Abstract
To investigate the association between alcohol consumption and multiple sclerosis risk, we performed a systematic literature search of PubMed, EmBase and Web of Science databases for all relevant articles regarding alcohol and multiple sclerosis. Our meta-analysis consisted of 10 studies, including nine case–controls and one cohort study. The odds ratios (OR) of the association between alcohol consumption and multiple sclerosis were 0.92 [95 % confidence interval (CI) 0.73–1.17] overall, 0.91 (95 % CI 0.39–2.41) for prospective study, and 0.92 (95 % CI 0.72–1.19) for retrospective studies. In addition, neither subgroup analyses nor sensitivity analyses showed a substantially change in the pooled OR and 95 % CI. Meta-analysis showed that there is no evidence that alcohol consumption is associated with an increased risk of multiple sclerosis. There may be a potential protective effect of alcohol consumption on MS incidence, however, this trend may not be obvious and should be validated by further research.
Similar content being viewed by others
References
Koch MW, Metz LM, Agrawal SM, Yong VW (2013) Environmental factors and their regulation of immunity in multiple sclerosis. J Neurol Sci 324(1–2):10–16
Hauser SL, Oksenberg JR (2006) The neurobiology of multiple sclerosis: genes, inflammation, and neurodegeneration. Neuron 52(1):61–76
Buljevac D, van Doornum GJ, Flach HZ, Groen J, Osterhaus AD, Hop W, van Doorn PA, van der Meche FG, Hintzen RQ (2005) Epstein-Barr virus and disease activity in multiple sclerosis. J Neurol Neurosurg Psychiatry 76(10):1377–1381
Handel AE, Williamson AJ, Disanto G, Handunnetthi L, Giovannoni G, Ramagopalan SV (2010) An updated meta-analysis of risk of multiple sclerosis following infectious mononucleosis. PloS One. doi:10.1371/journal.pone.0012496
Farrell RA, Antony D, Wall GR, Clark DA, Fisniku L, Swanton J, Khaleeli Z, Schmierer K, Miller DH, Giovannoni G (2009) Humoral immune response to EBV in multiple sclerosis is associated with disease activity on MRI. Neurology 73(1):32–38
Thacker EL, Mirzaei F, Ascherio A (2006) Infectious mononucleosis and risk for multiple sclerosis: a meta-analysis. Ann Neurol 59(3):499–503
Harandi AA, Harandi AA, Pakdaman H, Sahraian MA (2014) Vitamin D and multiple sclerosis. Iran J Neurol 13(1):1–6
Ramagopalan SV, Dobson R, Meier UC, Giovannoni G (2010) Multiple sclerosis: risk factors, prodromes, and potential causal pathways. Lancet Neurol 9(7):727–739
Handel AE, Williamson AJ, Disanto G, Dobson R, Giovannoni G, Ramagopalan SV (2011) Smoking and multiple sclerosis: an updated meta-analysis. PLoS ONE 6(1):e16149
Hedstrom AK, Baarnhielm M, Olsson T, Alfredsson L (2009) Tobacco smoking, but not Swedish snuff use, increases the risk of multiple sclerosis. Neurology 73(9):696–701
Romeo J, Warnberg J, Nova E, Diaz LE, Gomez-Martinez S, Marcos A (2007) Moderate alcohol consumption and the immune system: a review. Br J Nutr 98(Suppl 1):S111–S115
Massa J, O’Reilly EJ, Munger KL, Ascherio A (2013) Caffeine and alcohol intakes have no association with risk of multiple sclerosis. Multiple sclerosis 19(1):53–58
Nortvedt MW, Riise T, Maeland JG (2005) Multiple sclerosis and lifestyle factors: the Hordaland Health Study. Neurol Sci Off J Italian Neurol Soc Italian Soc Clin Neurophysiol 26(5):334–339
Hawkes CH (2005) Are multiple sclerosis patients risk-takers? QJM Month J Assoc Phys 98(12):895–911
Ghadirian P, Jain M, Ducic S, Shatenstein B, Morisset R (1998) Nutritional factors in the aetiology of multiple sclerosis: a case-control study in Montreal. Canada Int J Epidemiol 27(5):845–852
Hawkes CH, Boniface D (2013) Risk-associated behaviour in multiple sclerosis: a case control study. J Neurol 260:S178–S179
Brosseau L, Philippe P, Methot G, Duquette P, Haraoui B (1993) Drug abuse as a risk factor of multiple sclerosis: case-control analysis and a study of heterogeneity. Neuroepidemiology 12(1):6–14
Hedstrom AK, Hillert J, Olsson T, Alfredsson L (2014) Alcohol as a modifiable lifestyle factor affecting multiple sclerosis risk. JAMA Neurol 71(3):300–305
Ivashynka A, Leone M, Lucenti A, Naldi P, Raymkulova O, Ruggerone S (2012) Are smoking and alcohol use related to multiple sclerosis severity? A case–control study. Neuroepidemiology 39(3–4):245
Wells GA, Shea B, O’Connell D, et al (2001) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Department of Epidemiology and Community Medicine, University of Ottawa, Canada[J]. Available at: http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm. Accessed 16 Dec 2009
Higgins JPT, Green S (2011) Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration. Available at: www.cochrane-handbook.org. Accessed Mar 2011
Paras ML, Murad MH, Chen LP, Goranson EN, Sattler AL, Colbenson KM, Elamin MB, Seime RJ, Prokop LJ, Zirakzadeh A (2009) Sexual abuse and lifetime diagnosis of somatic disorders: a systematic review and meta-analysis. JAMA 302(5):550–561
Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560
Egger M (1997) Davey Smith G, Schneider M, Minder C: bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634
Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4):1088–1101
Duval S, Tweedie R (1998) Practical estimates of the effect of publication bias in meta-analysis[J]. Aust Epidemiol 5(4):14
Kotzamani D, Panou T, Mastorodemos V, Tzagournissakis M, Nikolakaki H, Spanaki C, Plaitakis A (2012) Rising incidence of multiple sclerosis in females associated with urbanization. Neurology 78(22):1728–1735
Pekmezovic T, Drulovic J, Milenkovic M, Jarebinski M, Stojsavljevic N, Mesaros S, Kisic D, Kostic J (2006) Lifestyle factors and multiple sclerosis: a case–control study in Belgrade. Neuroepidemiology 27(4):212–216
Goral J, Karavitis J, Kovacs EJ (2008) Exposure-dependent effects of ethanol on the innate immune system. Alcohol 42(4):237–247
Mann CJ (2003) Observational research methods. Research design II: cohort, cross sectional, and case-control studies. EMJ 20(1):54–60
Carle A, Pedersen IB, Knudsen N, Perrild H, Ovesen L, Rasmussen LB, Jorgensen T, Laurberg P (2012) Moderate alcohol consumption may protect against overt autoimmune hypothyroidism: a population-based case–control study. Eur J Endocrinol Eur Fed Endocr Soc 167(4):483–490
Pan HF, Leng RX, Wang J, Li XP, Ye DQ (2010) Protective role of moderate alcohol drinking in systemic lupus erythematosus. Clin Rheumatol 29(3):337
Di Giuseppe D, Alfredsson L, Bottai M, Askling J, Wolk A (2012) Long term alcohol intake and risk of rheumatoid arthritis in women: a population based cohort study. Br Med J. doi:10.1136/bmj.e4230
Kallberg H, Jacobsen S, Bengtsson C, Pedersen M, Padyukov L, Garred P, Frisch M, Karlson EW, Klareskog L, Alfredsson L (2009) Alcohol consumption is associated with decreased risk of rheumatoid arthritis: results from two Scandinavian case–control studies. Ann Rheum Dis 68(2):222–227
Liao KP, Alfredsson L, Karlson EW (2009) Environmental influences on risk for rheumatoid arthritis. Curr Opin Rheumatol 21(3):279–283
Mandrekar P, Catalano D, White B, Szabo G (2006) Moderate alcohol intake in humans attenuates monocyte inflammatory responses: inhibition of nuclear regulatory factor kappa B and induction of interleukin 10. Alcohol Clin Exp Res 30(1):135–139
Imhof A, Woodward M, Doering A, Helbecque N, Loewel H, Amouyel P, Lowe GD, Koenig W (2004) Overall alcohol intake, beer, wine, and systemic markers of inflammation in western Europe: results from three MONICA samples (Augsburg, Glasgow, Lille). Eur Heart J 25(23):2092–2100
Steinman L (2001) Myelin-specific CD8 T cells in the pathogenesis of experimental allergic encephalitis and multiple sclerosis. J Exp Med 194(5):F27–F30
Kuchroo VK, Martin CA, Greer JM, Ju ST, Sobel RA, Dorf ME (1993) Cytokines and adhesion molecules contribute to the ability of myelin proteolipid protein-specific T cell clones to mediate experimental allergic encephalomyelitis. J Immunol 151(8):4371–4382
Acknowledgments
This work was supported by three grants from the Ministry of Science and Technology of China (2008ZX10002-007,2008ZX10002-018, and 2008ZX10002-025), the leading talents of science in Shanghai 2010(022), the key discipline construction of evidence-based public health in Shanghai (12GWZX0602).
Conflict of interest
The authors declared that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Additional information
T. Zhu, X. Ye, T. Zhang, Z. Lin contributed equally and are co-first authors of this article.
Rights and permissions
About this article
Cite this article
Zhu, T., Ye, X., Zhang, T. et al. Association between alcohol consumption and multiple sclerosis: a meta-analysis of observational studies. Neurol Sci 36, 1543–1550 (2015). https://doi.org/10.1007/s10072-015-2326-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10072-015-2326-7