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Published on: December 9, 2015
Level of education and multiple sclerosis risk after adjustment for known risk factors: The EnvIMS study
Kjetil Bjørnevik1, Trond Riise2, Marianna Cortese3
1Department of Global Public Health and Primary Care, University of Bergen, Norway/The Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Norway kjetil.bjornevik@igs.uib.no.
Background:
Several recent studies have found a higher risk of multiple sclerosis (MS) among people with a low level of education. This has been suggested to reflect an effect of smoking and lower vitamin D status in the social class associated with lower levels of education.
Objective:
The objective of this paper is to investigate the association between level of education and MS risk adjusting for the known risk factors smoking, infectious mononucleosis, indicators of vitamin D levels and body size.
Methods:
Within the case-control study on Environmental Factors In MS (EnvIMS), 953 MS patients and 1717 healthy controls from Norway reported educational level and history of exposure to putative environmental risk factors.
Results:
Higher level of education were associated with decreased MS risk (p trend = 0.001) with an OR of 0.53 (95% CI 0.41-0.68) when comparing those with the highest and lowest level of education. This association was only moderately reduced after adjusting for known risk factors (OR 0.61, 95% CI 0.44-0.83). The estimates remained similar when cases with disease onset before age 28 were excluded.
Conclusion:
These findings suggest that factors related to lower socioeconomic status other than established risk factors are associated with MS risk.
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