{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:46:56Z","timestamp":1790293616275,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,2,8]],"date-time":"2020-02-08T00:00:00Z","timestamp":1581120000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Epidemiological research in multiple sclerosis (MS) has mainly been performed in socioeconomically and ethnically limited populations; influences on MS risk have not been studied in prospectively collected non\u2010White populations. We set out to study the influence of previously described MS risk factors in an ethnically diverse population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A nested case\u2013control study was created using primary care records of &gt;1 million individuals, &gt;50% of whom identify as Black, Asian, and Minority Ethnic (BAME). MS cases were compared to an age\u2010 and sex\u2010matched control cohort (1:4), and to a large unmatched cohort. Odds ratios (ORs) of disease were determined according to exposure of interest, and a multivariate model including all exposures was created. Potential pairwise interactions were considered where both indicated a significant effect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1,344 confirmed MS cases were included. MS OR in blacks aged &lt;40\u2009years was 1.15 (95% confidence interval [CI] = 0.81\u20131.62) compared to whites. MS odds in BAME current (OR = 1.71, 95% CI = 1.24\u20132.31) and ex\u2010smokers (OR = 2.83, 95% CI = 2.14\u20133.72) were considerably higher than in Whites (OR = 1.09, 95% CI = 0.88\u20131.34; OR = 1.44, 95% CI = 1.19\u20131.74, respectively). Prior infectious mononucleosis was associated with increased odds of MS in Blacks (OR = 4.94, 95% CI = 1.23\u201317.89). An increase in MS odds was seen in the least\u2010deprived quintile (OR = 2.46, 95% CI = 1.40\u20134.24), but no effect across deprived quintiles was seen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>This cohort provides novel data on factors potentially driving MS susceptibility in a diverse population, one\u2010third of whom live in poverty. Environmental exposures have differential risk across ethnicity. <jats:bold>ANN NEUROL 2020;87:599\u2013608<\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.1002\/ana.25688","type":"journal-article","created":{"date-parts":[[2020,1,24]],"date-time":"2020-01-24T05:54:05Z","timestamp":1579845245000},"page":"599-608","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Ethnic and Socioeconomic Associations with Multiple Sclerosis Risk"],"prefix":"10.1002","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2993-585X","authenticated-orcid":false,"given":"Ruth","family":"Dobson","sequence":"first","affiliation":[{"name":"Preventive Neurology Unit Wolfson Institute of Preventive Medicine, Queen Mary University of London"},{"name":"Department of Neurology Royal London Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Jitlal","sequence":"additional","affiliation":[{"name":"Preventive Neurology Unit Wolfson Institute of Preventive Medicine, Queen Mary University of London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles R.","family":"Marshall","sequence":"additional","affiliation":[{"name":"Preventive Neurology Unit Wolfson Institute of Preventive Medicine, Queen Mary University of London"},{"name":"Department of Neurology Royal London Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alastair J.","family":"Noyce","sequence":"additional","affiliation":[{"name":"Preventive Neurology Unit Wolfson Institute of Preventive Medicine, Queen Mary University of London"},{"name":"Department of Neurology Royal London Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Robson","sequence":"additional","affiliation":[{"name":"Department of Primary Care Queen Mary University of London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Cuzick","sequence":"additional","affiliation":[{"name":"Preventive Neurology Unit Wolfson Institute of Preventive Medicine, Queen Mary University of London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin","family":"Giovannoni","sequence":"additional","affiliation":[{"name":"Preventive Neurology Unit Wolfson Institute of Preventive Medicine, Queen Mary University of London"},{"name":"Department of Neurology Royal London Hospital"},{"name":"Blizard Institute, Queen Mary University of London  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181dad57e"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458515603798"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1507092"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004412"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu10030268"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awz088"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458515609794"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000005906"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25247"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458518783662"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdt116"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(14)70267-4"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2016.187"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458514554055"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12429"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458516638746"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1214\/13-STS453"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-016-0400-6"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30443-5"},{"key":"e_1_2_8_21_1","unstructured":"BakerC.Population estimates & GP registers: why the difference? 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