Smoking as a risk factor of multiple sclerosis: results of cohort study in volyn region
DOI:
https://doi.org/10.15587/2313-8416.2016.59256Keywords:
multiple sclerosis, smoking, Volyn, incapability, risk factors, disability, clinical course, progressionAbstract
Smoking is the modified risk factor of the multiple sclerosis (MS) development. In spite of the low smoking percentage in the population of Volyn region the rates of MS prevalence and morbidity is there the one of the highest in the country.
Aim of research: to assess an influence of smoking in Volyn dwellers on the type of clinical course, progression quickness and the incapability degree in patients with MS.
Materials and methods: According to the smoking status all patients were divided into three groups: smokers, ex-smokers, non-smokers. There were assessed age, sexual differences, the age of the debut of disease, neurological deficiency degree, the disease progression quickness between groups. Statistical analysis was carried out with the help of Microsoft Excel, SPSS program for Windows using the standard descriptive statistics, correlative and regressive analysis. For analysis of events achievement there were used the plural assessments of Kaplan-Meier. The comparison of survival functions in two groups was carried out using Cox and Wilkinson F-criterion.
Results: There were examined 338 patients with multiple sclerosis from all districts of Volyn region among them – 220 (65,1 %) women. The men-women ratio was 1,87:1. The mean age of patients was 47±12,18 years old, the age of the MS first symptoms appearance– 30±9,19 years old. The age of patients at the time of diagnosis– 33±9,4 years old. The mean grade on EDSS scale – 4±2,04. There was established that patients in the group of smokers were younger, the first symptoms appeared earlier compared with those who never smoked or stopped smoking (p<0,05). The disability level on EDSS scale was lower in the group of patients who never smoked (p=0,015). There was not revealed the statistically significant difference for the next rates: the type of clinical course, type of debut of disease and progression quickness of disease.
Conclusion: The MS appears earlier in smoking patients. The incapability degree in ex-smokers is reliably higher comparing with patients who never smoked. There was not revealed any influence of smoking on the type of clinical course and progression quickness of disease. It is reasonable to study the combination of smoking factor with the other possible factors of the disease development
References
Mishhenko, T. S., Shul'ga, O. D., Bobryk, N. V., Shul'ga, L. A. (2014). Rozsijanyj skleroz: global'ni perspektyvy. Ukr. med. Chasopys, 3, 84–87.
Manouchehrinia, A., Tench, C. R., Maxted, J., Bibani, R. H., Britton, J., Constantinescu, C. S. (2013). Tobacco smoking and disability progression in multiple sclerosis: United Kingdom cohort study. Brain, 136 (7), 2298–2304. doi: 10.1093/brain/awt139
Roudbari, S. A., Ansar, M. M., Yousefzad, A. (2013). Smoking as a risk factor for development of Secondary Progressive Multiple Sclerosis: A study in IRAN, Guilan. Journal of the Neurological Sciences, 330 (1-2), 52–55. doi: 10.1016/j.jns.2013.04.003
Arikanoglu, A., Shugaiv, E., Tüzün, E., Eraksoy, M. (2013). Impact of cigarette smoking on conversion from clinically isolated syndrome to clinically definite multiple sclerosis. International Journal of Neuroscience, 123 (7), 476–479. doi: 10.3109/00207454.2013.764498
Hawkes, C. H. (2007). Smoking is a risk factor for multiple sclerosis: a metanalysis. Multiple Sclerosis, 13 (5), 610–615. doi: 10.1177/1352458506073501
Ascherio, A., Munger, K. L. (2007). Environmental risk factors for multiple sclerosis. Part II: Noninfectious factors. Annals of Neurology, 61 (6), 504–513. doi: 10.1002/ana.21141
Zivadinov, R., Weinstock-Guttman, B., Hashmi, K., Abdelrahman, N., Stosic, M., Dwyer, M. et. al (2009). Smoking is associated with increased lesion volumes and brain atrophy in multiple sclerosis. Neurology, 73 (7), 504–510. doi: 10.1212/wnl.0b013e3181b2a706
Fusby, J. S., Kassmeier, M. D., Palmer, V. L., Perry, G. A., Anderson, D. K., Hackfort, B. T. et. al (2010). Cigarette smoke-induced effects on bone marrow B-cell subsets and CD4 + :CD8 + T-cell ratios are reversed by smoking cessation: Influence of bone mass on immune cell response to and recovery from smoke exposure. Inhalation Toxicology, 22 (9), 785–796. doi: 10.3109/08958378.2010.483258
Hedstrom, A., Baarnhielm, M., Olsson, T., Alfredsson, L. (2011). Exposure to environmental tobacco smoke is associated with increased risk for multiple sclerosis. Multiple Sclerosis Journal, 17 (7), 788–793. doi: 10.1177/1352458511399610
Birkett, N. J. (1997). Trends in Smoking by Birth Cohort for Births between 1940 and 1975: A Reconstructed Cohort Analysis of the 1990 Ontario Health Survey. Preventive Medicine, 26 (4), 534–541. doi: 10.1006/pmed.1997.0169
Gender, Health, Tobacco and Equity (2010). World Health Organization. Available at: http://www.who.int/tobacco/publications/gender/gender_tobacco_2010.pdf
Shul'ga, O. D. (2015). Kliniko-epidemiologichna harakterystyka rozsijanogo sklerozu u Volyns'kij oblasti. Problemy bezperervnoi' medychnoi' osvity ta nauky, 1, 16–18.
Shul'ga, O. D. (2014). Osoblyvosti perebigu rozsijanogo sklerozu u zhyteliv Volyni. Ukrai'ns'kyj naukovo-medychnyj molodizhnyj zhurnal, 3, 120–122.
World Health Organization Tobacco Free Initiative (2010). Cigarette consumption. Available at: http://www.who.int/tobacco/en/atlas8.pdf
World Health Organization Tobacco Free Initiative (2002). Female smoking. Available at: http://www.who.int/tobacco/en/atlas6.pdf
Koch, M., van Harten, A., Uyttenboogaart, M., De Keyser, J. (2007). Cigarette smoking and progression in multiple sclerosis. Neurology, 69(15), 1515–1520. doi: 10.1212/01.wnl.0000277658.78381.db
Alifirova, V. M., Titova, M. A. (2012). Analiz faktorovriska razvitija assejannogo skleroza v Tomskoj oblasti. Nevrologicheskij zhurnal, 3, 20–22.
Orynchak, L. B., Negrych, T. I. (2014). Vplyv indeksu masy tila ta kurinnja na perebig rozsijanogo sklerozu u naselennja Prykarpattja. Ukrai'ns'kyj nevrologichnyj zhurnal, 3-4, 36–41.
Polman, C. H., Reingold, S. C., Banwell, B., Clanet, M., Cohen, J. A., Filippi, M. et. al (2011). Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria. Annals of Neurology, 69 (2), 292–302. doi: 10.1002/ana.22366
Lublin, F. D., Reingold, S. C. (1996). Defining the clinical course of multiple sclerosis: Results of an international survey. Neurology, 46 (4), 907–911. doi: 10.1212/wnl.46.4.907
Verjans, E., Theys, P., Delmotte, P., Carton, H. (1983). Clinical parameters and intrathecal IgG synthesis as prognostic features in multiple sclerosis. Part I. Journal of Neurology, 229 (3), 155–165. doi: 10.1007/bf00313739
Kontrol' nad tjutjunom v Ukrai'ni. Drugyj nacional'nyj zvit (2014). Ministerstvo ohorony zdorov’ja Ukrai'ny. Kyiv, 128. Available at: http://moz.gov.ua/docfiles/Zvit-tutun-control2.pdf
Downloads
Published
Issue
Section
License
Copyright (c) 2016 Ольга Дмитрівна Шульга
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.