Reduced Childhood Outdoor Exposure Raises Pediatric Multiple Sclerosis (PedMS) Risk.
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Pilotto Silvy, Ghezzi Angelo, Bova Stefania Maria, Fronza Marzia, Annovazzi Pietro, Simone Marta, Gallo Antonio, Suppiej Agnese, Lanzillo Roberta, Rasia Sarah, Berardinelli Angela, Clerici Valentina Torri, Moiola Lucia, Viri Maurizio, Sotgiu Stefano, Malucchi Simona, Protti Alessandra, Canavese Carlotta, Lus Giacomo, Grimaldi Luigi M E, Conti Marta Zaffira, Borriello Giovanna, De Luca Giovanna, Tomassini Valentina, Priori Alberto, Tosi Martina, Pomella Nicola, Corona Andrea, Zollo Alen, Amato Maria Pia, Cocco Eleonora, Trojano Maria, Martinelli-Boneschi Filippo, D'Alfonso Sandra, Bergamaschi Roberto, Pugliatti Maura, and the PEDIGREE Study Group
Аннотация
METHODS: In the Italian multicenter PEDIGREE Study, environmental data were collected using the PEQ-IT questionnaire. We enrolled individuals < 18 years with PedMS and disease duration ≤ 5 years and controls without CNS inflammatory disorders. Outdoor time was reported by season and age (0-1, 1-2, 3-5 years); reduced activity was defined as < 60 min/week.
RESULTS: We included 114 PedMS cases and 121 controls. Cases were 77.2% female; mean (SD) age 16.8 (2.7) years; mean (SD) age at onset 14.2 (2.6) years; median EDSS 1.0 (range 0-4.0). Associations were strongest in winter: reduced outdoor time was associated with higher odds of PedMS in the first year (adjOR 3.02, 95%CI 1.50-6.08), ages 1-2 (adjOR 2.72, 95%CI 1.45-5.09), and ages 3-5 (adjOR 2.66, 95%CI 1.40-5.07). Across ages 0-5, low winter outdoor activity remained strongly associated (adjOR 4.30, 95%CI 1.82-10.17). Other seasons showed weaker but overall significant trends.
CONCLUSION: Limited early-childhood outdoor activity may be associated with increased PedMS risk; larger longitudinal studies are needed.