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@ARTICLE{Holz:303099,
      author       = {A. Holz and N. Obi and T. Pischon and M. B. Schulze and W.
                      Ahrens and K. Berger and B. Bohn and H. Brenner$^*$ and C.
                      Emmel and B. Fischer and K. H. Greiser$^*$ and V. Harth and
                      B. Holleczek and R. Kaaks$^*$ and A. Karch and V. Katzke$^*$
                      and T. Keil and L. Krist and M. Leitzmann and C.
                      Meinke-Franze and K. B. Michels and K. Nimptsch and A.
                      Peters and O. Riedel and T. Schikowski and S. Schipf and B.
                      Schmidt and S. Thierry and K. Hellwig and K. Riemann-Lorenz
                      and C. Heesen and H. Becher},
      title        = {{T}he {R}elation of {M}ultiple {S}clerosis to {F}amily
                      {H}istory, {L}ifestyle, and {H}ealth {F}actors in
                      {C}hildhood and {A}dolescence: {F}indings of a
                      {C}ase-{C}ontrol {S}tudy {N}ested {W}ithin the {G}erman
                      {N}ational {C}ohort ({NAKO}) {S}tudy.},
      journal      = {Deutsches Ärzteblatt international},
      volume       = {112},
      number       = {13},
      issn         = {1866-0452},
      address      = {Köln},
      publisher    = {Dt. Ärzte-Verl.},
      reportid     = {DKFZ-2025-01524},
      pages        = {348-354},
      year         = {2025},
      abstract     = {Multiple sclerosis (MS) is a neuroinflammatory disease of
                      presumed autoimmune origin. A combination of genetic
                      susceptibility and exposure to certain environmental and
                      lifestyle factors might trigger the onset of MS. The
                      currently known risk factors include a genetic
                      predisposition, infection with the Epstein-Barr virus (EBV),
                      smoking, and an increased body mass index.In 2021-22, we
                      carried out a case-control study nested within the German
                      National Cohort (NAKO) to investigate associations of
                      potential risk factors with MS.The subjects included 576
                      persons with MS (cases) and 895 without MS (controls).
                      Beyond the known risk factors, we observed associations
                      between MS and the cumulative number of common childhood
                      infections (odds ratio (OR) 1.14 per additional infection,
                      $95\%$ confidence interval (CI): [1.03; 1.25]), major
                      stressful life events (SLE) (OR 1.25 per additional event,
                      [1.06; 1.48]), being the firstborn child of a mother aged 30
                      or older (OR 2.11, [1.08; 4.13]); higher amounts of physical
                      activity in the teenage years were associated with a lower
                      risk of MS (OR 0.82 per unit increase in activity level,
                      [0.71; 0.95]).We confirmed known risk factors for MS and
                      found associations with a number of new ones, e.g., the
                      cumulative number of common childhood infections. These
                      findings may shed light on the etiology of MS and merit
                      further study.},
      keywords     = {Humans / Multiple Sclerosis: epidemiology / Multiple
                      Sclerosis: genetics / Multiple Sclerosis: etiology / Female
                      / Male / Case-Control Studies / Germany: epidemiology /
                      Adolescent / Life Style / Child / Risk Factors / Adult /
                      Cohort Studies / Middle Aged / Young Adult / Genetic
                      Predisposition to Disease: epidemiology / Child, Preschool},
      cin          = {C070 / C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40392126},
      doi          = {10.3238/arztebl.m2025.0069},
      url          = {https://inrepo02.dkfz.de/record/303099},
}