The association between weight during early life and multiple sclerosis onset in a nationwide Dutch birth year cohort

ABSTRACT

Background

The relationship between being overweight during early life and disease course in multiple sclerosis (MS) is unresolved. We investigated the association between being overweight or obese during early life (childhood and adolescence) and MS case status, age of first symptom onset and onset type in people with MS (pwMS) of the same birth year.

Methods

We enrolled 363 PwMS and 125 healthy controls (HC) from Project Y, a Dutch population-based cross-sectional cohort study including all PwMS born in 1966 and age and sex-matched HC. The associations between weight during childhood and adolescence (non-overweight vs. overweight or obese) and MS, age at symptom onset and onset type (relapsing vs. progressive) were assessed using logistic and linear regressions. In addition, sex-separated associations were explored.

Results

Being overweight or obese during childhood (OR = 2.82, 95% CI 1.17–6.80) and adolescence (OR = 2.45, 95% CI 1.13–5.34) was associated with developing MS. Furthermore, being overweight or obese during adolescence was associated with a younger age of onset (β = −0.11, p = 0.041). Of all 47 patients with a primary progressive (PP) onset type, only one patient (2.1%) was overweight or obese during childhood, whereas 45 patients with a relapsing remitting (RR) onset (14.3%) were overweight or obese during childhood (PP vs. RR p = 0.017; PP vs. HC p = 0.676; RR vs. HC, p = 0.015). However, using logistic regression analysis we did not find evidence of a significant association.

Conclusion

In a nationwide population-based birth year cohort, being overweight or obese during childhood or adolescence is associated with MS prevalence and an earlier age of onset, but does not seem to associate with the type of onset.

KEYWORDS:

• Multiple sclerosis
• obesity
• age of onset
• Relapsing remitting multiple sclerosis
• primary progressive multiple sclerosis
• childhood
• adolescence
• population-based

Acknowledgements

The authors thank all participants of Project Y for their participation. Moreover, they thank our research assistance as well as our team of the MS Center Amsterdam for their continuous support.

Disclosure statement

F. C. Loonstra, L. R. J. de Ruiter, E. M. M. Strijbis, B.A. de Jong report no disclosures. B. M. J. Uitdehaag received consultancy fees from Biogen Idec, Genzyme, Merck Serono, Novartis, Roche, Teva and Immunic Therapeutics.

Data availability statement

The data that support the findings of this study are available from the corresponding author, FCL, upon reasonable request.

Additional information

Funding

This study was supported by the VriendenLoterij, Dutch MS Research Foundation, Mission Summit, VUmc Foundation.

Notes on contributors

Floor C. Loonstra

Floor C. Loonstra is a MD PhD student at the Amsterdam UMC, location VUmc; Lodewijk R. J. de Ruiter is a MD PhD student at the Amsterdam UMC, location VUmc; Eva M. M. Strijbis is a neurologist at the Amsterdam UMC, location VUmc; Brigit A. de Jong is a neurologist at the Amsterdam UMC, location VUmc; Bernard M.J. Uitdehaag is a professor at the Amsterdam UMC, location VUmc.