Association between sun exposure habits and disease progression in multiple sclerosis

Author:

Wu Jing1ORCID,Olsson Tomas2,Alfredsson Lars234,Hedström Anna Karin2ORCID

Affiliation:

1. Department of Neurobiology, Care Sciences and Society, Aging Research Center Karolinska Institutet and Stockholm University Stockholm Sweden

2. Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden

3. Institute of Environmental Medicine, Karolinska Institutet Stockholm Sweden

4. Centre for Occupational and Environmental Medicine, Region Stockholm Stockholm Sweden

Abstract

AbstractBackground and purposeHigher latitude has been associated with increased occurrence of multiple sclerosis (MS) and with more severe disease. The aim was to study the impact of sun exposure habits on MS disease progression and health‐related quality of life.MethodsPatients from a population‐based case–control study were categorized based on sun exposure habits at diagnosis and were followed up to 15 years post‐diagnosis through the Swedish MS registry (n = 3314) with regard to changes in Expanded Disability Status Scale (EDSS). Linear mixed models were used to analyse long‐term changes, while Cox regression models, with 95% confidence intervals, were used to investigate outcomes, including 24‐week confirmed diasability worsening, EDSS3, EDSS4, and physical worsening as measured by the physical component of the Multiple Sclerosis Impact Scale 29.ResultsCompared to average sun exposure (median value), low exposure to sunlight was associated with faster EDSS progression, increased risk of confirmed disability worsening (hazard ratio [HR] 1.48, 95% CI 1.21–1.81), increased risk of reaching EDSS 3 (HR 1.35, 95% CI 1.02–1.79), EDSS 4 (HR 1.47, 95% CI 1.01–2.20) and self‐reported physical worsening (HR 1.27, 95% CI 1.00–1.62). Significant trends revealed a lower risk of unfavourable outcomes with increasing sun exposure.ConclusionsVery low levels of sun exposure are associated with worse disease progression and health‐related quality of life in patients with MS.

Funder

Medicinska Forskningsrådet

Hjärnfonden

Forskningsrådet om Hälsa, Arbetsliv och Välfärd

Vetenskapsrådet

Publisher

Wiley

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