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- Title
Distinct effects of obesity and puberty on risk and age at onset of pediatric MS.
- Authors
Chitnis, Tanuja; Graves, Jennifer; Weinstock‐Guttman, Bianca; Belman, Anita; Olsen, Cody; Misra, Madhusmita; Aaen, Gregory; Benson, Leslie; Candee, Meghan; Gorman, Mark; Greenberg, Benjamin; Krupp, Lauren; Lotze, Timothy; Mar, Soe; Ness, Jayne; Rose, John; Rubin, Jennifer; Schreiner, Teri; Tillema, Jan; Waldman, Amy
- Abstract
Objective The aim of this study was to examine the relative contributions of body mass index ( BMI) and pubertal measures for risk and age of onset of pediatric MS. Methods Case-control study of 254 (63% female) MS cases (onset<18 years of age) and 420 (49% female) controls conducted at 14 U.S. Pediatric MS Centers. Sex- and age-stratified BMI percentiles were calculated using CDC growth charts from height and weight measured at enrollment for controls, and within 1 year of onset for MS cases. Sex-stratified associations between MS risk and age at symptom onset with both BMI and pubertal factors were estimated controlling for race and ethnicity. Results Only 11% of girls and 15% of boys were prepubertal (Tanner stage I) at MS onset. 80% of girls had onset of MS after menarche. BMI percentiles were higher in MS cases versus controls (girls: P < 0.001; boys: P = 0.018). BMI was associated with odds of MS in multivariate models in postpubertal girls ( OR = 1.60, 95% confidence interval [ CI]: 1.12, 2.27, P = 0.009) and boys ( OR = 1.43, 95% CI: 1.08, 1.88, P = 0.011). In girls with MS onset after menarche, higher BMI was associated with younger age at first symptoms ( P = 0.031). Younger menarche was associated with stronger effects of BMI through mediation and interaction analysis. In pubertal/postpubertal boys, 89% of whom were obese/overweight, earlier sexual maturity was associated with earlier onset of MS ( P < 0.001). Interpretation Higher BMI in early adolescence is a risk factor for MS in girls and boys. Earlier age at sexual maturity contributes to earlier age at MS onset, particularly in association with obesity.
- Subjects
PUBERTY; OBESITY risk factors; BODY mass index; AGE groups; MENARCHE
- Publication
Annals of Clinical & Translational Neurology, 2016, Vol 3, Issue 12, p897
- ISSN
2328-9503
- Publication type
Article
- DOI
10.1002/acn3.365