Neurology:多多在阳光下户外活动或有效预防儿童多发性硬化的发生!

2021-12-13 Naomi MedSci原创

近日,有研究人员分析了一项多中心病例对照研究的数据,该研究调查了儿童多发性硬化症的环境风险因素。如因果关系成立,则夏季多晒太阳可能对儿童患多发性硬化症有很强的预防保护作用,且居住阳光充沛地方更佳。

      多发性硬化症(MS)的发病年龄通常在20岁-50岁;然而,3-5%的MS患者在18岁之前就开始出现症状。儿科多发性硬化症最初通常表现为高度炎症病程,但随后比成人多发性硬化症进展到不可逆转的残疾需要更长的时间,尽管残疾里程碑仍然平均提前了大约10年。

      MS病因学被认为是遗传易感性、感染性暴露、其他环境和行为风险因素的综合作用。尤其是,低太阳暴露、低紫外线辐射(UVR)暴露和低维生素D状态已被很好地描述为成人型多发性硬化症的环境风险因素,与儿童时期阳光暴露不足有关的风险尤其增加。然而,迄今为止,对多发性硬化症太阳/UVR暴露的研究主要局限于成人人群。

      近日,有研究人员分析了一项多中心病例对照研究的数据,该研究调查了儿童多发性硬化症的环境风险因素。其目标是探究阳光暴露(以户外活动时间衡量)、紫外线照射(以周围紫外线剂量衡量)与儿童多发性硬化症风险的关系。基于这些因素与成人型多发性硬化症风险的已知关联,研究假设在这一儿科人群中,低阳光暴露和低紫外线暴露将与更大的MS风险相关。

      从美国多个中心招募的患有多发性硬化症的儿童和对照组的儿童在性别和年龄上都是匹配的。采用多因素条件Logistic回归分析,研究出生前一年和确诊前一年夏季每天户外活动时间、使用防晒霜和夏季环境紫外线照射剂量与MS风险的关系,并调整性别、年龄、种族、出生季节、儿童肤色、母亲教育程度、吸烟暴露、超重和Epstein-Barr病毒感染。

  • 在性别和年龄匹配后,纳入332名MS儿童(中位病程:7.3个月)和534名对照儿童。
  • 在一个完全调整的模型中,与最近夏天每天在户外的时间少于30分钟相比,更长的户外时间与患多发性硬化症的几率显著降低相关,并有剂量反应的证据(30分钟至1小时:调整后的优势比=0.48,95%可信区间[95%CI]0.23-0.99,p=0.001;1-2小时:调整后的优势比=0.19,95%CI为0.09-0.40,p<0.001)。
  • 较高的夏季环境UVR剂量对MS也有保护作用(AOR=0.76/kJ/m2,95%CI 0.620.94,p=0.01)。

      如果这是一种因果关系,那么夏季多晒太阳可能对患儿科多发性硬化症有很强的预防保护作用,而且居住在阳光更充足的地方也能起到很好的保护作用。

文献来源:Sebastian P, Cherbuin N, Barcellos LF, et al. Association Between Time Spent Outdoors and Risk of Multiple Sclerosis [published online ahead of print, 2021 Dec 8]. Neurology. 2021;10.1212/WNL.0000000000013045. doi:10.1212/WNL.0000000000013045

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    2022-01-23 yinhl1978
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    2022-01-02 jml2009
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    2021-12-17 旋律永久

    学习

    0

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    2021-12-14 黄婷婷

    这么神奇

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    2021-12-13 今天明天aaaaaaf9

    申拨单位

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    2021-12-13 查查佳佳

    气管哮喘是一种常见的呼吸道疾病,急性发

    0

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