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February 05, 2013; 80 (6) Article

Childhood obesity and risk of pediatric multiple sclerosis and clinically isolated syndrome

Annette Langer-Gould, Sonu M. Brara, Brandon E. Beaber, Corinna Koebnick
First published January 30, 2013, DOI: https://doi.org/10.1212/WNL.0b013e31828154f3
Annette Langer-Gould
From the Department of Research & Evaluation (A.L.-G., C.K.), Kaiser Permanente of Southern California, Pasadena; and the Neurology Department (A.L.-G., S.M.B., B.E.B.), Los Angeles Medical Center, Southern California Permanente Medical Group, Harbor City.
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Sonu M. Brara
From the Department of Research & Evaluation (A.L.-G., C.K.), Kaiser Permanente of Southern California, Pasadena; and the Neurology Department (A.L.-G., S.M.B., B.E.B.), Los Angeles Medical Center, Southern California Permanente Medical Group, Harbor City.
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Brandon E. Beaber
From the Department of Research & Evaluation (A.L.-G., C.K.), Kaiser Permanente of Southern California, Pasadena; and the Neurology Department (A.L.-G., S.M.B., B.E.B.), Los Angeles Medical Center, Southern California Permanente Medical Group, Harbor City.
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Corinna Koebnick
From the Department of Research & Evaluation (A.L.-G., C.K.), Kaiser Permanente of Southern California, Pasadena; and the Neurology Department (A.L.-G., S.M.B., B.E.B.), Los Angeles Medical Center, Southern California Permanente Medical Group, Harbor City.
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Citation
Childhood obesity and risk of pediatric multiple sclerosis and clinically isolated syndrome
Annette Langer-Gould, Sonu M. Brara, Brandon E. Beaber, Corinna Koebnick
Neurology Feb 2013, 80 (6) 548-552; DOI: 10.1212/WNL.0b013e31828154f3

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Abstract

Objective: To determine whether childhood obesity is a risk factor for developing pediatric multiple sclerosis (MS) or clinically isolated syndrome (CIS).

Methods: Cases were identified through the Kaiser Permanente Southern California (KPSC) Pediatric Acquired Demyelinating Diseases Cohort between 2004 and 2010. For cases, body mass index (BMI) was obtained prior to symptom onset, for the underlying cohort BMI was obtained through the KPSC Children's health study (n = 913,097). Weight classes of normal weight, overweight, moderate obesity, and extreme obesity were assigned based on BMI specific for age and sex.

Results: We identified 75 newly diagnosed pediatric cases of MS or CIS, the majority of which were in girls (n = 41, 55%), age 11–18 (n = 54, 72%). Obesity was associated with a significantly increased risk of MS/CIS in girls (p = 0.005 for trend) but not in boys (p = 0.93). The adjusted odds ratio and 95% confidence intervals for CIS/MS among girls was 1.58 (0.71–3.50) for overweight compared to normal weight (reference category), 1.78 (0.70–4.49) for moderately obese, and 3.76 (1.54–9.16) for extremely obese. Moderately and extremely obese cases were more likely to present with transverse myelitis compared with normal/overweight children (p = 0.003).

Conclusion: Our findings suggest the childhood obesity epidemic is likely to lead to increased morbidity from MS/CIS, particularly in adolescent girls.

GLOSSARY

ADS=
acquired demyelinating diseases;
BMI=
body mass index;
CI=
confidence intervals;
CIS=
clinically isolated syndrome;
KPSC=
Kaiser Permanente Southern California;
MS=
multiple sclerosis;
ON=
optic neuritis;
OR=
odds ratios;
TM=
transverse myelitis

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.

  • Received June 25, 2012.
  • Accepted October 4, 2012.
  • © 2013 American Academy of Neurology
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Letters: Rapid online correspondence

  • Vitamin D: a link between childhood obesity and paediatric multiple sclerosis
    • Julia Pakpoor, Medical student, Department of Physiology, Anatomy and Genetics and Medical Research Council Functional Genomics Unitjulia.pakpoor@medschool.ox.ac.uk
    • Julia Pakpoor, Oxford, UK; Jina Pakpoor, Cambridge, UK
    Submitted February 12, 2013
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