Due to the possible existence of a vulnerable period of multiple sclerosis (MS) susceptibility in adolescence and because Danish teenagers have a high alcohol consumption, we investigated the association between alcohol consumption at ages 15–19 and the risk of developing MS.
Methods:
A total of 1717 patients with MS and 4685 healthy blood donors filled in a comprehensive environmental and lifestyle questionnaire. Data were analysed by logistic regression models and adjusted for selected confounders.
Results:
We found an inverse association between alcohol consumption in adolescence and risk of developing MS in both women (p < 0.001) and men (p = 0.012). Women with low alcohol consumption had an odds ratio (OR) of 0.56 (95% confidence interval (CI): 0.47–0.66) compared with non-drinking women. The ORs were similar for women with moderate (OR = 0.49, 95% CI: 0.38–0.62) and high consumption (OR = 0.57, 95% CI: 0.38–0.84). Men with low alcohol consumption had an OR of 0.69 (95% CI: 0.53–0.89) compared with non-drinking men but no decreased risk was found for men with moderate and high consumption.
Conclusion:
Alcohol consumption in adolescence was associated with lower risk of developing MS among both sexes.
AscherioAMungerKLSimonKC.Vitamin D and multiple sclerosis. Lancet Neurol2010; 9(6): 599–612.
2.
BelbasisLBellouVEvangelouE, et al. Environmental risk factors and multiple sclerosis: An umbrella review of systematic reviews and meta-analyses. Lancet Neurol2015; 14(3): 263–273.
3.
HandelAEWilliamsonAJDisantoG, et al. Smoking and multiple sclerosis: An updated meta-analysis. PLoS ONE2011; 6(1): e16149.
4.
GianfrancescoMAAcunaBShenL, et al. Obesity during childhood and adolescence increases susceptibility to multiple sclerosis after accounting for established genetic and environmental risk factors. Obes Res Clin Pract2014; 8(5): e435–e447.
5.
MassaJO’ReillyEJMungerKL, et al. Caffeine and alcohol intakes have no association with risk of multiple sclerosis. Mult Scler2013; 19(1): 53–58.
6.
NortvedtMWRiiseTMaelandJG.Multiple sclerosis and lifestyle factors: The Hordaland Health Study. Neurol Sci2005; 26(5): 334–339.
7.
BrosseauLPhilippePMéthotG, et al. Drug abuse as a risk factor of multiple sclerosis: Case-control analysis and a study of heterogeneity. Neuroepidemiology1993; 12(1): 6–14.
8.
HedströmAKHillertJOlssonT, et al. Alcohol as a modifiable lifestyle factor affecting multiple sclerosis risk. JAMA Neurol2014; 71(3): 300–305.
9.
PekmezovicTDrulovicJMilenkovicM, et al. Lifestyle factors and multiple sclerosis: A case-control study in Belgrade. Neuroepidemiology2006; 27(4): 212–216.
10.
RomeoJWärnbergJNovaE, et al. Moderate alcohol consumption and the immune system: A review. Br J Nutr2007; 98(Suppl. 1): S111–S115.
11.
KällbergHJacobsenSBengtssonC, et al. Alcohol consumption is associated with decreased risk of rheumatoid arthritis: Results from two Scandinavian case-control studies. Ann Rheum Dis2009; 68(2): 222–227.
12.
WangJPanHFYeDQ, et al. Moderate alcohol drinking might be protective for systemic lupus erythematosus: A systematic review and meta-analysis. Clin Rheumatol2008; 27(12): 1557–1563.
13.
CarléAPedersenIBKnudsenN, et al. Moderate alcohol consumption may protect against overt autoimmune hypothyroidism: A population-based case-control study. Eur J Endocrinol2012; 167(4): 483–490.
14.
HedströmAKOlssonTAlfredssonL.High body mass index before age 20 is associated with increased risk for multiple sclerosis in both men and women. Mult Scler2012; 18(9): 1334–1336.
15.
PolmanCHReingoldSCBanwellB, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol2011; 69(2): 292–302.
16.
PolmanCHReingoldSCEdanG, et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the McDonald criteria. Ann Neurol2005; 58: 840–846.
17.
PedersenOBErikstrupCKotzéSR, et al. The Danish Blood Donor Study: A large, prospective cohort and biobank for medical research. Vox Sang2012; 102(3): 271.
18.
HedströmAKKatsoulisMHössjerO, et al. The interaction between smoking and HLA genes in multiple sclerosis: Replication and refinement. Eur J Epidemiol2017; 32(10): 909–919.
19.
AkbaralyTNShipleyMJFerrieJE, et al. Long-term adherence to healthy dietary guidelines and chronic inflammation in the prospective Whitehall II study. Am J Med2015; 128(2): 152.e4–160.e4.
20.
RomeoJWärnbergJNovaE, et al. Changes in the immune system after moderate beer consumption. Ann Nutr Metab2007; 51(4): 359–366.
21.
LeeSRivierC.Gender differences in the effect of prenatal alcohol exposure on the hypothalamic-pituitary-adrenal axis response to immune signals. Psychoneuroendocrinology1996; 21(2): 145–155.
22.
LemmensPH.The alcohol content of self-report and ‘standard’ drinks. Addiction1994; 89(5): 593–601.
EdgrenGTranTNHjalgrimH, et al. Improving health profile of blood donors as a consequence of transfusion safety efforts. Transfusion2007; 47(11): 2017–2024.
25.
GoldingJNorthstoneKMillerLL, et al. Differences between blood donors and a population sample: Implications for case-control studies. Int J Epidemiol2013; 42(4): 1145–1156.
26.
VolkenTWeidmannCBartT, et al. Individual characteristics associated with blood donation: A cross-national comparison of the German and Swiss population between 1994 and 2010. Transfus Med Hemother2013; 40(2): 133–138.
27.
SalonenJTTuomainenTPSalonenR, et al. Donation of blood is associated with reduced risk of myocardial infarction. The Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Epidemiol1998; 148(5): 445–451.
28.
WijnandsJMAKingwellEZhuF, et al. Health-care use before a first demyelinating event suggestive of a multiple sclerosis prodrome: A matched cohort study. Lancet Neurol2017; 16(6): 445–451.
29.
MarrieRAYuNWeiY, et al. High rates of physician services utilization at least five years before multiple sclerosis diagnosis. Mult Scler J2013; 19(8): 1113–1119.
30.
HedströmAKOlssonTAlfredssonL.Body mass index during adolescence, rather than childhood, is critical in determining MS risk. Mult Scler2016; 22(7): 878–883.
31.
MungerKLLevinLIHollisBW, et al. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA2006; 296(23): 2832–2838.
32.
HedströmAKÅkerstedtTHillertJ, et al. Shift work at young age is associated with increased risk for multiple sclerosis. Ann Neurol2011; 70(5): 733–741.
33.
GaleCRMartynCN.Migrant studies in multiple sclerosis. Prog Neurobiol1995; 47: 425–448.
34.
SundqvistESundströmPLindénM, et al. Epstein-Barr virus and multiple sclerosis: Interaction with HLA. Genes Immun2012; 13(1): 14–20.
35.
HedströmAKLima BomfimIBarcellosL, et al. Interaction between adolescent obesity and HLA risk genes in the etiology of multiple sclerosis. Neurology2014; 82(10): 865–872.
