International journal of epidemiology · 2026
Dental-amalgam exposure and the risk and progression of multiple sclerosis.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Guo Jie, Olsson Tomas, Alfredsson Lars, Hedström Anna Karin
Аннотация
BACKGROUND: Concerns about the neurotoxic potential of dental amalgam in multiple sclerosis (MS) persists but its impact on disease risk and progression remains unclear.
METHODS: We used data from a Swedish population-based case-control study (2386 cases, 4849 controls) to investigate the association between dental amalgam exposure and MS risk. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by using logistic regression and interaction with smoking was evaluated. Relapsing-onset MS cases born between 1965 and 1985 (n = 1191) were followed longitudinally by using clinical data from the Swedish MS registry. The time to confirmed disability worsening (CDW) and Expanded Disability Status Scale (EDSS) 3 and 4 were assessed by using Cox regression; EDSS trajectories were analysed by using linear mixed-effects models.
RESULTS: Amalgam exposure was associated with increased MS risk in a dose-dependent manner (OR for trend 1.14, 95% CI 1.08-1.20). A significant interaction with smoking was observed (attributable proportion due to interaction 0.25, 95% CI 0.10-0.40). In the longitudinal cohort, those with at least six fillings had increased risk of CDW [hazard ratio (HR) 1.35, 95% CI 1.07-1.71] and progression to EDSS 3 (HR 1.48, 95% CI 1.07-2.05) and EDSS 4 (1.68, 95% CI 1.01-2.83). Associations were stronger among current smokers, those diagnosed after age 40 years, and individuals on low-efficacy therapies. The EDSS trajectories also showed faster progression in the high-exposure group (P = .044).
CONCLUSION: Dental amalgam exposure may be associated with both increased risk of MS and faster disability progression. Findings support a potential synergistic effect with smoking and raise the hypothesis that mercury may contribute to MS-related neurodegeneration.
METHODS: We used data from a Swedish population-based case-control study (2386 cases, 4849 controls) to investigate the association between dental amalgam exposure and MS risk. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by using logistic regression and interaction with smoking was evaluated. Relapsing-onset MS cases born between 1965 and 1985 (n = 1191) were followed longitudinally by using clinical data from the Swedish MS registry. The time to confirmed disability worsening (CDW) and Expanded Disability Status Scale (EDSS) 3 and 4 were assessed by using Cox regression; EDSS trajectories were analysed by using linear mixed-effects models.
RESULTS: Amalgam exposure was associated with increased MS risk in a dose-dependent manner (OR for trend 1.14, 95% CI 1.08-1.20). A significant interaction with smoking was observed (attributable proportion due to interaction 0.25, 95% CI 0.10-0.40). In the longitudinal cohort, those with at least six fillings had increased risk of CDW [hazard ratio (HR) 1.35, 95% CI 1.07-1.71] and progression to EDSS 3 (HR 1.48, 95% CI 1.07-2.05) and EDSS 4 (1.68, 95% CI 1.01-2.83). Associations were stronger among current smokers, those diagnosed after age 40 years, and individuals on low-efficacy therapies. The EDSS trajectories also showed faster progression in the high-exposure group (P = .044).
CONCLUSION: Dental amalgam exposure may be associated with both increased risk of MS and faster disability progression. Findings support a potential synergistic effect with smoking and raise the hypothesis that mercury may contribute to MS-related neurodegeneration.