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May 07, 2013; 80 (19) Article

Incidence of multiple sclerosis in multiple racial and ethnic groups

Annette Langer-Gould, Sonu M. Brara, Brandon E. Beaber, Jian L. Zhang
First published May 6, 2013, DOI: https://doi.org/10.1212/WNL.0b013e3182918cc2
Annette Langer-Gould
From the Department of Research and Evaluation (A.L.-G., J.L.Z.), Kaiser Permanente, Southern California, Pasadena; and Neurology Department (A.L.-G., S.M.B., B.E.B.), Kaiser Permanente, Southern California Los Angeles Medical Center, CA.
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Sonu M. Brara
From the Department of Research and Evaluation (A.L.-G., J.L.Z.), Kaiser Permanente, Southern California, Pasadena; and Neurology Department (A.L.-G., S.M.B., B.E.B.), Kaiser Permanente, Southern California Los Angeles Medical Center, CA.
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Brandon E. Beaber
From the Department of Research and Evaluation (A.L.-G., J.L.Z.), Kaiser Permanente, Southern California, Pasadena; and Neurology Department (A.L.-G., S.M.B., B.E.B.), Kaiser Permanente, Southern California Los Angeles Medical Center, CA.
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Jian L. Zhang
From the Department of Research and Evaluation (A.L.-G., J.L.Z.), Kaiser Permanente, Southern California, Pasadena; and Neurology Department (A.L.-G., S.M.B., B.E.B.), Kaiser Permanente, Southern California Los Angeles Medical Center, CA.
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Incidence of multiple sclerosis in multiple racial and ethnic groups
Annette Langer-Gould, Sonu M. Brara, Brandon E. Beaber, Jian L. Zhang
Neurology May 2013, 80 (19) 1734-1739; DOI: 10.1212/WNL.0b013e3182918cc2

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Abstract

Objective: To determine whether the incidence of multiple sclerosis (MS) varies by race/ethnicity in a multiethnic, population-based cohort.

Methods: We conducted a retrospective cohort study of more than 9 million person-years of observation from the multiethnic, community-dwelling members of Kaiser Permanente Southern California health plan from January 1, 2008 to December 31, 2010. Incidence of MS and risk ratios comparing incidence rates between racial/ethnic groups were calculated using Poisson regression.

Results: We identified 496 patients newly diagnosed with MS who met McDonald criteria. The average age at diagnosis was 41.6 years (range 8.6–78.3 years) and 70.2% were women. The female preponderance was more pronounced among black (79.3%) than white, Hispanic, and Asian individuals with MS (67.8%, 68.1%, and 69.2%, respectively; p = 0.03). The incidence of MS was higher in blacks (10.2, 95% confidence interval [CI] 8.4–12.4; p < 0.0001) and lower in Hispanics (2.9, 95% CI 2.4–3.5; p < 0.0001) and Asians (1.4, 95% CI 0.7–2.4; p < 0.0001) than whites (6.9, 95% CI 6.1–7.8). Black women had a higher risk of MS (risk ratio 1.59, 95% CI 1.27–1.99; p = 0.0005) whereas black men had a similar risk of MS (risk ratio 1.04, 95% CI = 0.67–1.57) compared with whites.

Conclusions: Our findings do not support the widely accepted assertion that blacks have a lower risk of MS than whites. A possible explanation for our findings is that people with darker skin tones have lower vitamin D levels and thereby an increased risk of MS, but this would not explain why Hispanics and Asians have a lower risk of MS than whites or why the higher risk of MS among blacks was found only among women.

GLOSSARY

CI=
confidence interval;
CIS=
clinically isolated syndrome;
ICD-9=
International Classification of Diseases, ninth revision;
MS=
multiple sclerosis

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at www.neurology.org

  • Received September 19, 2012.
  • Accepted in final form January 24, 2013.
  • © 2013 American Academy of Neurology
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