Distinct effects of obesity and puberty on risk and age at onset of pediatric MS

the U.S. Network of Pediatric MS Centers

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Objective: The aim of this study was to examine the relative contributions of body mass index (BMI) and pubertal measures for risk and age of onset of pediatric MS. Methods: Case–control study of 254 (63% female) MS cases (onset<18 years of age) and 420 (49% female) controls conducted at 14 U.S. Pediatric MS Centers. Sex- and age-stratified BMI percentiles were calculated using CDC growth charts from height and weight measured at enrollment for controls, and within 1 year of onset for MS cases. Sex-stratified associations between MS risk and age at symptom onset with both BMI and pubertal factors were estimated controlling for race and ethnicity. Results: Only 11% of girls and 15% of boys were prepubertal (Tanner stage I) at MS onset. 80% of girls had onset of MS after menarche. BMI percentiles were higher in MS cases versus controls (girls: P < 0.001; boys: P = 0.018). BMI was associated with odds of MS in multivariate models in postpubertal girls (OR = 1.60, 95% confidence interval [CI]: 1.12, 2.27, P = 0.009) and boys (OR = 1.43, 95% CI: 1.08, 1.88, P = 0.011). In girls with MS onset after menarche, higher BMI was associated with younger age at first symptoms (P = 0.031). Younger menarche was associated with stronger effects of BMI through mediation and interaction analysis. In pubertal/postpubertal boys, 89% of whom were obese/overweight, earlier sexual maturity was associated with earlier onset of MS (P < 0.001). Interpretation: Higher BMI in early adolescence is a risk factor for MS in girls and boys. Earlier age at sexual maturity contributes to earlier age at MS onset, particularly in association with obesity.

Original languageEnglish (US)
Pages (from-to)897-907
Number of pages11
JournalAnnals of Clinical and Translational Neurology
Volume3
Issue number12
DOIs
StatePublished - Dec 1 2016

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Puberty
Age of Onset
Body Mass Index
Obesity
Pediatrics
Menarche
Growth Charts
Confidence Intervals
Centers for Disease Control and Prevention (U.S.)
Weights and Measures

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Distinct effects of obesity and puberty on risk and age at onset of pediatric MS. / the U.S. Network of Pediatric MS Centers.

In: Annals of Clinical and Translational Neurology, Vol. 3, No. 12, 01.12.2016, p. 897-907.

Research output: Contribution to journalArticle

the U.S. Network of Pediatric MS Centers. / Distinct effects of obesity and puberty on risk and age at onset of pediatric MS. In: Annals of Clinical and Translational Neurology. 2016 ; Vol. 3, No. 12. pp. 897-907.
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abstract = "Objective: The aim of this study was to examine the relative contributions of body mass index (BMI) and pubertal measures for risk and age of onset of pediatric MS. Methods: Case–control study of 254 (63{\%} female) MS cases (onset<18 years of age) and 420 (49{\%} female) controls conducted at 14 U.S. Pediatric MS Centers. Sex- and age-stratified BMI percentiles were calculated using CDC growth charts from height and weight measured at enrollment for controls, and within 1 year of onset for MS cases. Sex-stratified associations between MS risk and age at symptom onset with both BMI and pubertal factors were estimated controlling for race and ethnicity. Results: Only 11{\%} of girls and 15{\%} of boys were prepubertal (Tanner stage I) at MS onset. 80{\%} of girls had onset of MS after menarche. BMI percentiles were higher in MS cases versus controls (girls: P < 0.001; boys: P = 0.018). BMI was associated with odds of MS in multivariate models in postpubertal girls (OR = 1.60, 95{\%} confidence interval [CI]: 1.12, 2.27, P = 0.009) and boys (OR = 1.43, 95{\%} CI: 1.08, 1.88, P = 0.011). In girls with MS onset after menarche, higher BMI was associated with younger age at first symptoms (P = 0.031). Younger menarche was associated with stronger effects of BMI through mediation and interaction analysis. In pubertal/postpubertal boys, 89{\%} of whom were obese/overweight, earlier sexual maturity was associated with earlier onset of MS (P < 0.001). Interpretation: Higher BMI in early adolescence is a risk factor for MS in girls and boys. Earlier age at sexual maturity contributes to earlier age at MS onset, particularly in association with obesity.",
author = "{the U.S. Network of Pediatric MS Centers} and Tanuja Chitnis and Jennifer Graves and Bianca Weinstock-Guttman and Anita Belman and Cody Olsen and Madhusmita Misra and Gregory Aaen and Leslie Benson and Meghan Candee and Mark Gorman and Benjamin Greenberg and Lauren Krupp and Timothy Lotze and Soe Mar and Jayne Ness and John Rose and Jennifer Rubin and Teri Schreiner and Jan Tillema and Amy Waldman and Moses Rodriguez and Charlie Casper and Emmanuelle Waubant",
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AU - Chitnis, Tanuja

AU - Graves, Jennifer

AU - Weinstock-Guttman, Bianca

AU - Belman, Anita

AU - Olsen, Cody

AU - Misra, Madhusmita

AU - Aaen, Gregory

AU - Benson, Leslie

AU - Candee, Meghan

AU - Gorman, Mark

AU - Greenberg, Benjamin

AU - Krupp, Lauren

AU - Lotze, Timothy

AU - Mar, Soe

AU - Ness, Jayne

AU - Rose, John

AU - Rubin, Jennifer

AU - Schreiner, Teri

AU - Tillema, Jan

AU - Waldman, Amy

AU - Rodriguez, Moses

AU - Casper, Charlie

AU - Waubant, Emmanuelle

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