Risk Factors Associated with Multiple Sclerosis: A Case-Control Study in Damascus, Syria

Abstract

Objectives. To assess the probable risk factors associated with Multiple sclerosis among Syrian patients in the city of Damascus. Method. In a case-control study conducted from May to September 2020, 140 MS patients and 140 healthy controls were selected from two main hospitals in Damascus. Data regarding risk factors associated with MS was collected via a structured questionnaire and complementary laboratory tests. The statistical analysis was carried out by the SPSS Statistical Software Version 26. Results. Factors such as smoking, family history of MS, migraine, and vitamin D deficiency were associated with a higher risk of developing MS: Smoking ( $\text{OR}=2.275$ 95% CI (1.348-3.841) $P=0.002$ ). Family history of MS ( $\text{OR}=3.970$ 95% CI (1.807-8.719) $P\le 0.001$ ). Migraine ( $\text{OR}=3.011$ 95% CI (1.345-6.741) $P=0.005$ ). Vitamin D deficiency ( $\text{OR}=4.778$ 95% CI (2.863-7.972) $P\le 0.001$ ). However, factors such as diabetes, hypertension, a surgical history of appendectomy, tonsillectomy, and being the first-born in a family were statistically irrelevant: Diabetes ( $\text{OR}=0.652$ 95% CI (0.226-1.882) $P=0.426$ ). Hypertension ( $\text{OR}=1.445$ 95% CI (0.724-2.885) $P=0.295$ ) Appendectomy ( $\text{OR}=1.269$ 95% CI (0.486-3.317) $P=0.626$ ) Tonsillectomy ( $\text{OR}=1.280$ 95% CI (0.576-2.843) $P=0.544$ ). First-born Child ( $\text{OR}=0.933$ 95% CI (0.558-1.562) $P=0.793$ ). Conclusion. Our study suggests that smoking, vitamin D deficiency, family history of MS, and migraine are probable risk factors for multiple sclerosis. Therefore, engaging in outdoor activities and maintaining a healthy diet—for females in particular—is highly recommended.