MS is Black and White Disease…Breaking the racial stereo mould

Langer-Gould A, Brara SM, Beaber BE, Zhang JL. Incidence of multiple sclerosis in multiple racial and ethnic groups.Neurology. 2013 May 7;80(19):1734-9. doi:10.1212/WNL.0b013e3182918cc2.

#MSresearch: MS a black and white disease

OBJECTIVE:To determine whether the incidence of multiple sclerosis (MS) varies by race/ethnicity in a multiethnic, population-based cohort.

METHODS:We conducted a retrospective cohort study of more than 9 million person-years of observation from the multiethnic, community-dwelling members of Kaiser Permanente Southern California health plan from January 1, 2008 to December 31, 2010. Incidence of MS and risk ratios comparing incidence rates between racial/ethnic groups were calculated.
RESULTS:We identified 496 patients newly diagnosed with MS who met McDonald criteria. The average age at diagnosis was 41.6 years (range 8.6-78.3 years) and 70.2% were women. The female preponderance was more pronounced among black (79.3%) than white, Hispanic, and Asian individuals with MS (67.8%, 68.1%, and 69.2%, respectively; p = 0.03). The incidence of MS was higher in blacks (10.2, 95% confidence interval [CI] 8.4-12.4; p < 0.0001) and lower in Hispanics (2.9, 95% CI 2.4-3.5; p < 0.0001) and Asians (1.4, 95% CI 0.7-2.4; p < 0.0001) than whites (6.9, 95% CI 6.1-7.8). Black women had a higher risk of MS (risk ratio 1.59, 95% CI 1.27-1.99; p = 0.0005) whereas black men had a similar risk of MS (risk ratio 1.04, 95% CI = 0.67-1.57) compared with whites.
CONCLUSIONS:Our findings do not support the widely accepted assertion that blacks have a lower risk of MS than whites. A possible explanation for our findings is that people with darker skin tones have lower vitamin D levels and thereby an increased risk of MS, but this would not explain why Hispanics and Asians have a lower risk of MS than whites or why the higher risk of MS among blacks was found only among women.

A bit of an eye opener, the stereo view is that MS is a disease of White Northern Europeans….The Viking hypothesis. This study challenges this. We recently saw a increase in black people in the US military and I get to meet plenty of non-white MSers. I expect this is the type of equality no-one would want…Equality in Disease

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  • Absolutely, the longstanding idea of "genetic predisposition" has already proven itself wrong but what a great clue (among so many great clues that historical MS incidence data has left for us) that MS incidence truly was restricted to whites of Northern European descent who lived in the areas of the industrial revolution in American and Northern Europe.

    Although it kind of sucks that what we've always considered the "facts" of MS data is a little spongy due to being entirely derived from averages, I think there really is much to be learned from it.

    The history of MS incidence is so abruptly contrasting that the answers are almost certainly going to be amazingly obvious….once we determine what they are.

    The long history of the search for the cures for the diseases of what we now realize were vitamin deficiencies are always the examples which come to my mind when looking at the struggle for MS information.

    Now, in hindsight even the most dense school boy knows that you need to eat citrus fruits to avoid scurvy, foods with thiamine to avoid beriberi, foods with niacine to avoid pellagra and vitamin D to avoid rickets but what seems so hideously simple to us now kept the medical field at an absolute loss for many years and the long search for the cause/cure for MS situation seems so similar.

    That in no way is meant to hint that MS incidence is owed to a vitamin deficiency, although if the loss of "evolutionary normal" conditions does prove to have some responsibility, in essence that really would involve a deficiency of sorts.

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