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Multiple Sclerosis, Vol. 13, No. 3, 369-375 (2007)
DOI: 10.1177/135245850607192
© 2007 SAGE Publications

Studies of associations between disability in multiple sclerosis, skin type, gender and ultraviolet radiation

J.A. Woolmore

Keele Multiple Sclerosis Research, Human Genomics Research Group, Institute of Science and Technology in Medicine, Keele University Medical School, Hartshill Campus, University Hospital of North Staffordshire, Stoke on Trent, Staffordshire ST4 7LN, UK

M. Stone

Keele Multiple Sclerosis Research, Human Genomics Research Group, Institute of Science and Technology in Medicine, Keele University Medical School, Hartshill Campus, University Hospital of North Staffordshire, Stoke on Trent, Staffordshire ST4 7LN, UK

E.M. Pye

Keele Multiple Sclerosis Research, Human Genomics Research Group, Institute of Science and Technology in Medicine, Keele University Medical School, Hartshill Campus, University Hospital of North Staffordshire, Stoke on Trent, Staffordshire ST4 7LN, UK

J.M. Partridge

Keele Multiple Sclerosis Research, Human Genomics Research Group, Institute of Science and Technology in Medicine, Keele University Medical School, Hartshill Campus, University Hospital of North Staffordshire, Stoke on Trent, Staffordshire ST4 7LN, UK

M. Boggild

The Walton Centre, NHS Trust, Lower Lane, Liverpool L9 7LJ, UK

C. Young

Keele Multiple Sclerosis Research, Human Genomics Research Group, Institute of Science and Technology in Medicine, Keele University Medical School, Hartshill Campus, University Hospital of North Staffordshire, Stoke on Trent, Staffordshire ST4 7LN, UK

P.W. Jones

School of Mathematics and Computing, Keele University, Keele, Staffordshire ST5 5BG, UK

A.A. Fryer

Keele Multiple Sclerosis Research, Human Genomics Research Group, Institute of Science and Technology in Medicine, Keele University Medical School, Hartshill Campus, University Hospital of North Staffordshire, Stoke on Trent, Staffordshire ST4 7LN, UK

C.P. Hawkins

Keele Multiple Sclerosis Research, Human Genomics Research Group, Institute of Science and Technology in Medicine, Keele University Medical School, Hartshill Campus, University Hospital of North Staffordshire, Stoke on Trent, Staffordshire ST4 7LN, UK

R.C. Strange

Keele Multiple Sclerosis Research, Human Genomics Research Group, Institute of Science and Technology in Medicine, Keele University Medical School, Hartshill Campus, University Hospital of North Staffordshire, Stoke on Trent, Staffordshire ST4 7LN, UK,r.c.strange@ path.keele.ac.uk

Recent studies suggest ultraviolet radiation (UVR)/vitamin D is protective against the development of multiple sclerosis (MS). We determined if outcome in MS is associated with the surrogate for host pigmentation, skin type, and parameters of UVR exposure. We used a validated questionnaire to determine skin type and UVR exposure during childhood (0-16 years), and early adult life (17-40 years), in 448 Caucasians with MS. Outcome was assessed using the Kurtzke Expanded Disability Status Score (EDSS) and Multiple Sclerosis Severity Scale (MSSS). We studied the association of skin type and exposure with dichotomized values of EDSS (< and ≥6) and MSSS (continuous variable) using logistic and linear regression analyses, respectively. Sex, onset age and MS duration were significantly associated with outcome in all patients. In 169 females with established disease (≥10 years), sun sensitive skin types 1 and 2 were associated with reduced risk of EDSS ≥6 (odds ratio =0.50; 95% CI = 0.26-0.97), and higher MSSS values (coefficient = -0.86; 95% CI = -1.67 to -0.05). Parameters of UVR exposure were not significantly associated with outcome. These preliminary data show an association between skin type and disability in female MS patients. They are compatible with independent studies suggesting that exposure mediates MS pathogenesis via vitamin D. Further studies are required to properly assess these potentially important findings. Multiple Sclerosis 2007; 13: 369-375. http://msj.sagepub.com

Key Words: disability evaluation • epidemiology • multiple sclerosis • sex factors • skin type • ultraviolet rays


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