Abstract Details

Title Are Obesity and Tobacco Smoke Risk Factors for Conversion from Clinically Isolated Syndrome to Multiple Sclerosis?

Topic MS and Related Diseases

Presentation(s) P05 - (-)

Poster/Presentation
Number 140

Objective

Background BACKGROUND: Teenage obesity and smoking increase the risk of developing multiple sclerosis (MS). It is unknown whether these factors influence the risk of conversion from clinically isolated syndrome (CIS) to MS.

Design/Methods DESIGN/METHODS: Retrospective cohort study of incident CIS cases identified through the Kaiser Permanente Southern California membership between 2008 and 2009 (n=305). Full electronic health records were abstracted for clinical and radiologic variables. The average duration of follow-up was 3.5 years. Smoking status (never, quit, current) and BMI prior to symptom onset were missing in 3 cases. Hazards ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards.

Results RESULTS: Current (n=38, 12.6%) and former smokers (n=58, 19.2%) were older (mean age=45 versus 36 years; p<0.0001), more likely to be males (37.4% vs. 26.2%; p=0.05) and less likely to be Hispanic (14.3% vs. 37.1%) than never smokers. Current and former smokers were more likely to have asymptomatic brain MRI lesions at onset (71.3% vs. 63.7%, p=0.18). After adjusting for age, gender and polyregional onset of symptoms, smoking increased the risk of conversion from CIS to MS (HR=1.47, 95%CI=0.97-2.25, p=0.06). Overweight (29.3%), class I obese (20.9%) and class II or higher obese (19.8%) individuals were more likely to be older (p=0.0006) and black or Hispanic than normal weight CIS patients. Obesity was not associated with asymptomatic brain lesions, or an increased risk of conversion to MS in either univariate or multivariate analyses.

Conclusions CONCLUSIONS: Findings from our pilot study suggest that smoking may independently increase the risk conversion from CIS to MS although this finding did not reach statistical significance. Obesity at the time of symptom onset does not appear to influence the risk of conversion from CIS to MS.

Authors/Disclosures
PRESENTER	No disclosure on file
Annette M. Langer-Gould, MD, PhD (Kaiser Permanente Southern California)	An immediate family member of Dr. Langer-Gould has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Annals of American Thoracic Society. The institution of Dr. Langer-Gould has received research support from PCORI. The institution of an immediate family member of Dr. Langer-Gould has received research support from PCORI, ARQ, NIH. Dr. Langer-Gould has a non-compensated relationship as a Voting Member with ICER CTAF Panel that is relevant to AAN interests or activities.
Jian Zhang, PhD (Map Pharmaceuticals Inc)	No disclosure on file
Gilles Edan	Gilles Edan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celgene. Gilles Edan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Gilles Edan has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Biogen. Gilles Edan has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Merck.

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