Small-scale geographical variation in multiple sclerosis: A case-control study using Danish register data 1971–2013

Kristine Bihrmann*, Nete Munk Nielsen, Melinda Magyari, Nils Koch-Henriksen, Rikke Baastrup Nordsborg, Annette Kjær Ersbøll

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Abstract

Background: The aetiology of multiple sclerosis (MS) is largely unknown, but commonly assumed to be a complex interaction between genes and environmental exposures, presumably during early life. To evaluate the possible importance and timing of environmental exposures we investigated the spatial variation in the risk of MS in Denmark according to residence at birth, age 15, and clinical onset of disease. Methods: We carried out a nationwide, register-based case-control study including 12 993 Danish MS cases with onset of disease 1971–2013. Information on exact residential addresses was available for all study subjects in the Danish Civil Registration System. The spatial variation in risk of MS was estimated by kernel regression. Results: We identified spatial variation in the risk of MS according to residence at birth, age 15, and onset of disease. Several high- and low-risk areas were identified across the country with some variation between birth, age 15, and onset. Conclusions: Small-scale geographical variation in the risk of MS suggests that local environmental risk factors could be at play and may be related to life style factors.

Original languageEnglish
JournalMultiple Sclerosis and Related Disorders
Volume23
Pages (from-to)40-45
ISSN2211-0348
DOIs
Publication statusPublished - 1. Jul 2018

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Case-Control Studies
Environmental Exposure
Age of Onset
Denmark

Keywords

  • Case-control study
  • Denmark
  • Geographical differences
  • Multiple sclerosis
  • Registry
  • Spatial analysis

Cite this

@article{a5eb0075597244399411255cb02ae12c,
title = "Small-scale geographical variation in multiple sclerosis: A case-control study using Danish register data 1971–2013",
abstract = "Background: The aetiology of multiple sclerosis (MS) is largely unknown, but commonly assumed to be a complex interaction between genes and environmental exposures, presumably during early life. To evaluate the possible importance and timing of environmental exposures we investigated the spatial variation in the risk of MS in Denmark according to residence at birth, age 15, and clinical onset of disease. Methods: We carried out a nationwide, register-based case-control study including 12 993 Danish MS cases with onset of disease 1971–2013. Information on exact residential addresses was available for all study subjects in the Danish Civil Registration System. The spatial variation in risk of MS was estimated by kernel regression. Results: We identified spatial variation in the risk of MS according to residence at birth, age 15, and onset of disease. Several high- and low-risk areas were identified across the country with some variation between birth, age 15, and onset. Conclusions: Small-scale geographical variation in the risk of MS suggests that local environmental risk factors could be at play and may be related to life style factors.",
keywords = "Case-control study, Denmark, Geographical differences, Multiple sclerosis, Registry, Spatial analysis",
author = "Kristine Bihrmann and Nielsen, {Nete Munk} and Melinda Magyari and Nils Koch-Henriksen and Nordsborg, {Rikke Baastrup} and Ersb{\o}ll, {Annette Kj{\ae}r}",
year = "2018",
month = "7",
day = "1",
doi = "10.1016/j.msard.2018.04.021",
language = "English",
volume = "23",
pages = "40--45",
journal = "Multiple Sclerosis and Related Disorders",
issn = "2211-0348",
publisher = "Elsevier",

}

Small-scale geographical variation in multiple sclerosis : A case-control study using Danish register data 1971–2013. / Bihrmann, Kristine; Nielsen, Nete Munk; Magyari, Melinda; Koch-Henriksen, Nils; Nordsborg, Rikke Baastrup; Ersbøll, Annette Kjær.

In: Multiple Sclerosis and Related Disorders, Vol. 23, 01.07.2018, p. 40-45.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Small-scale geographical variation in multiple sclerosis

T2 - A case-control study using Danish register data 1971–2013

AU - Bihrmann, Kristine

AU - Nielsen, Nete Munk

AU - Magyari, Melinda

AU - Koch-Henriksen, Nils

AU - Nordsborg, Rikke Baastrup

AU - Ersbøll, Annette Kjær

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Background: The aetiology of multiple sclerosis (MS) is largely unknown, but commonly assumed to be a complex interaction between genes and environmental exposures, presumably during early life. To evaluate the possible importance and timing of environmental exposures we investigated the spatial variation in the risk of MS in Denmark according to residence at birth, age 15, and clinical onset of disease. Methods: We carried out a nationwide, register-based case-control study including 12 993 Danish MS cases with onset of disease 1971–2013. Information on exact residential addresses was available for all study subjects in the Danish Civil Registration System. The spatial variation in risk of MS was estimated by kernel regression. Results: We identified spatial variation in the risk of MS according to residence at birth, age 15, and onset of disease. Several high- and low-risk areas were identified across the country with some variation between birth, age 15, and onset. Conclusions: Small-scale geographical variation in the risk of MS suggests that local environmental risk factors could be at play and may be related to life style factors.

AB - Background: The aetiology of multiple sclerosis (MS) is largely unknown, but commonly assumed to be a complex interaction between genes and environmental exposures, presumably during early life. To evaluate the possible importance and timing of environmental exposures we investigated the spatial variation in the risk of MS in Denmark according to residence at birth, age 15, and clinical onset of disease. Methods: We carried out a nationwide, register-based case-control study including 12 993 Danish MS cases with onset of disease 1971–2013. Information on exact residential addresses was available for all study subjects in the Danish Civil Registration System. The spatial variation in risk of MS was estimated by kernel regression. Results: We identified spatial variation in the risk of MS according to residence at birth, age 15, and onset of disease. Several high- and low-risk areas were identified across the country with some variation between birth, age 15, and onset. Conclusions: Small-scale geographical variation in the risk of MS suggests that local environmental risk factors could be at play and may be related to life style factors.

KW - Case-control study

KW - Denmark

KW - Geographical differences

KW - Multiple sclerosis

KW - Registry

KW - Spatial analysis

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DO - 10.1016/j.msard.2018.04.021

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VL - 23

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JO - Multiple Sclerosis and Related Disorders

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