The Relation of Multiple Sclerosis to Family History, Lifestyle, and Health Factors in Childhood and Adolescence: Findings of a Case-Control Study Nested Within the German National Cohort (NAKO) Study

Abstract

Background: Multiple sclerosis (MS) is a neuroinflammatory disease of presumed autoimmune origin. A combination of genetic susceptibility and exposure to certain environmental and lifestyle factors might trigger the onset of MS. The currently known risk factors include a genetic predisposition, infection with the Epstein-Barr virus (EBV), smoking, and an increased body mass index.

Methods: In 2021-22, we carried out a case-control study nested within the German National Cohort (NAKO) to investigate associations of potential risk factors with MS.

Results: The subjects included 576 persons with MS (cases) and 895 without MS (controls). Beyond the known risk factors, we observed associations between MS and the cumulative number of common childhood infections (odds ratio (OR) 1.14 per additional infection, 95% confidence interval (CI): [1.03; 1.25]), major stressful life events (SLE) (OR 1.25 per additional event, [1.06; 1.48]), being the firstborn child of a mother aged 30 or older (OR 2.11, [1.08; 4.13]); higher amounts of physical activity in the teenage years were associated with a lower risk of MS (OR 0.82 per unit increase in activity level, [0.71; 0.95]).

Conclusion: We confirmed known risk factors for MS and found associations with a number of new ones, e.g., the cumulative number of common childhood infections. These findings may shed light on the etiology of MS and merit further study.