title: [The relationship between season/latitude and multiple sclerosis].
abstract: OBJECTIVE
  To explore the impact of season and latitude on multiple sclerosis by study the onset/relapse season and latitude distribution in multiple sclerosis (MS) patients.
  
  
  METHODS
  A total of 264 MS patients, with 88 males and 176 females, who were hospitalized in Beijing Tiantan Hospital from January 2002 to December 2012, were enrolled in the study and all the clinical data were retrospectively analyzed. The mean age was (33.9±12.3) years old, with the disease duration of (6.3±4.5) years and 453 cases of relapse. The recurrence of MS was collected by four seasons, with March to May defined as spring, June to August as summer, September to November as autumn and December to February as winter. MS patients lived in Beijing (39.39° N-41.07°N) were chosen to test the correlation between the incidence/recurrence and monthly mean temperature, sunlight exposure intensity and duration. All the patients were divided into the high latitude group and the low latitude group, taken the latitude median (40.22° N) of Beijing area as the boundary. Gender composition, age of onset, disease duration and recurrence rate were compared between the two groups.
  
  
  RESULTS
  Most of the onset/ relapse of MS were observed in winter (134 cases), while summer (97 cases) took the least. In the same latitude region (Beijing area), the onset/ relapse of MS was negatively correlated to the mean temperature and sunlight exposure intensity (r=-0.699, P=0.006; r=-0.623, P=0.015). Recurrence was higher in the high latitude group than in the low latitude group [68.7%(123/179) vs 63.0%(51/81), P=0.000], while no significant difference was found in gender composition, age of onset and disease duration between the two groups.
  
  
  CONCLUSIONS
  The onset/recurrence of MS has obvious seasonal characteristics. The onset/recurrence of MS is correlated with latitude, temperature and sunlight exposure intensity of the habitation of MS patients. Environmental factors are important cause of the onset/recurrence of MS, with sunshine exposure as the most key factor.
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Beijing 100050, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Beijing 100050, China; Email: xhzhtiantan@hotmail.com.
authors.forename: Xinghu
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000068476:Beijing; D002980:Climate; D005260:Female; D006761:Hospitals; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000209:etiology*; D012008:Recurrence; D012189:Retrospective Studies; D012621:Seasons; D013472:Sunlight; D055815:Young Adult