To compare childhood neighborhood environment, biomarkers of allostatic load (AL), and current health insurance among pediatric onset MS (POMS) and adult onset MS (AOMS) patients.

Adversity can occur at the individual, family, and neighborhood levels. These chronic life stressors can trigger a physiologic stress response with downstream effects on the immune system, brain, and overall health. Allostatic load (AL) describes the wear and tear of stress on the body and some AL biomarkers can be measured with routine laboratory tests.

30 POMS and 30 AOMS participants (all young adults, age range 18-35 years) were consecutively recruited to the study during their routine MS clinic visit (seeing providers who accept the same health insurances). Self-report measures and serum samples were collected. The Area Deprivation Index (ADI), a measure of neighborhood adversity, was determined based on zip codes for childhood and current residence. Serum biomarkers were transformed to z-scores using age-normative values from NHANES database.

POMS vs. AOMS groups had similar MS disease duration: 6.09 + 2.90 vs. 6.16 + 3.53 years. Among POMS vs. AOMS, those self-reporting as white was lower: 43.3% vs. 56.7% while more participants self-reported as black 30.0% vs. 23.3%. POMS vs. AOMS were more often on public insurance (56.7% vs. 20%, p=.003) as opposed to private insurance. POMS vs. AOMS had a trend for greater childhood ADI (4.38 vs. 3.48, p=.054) but did not differ on current ADI. Overall, POMS vs. AOMS young adults had higher AL biomarkers of LDL (p=.004) and total cholesterol (p=.014). Blood pressure, triglycerides, and C-reactive protein levels were also elevated.

POMS vs. AOMS participants were more likely to be exposed to disadvantaged neighborhoods during childhood, were more frequently on public insurance and exhibit worse markers of increased AL. Better understanding is needed regarding how childhood adversity might affect later MS disease expression.