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Factores de riesgo ambiental y conversión a esclerosis múltiple en sujetos con síndrome radiológicamente aislado: un
Chiara Zanetta1,2, Antonino Giordano3,4, Francesco Laserra1
1Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Journal of neurology
|January 29, 2026
Resumen
Ciertos factores de la adolescencia como el bajo peso, las pérdidas de embarazo y el uso de tecnología de reproducción asistida aumentan el riesgo de que el síndrome radiológicamente aislado (SRI) progrese a esclerosis múltiple (EM). La actividad al aire libre en la infancia se relacionó con un menor riesgo de inicio de síndrome clínicamente aislado/esclerosis múltiple remitente-recurrente.
Área de la Ciencia:
- Neurología
- Medicina Ambiental
- Epidemiología
Sus antecedentes:
- El síndrome radiológicamente aislado (SRI) se caracteriza por lesiones detectadas por RM típicas de la esclerosis múltiple (EM) en individuos asintomáticos.
- Es crucial comprender los factores ambientales asociados con la progresión del SRI a un evento clínico para una intervención temprana.
Objetivo del estudio:
- Investigar los factores ambientales relacionados con el primer evento clínico en pacientes con síndrome radiológicamente aislado (SRI).
- Identificar los factores de riesgo de progresión de SRI a esclerosis múltiple (EM) clínicamente evidente.
Principales métodos:
- Estudio de casos y controles que compara pacientes con SRI con individuos que presentan síndrome clínicamente aislado (CIS) o EM remitente-recurrente (RRMS) al inicio.
- Se administraron cuestionarios ambientales para evaluar factores del estilo de vida.
- Se realizaron análisis estadísticos para identificar factores de riesgo de progresión en pacientes con SRI.
Principales resultados:
- Pasar más tiempo al aire libre durante la infancia se asoció con un menor riesgo de inicio de CIS/RRMS.
- Los pacientes con SRI que progresaron a EM en un plazo de 5 años tenían más probabilidades de tener bajo peso durante la adolescencia (HR 11,57).
- Las pérdidas de embarazo (HR 4,48) y el uso de tecnología de reproducción asistida (TRA) antes del diagnóstico de SRI (HR 20,42) se asociaron con un mayor riesgo de progresión.
Conclusiones:
- El bajo peso en la adolescencia, las pérdidas de embarazo y el uso de TRA son factores de riesgo significativos para la progresión de SRI a EM.
- Una mayor actividad al aire libre en la infancia puede ser protectora contra el desarrollo de CIS/RRMS.
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