 43.991.4) of FCD onset. High anti-EBNA IgG was another important contributor.

Conclusions: A high proportion of FCD onset can be explained by the currently known risk factors, with HLA-DR15, ever smoking and low cumulative sun exposure explaining most. We identified a significant interaction between HLA-DR15 and history of IM in predicting an FCD of CNS demyelination, which together with previous observations suggests that this is a true interaction.

Item Details

Item Type:Refereed Article
Keywords:first demyelinating event, gene-environment interaction, multiple sclerosis, population attributable fraction, risk factors
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Epidemiology not elsewhere classified
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:van der Mei, IAF (Professor Ingrid van der Mei)
UTAS Author:Taylor, BV (Professor Bruce Taylor)
UTAS Author:Otahal, P (Mr Petr Otahal)
ID Code:102091
Year Published:2016 (online first 2015)
Web of Science® Times Cited:43
Deposited By:Menzies Institute for Medical Research
Deposited On:2015-07-28
Last Modified:2017-11-03

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