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Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis.
JAMA. 2006 Dec 20; 296(23):2832-8.JAMA

Abstract

CONTEXT

Epidemiological and experimental evidence suggests that high levels of vitamin D, a potent immunomodulator, may decrease the risk of multiple sclerosis. There are no prospective studies addressing this hypothesis.

OBJECTIVE

To examine whether levels of 25-hydroxyvitamin D are associated with risk of multiple sclerosis.

DESIGN, SETTING, AND PARTICIPANTS

Prospective, nested case-control study among more than 7 million US military personnel who have serum samples stored in the Department of Defense Serum Repository. Multiple sclerosis cases were identified through Army and Navy physical disability databases for 1992 through 2004, and diagnoses were confirmed by medical record review. Each case (n = 257) was matched to 2 controls by age, sex, race/ethnicity, and dates of blood collection. Vitamin D status was estimated by averaging 25-hydroxyvitamin D levels of 2 or more serum samples collected before the date of initial multiple sclerosis symptoms.

MAIN OUTCOME MEASURES

Odds ratios of multiple sclerosis associated with continuous or categorical levels (quantiles or a priori-defined categories) of serum 25-hydroxyvitamin D within each racial/ethnic group.

RESULTS

Among whites (148 cases, 296 controls), the risk of multiple sclerosis significantly decreased with increasing levels of 25-hydroxyvitamin D (odds ratio [OR] for a 50-nmol/L increase in 25-hydroxyvitamin D, 0.59; 95% confidence interval, 0.36-0.97). In categorical analyses using the lowest quintile (<63.3 nmol/L) as the reference, the ORs for each subsequent quintile were 0.57, 0.57, 0.74, and 0.38 (P = .02 for trend across quintiles). Only the OR for the highest quintile, corresponding to 25-hydroxyvitamin D levels higher than 99.1 nmol/L, was significantly different from 1.00 (OR, 0.38; 95% confidence interval, 0.19-0.75; P = .006). The inverse relation with multiple sclerosis risk was particularly strong for 25-hydroxyvitamin D levels measured before age 20 years. Among blacks and Hispanics (109 cases, 218 controls), who had lower 25-hydroxyvitamin D levels than whites, no significant associations between vitamin D and multiple sclerosis risk were found.

CONCLUSION

The results of our study suggest that high circulating levels of vitamin D are associated with a lower risk of multiple sclerosis.

Authors+Show Affiliations

Department of Nutrition, Harvard School of Public Health, and Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass 02115, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17179460

Citation

Munger, Kassandra L., et al. "Serum 25-hydroxyvitamin D Levels and Risk of Multiple Sclerosis." JAMA, vol. 296, no. 23, 2006, pp. 2832-8.
Munger KL, Levin LI, Hollis BW, et al. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA. 2006;296(23):2832-8.
Munger, K. L., Levin, L. I., Hollis, B. W., Howard, N. S., & Ascherio, A. (2006). Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA, 296(23), 2832-8.
Munger KL, et al. Serum 25-hydroxyvitamin D Levels and Risk of Multiple Sclerosis. JAMA. 2006 Dec 20;296(23):2832-8. PubMed PMID: 17179460.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. AU - Munger,Kassandra L, AU - Levin,Lynn I, AU - Hollis,Bruce W, AU - Howard,Noel S, AU - Ascherio,Alberto, PY - 2006/12/21/pubmed PY - 2006/12/23/medline PY - 2006/12/21/entrez SP - 2832 EP - 8 JF - JAMA JO - JAMA VL - 296 IS - 23 N2 - CONTEXT: Epidemiological and experimental evidence suggests that high levels of vitamin D, a potent immunomodulator, may decrease the risk of multiple sclerosis. There are no prospective studies addressing this hypothesis. OBJECTIVE: To examine whether levels of 25-hydroxyvitamin D are associated with risk of multiple sclerosis. DESIGN, SETTING, AND PARTICIPANTS: Prospective, nested case-control study among more than 7 million US military personnel who have serum samples stored in the Department of Defense Serum Repository. Multiple sclerosis cases were identified through Army and Navy physical disability databases for 1992 through 2004, and diagnoses were confirmed by medical record review. Each case (n = 257) was matched to 2 controls by age, sex, race/ethnicity, and dates of blood collection. Vitamin D status was estimated by averaging 25-hydroxyvitamin D levels of 2 or more serum samples collected before the date of initial multiple sclerosis symptoms. MAIN OUTCOME MEASURES: Odds ratios of multiple sclerosis associated with continuous or categorical levels (quantiles or a priori-defined categories) of serum 25-hydroxyvitamin D within each racial/ethnic group. RESULTS: Among whites (148 cases, 296 controls), the risk of multiple sclerosis significantly decreased with increasing levels of 25-hydroxyvitamin D (odds ratio [OR] for a 50-nmol/L increase in 25-hydroxyvitamin D, 0.59; 95% confidence interval, 0.36-0.97). In categorical analyses using the lowest quintile (<63.3 nmol/L) as the reference, the ORs for each subsequent quintile were 0.57, 0.57, 0.74, and 0.38 (P = .02 for trend across quintiles). Only the OR for the highest quintile, corresponding to 25-hydroxyvitamin D levels higher than 99.1 nmol/L, was significantly different from 1.00 (OR, 0.38; 95% confidence interval, 0.19-0.75; P = .006). The inverse relation with multiple sclerosis risk was particularly strong for 25-hydroxyvitamin D levels measured before age 20 years. Among blacks and Hispanics (109 cases, 218 controls), who had lower 25-hydroxyvitamin D levels than whites, no significant associations between vitamin D and multiple sclerosis risk were found. CONCLUSION: The results of our study suggest that high circulating levels of vitamin D are associated with a lower risk of multiple sclerosis. SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/17179460/Serum_25_hydroxyvitamin_D_levels_and_risk_of_multiple_sclerosis_ L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.296.23.2832 DB - PRIME DP - Unbound Medicine ER -