Tags

Type your tag names separated by a space and hit enter

Sun exposure and vitamin D are independent risk factors for CNS demyelination.
Neurology 2011; 76(6):540-8Neur

Abstract

OBJECTIVES

To examine whether past and recent sun exposure and vitamin D status (serum 25-hydroxyvitamin D [25(OH)D] levels) are associated with risk of first demyelinating events (FDEs) and to evaluate the contribution of these factors to the latitudinal gradient in FDE incidence in Australia.

METHODS

This was a multicenter incident case-control study. Cases (n = 216) were aged 18-59 years with a FDE and resident within one of 4 Australian centers (from latitudes 27°S to 43°S), from November 1, 2003, to December 31, 2006. Controls (n = 395) were matched to cases on age, sex, and study region, without CNS demyelination. Exposures measured included self-reported sun exposure by life stage, objective measures of skin phenotype and actinic damage, and vitamin D status.

RESULTS

Higher levels of past, recent, and accumulated leisure-time sun exposure were each associated with reduced risk of FDE, e.g., accumulated leisure-time sun exposure (age 6 years to current), adjusted odds ratio (AOR) = 0.70 (95% confidence interval [CI] 0.53-0.94) for each ultraviolet (UV) dose increment of 1,000 kJ/m(2) (range 508-6,397 kJ/m(2)). Higher actinic skin damage (AOR = 0.39 [95% CI 0.17-0.92], highest grade vs the lowest) and higher serum vitamin D status (AOR = 0.93 [95% CI 0.86-1.00] per 10 nmol/L increase in 25(OH)D) were independently associated with decreased FDE risk. Differences in leisure-time sun exposure, serum 25(OH)D level, and skin type additively accounted for a 32.4% increase in FDE incidence from the low to high latitude regions.

CONCLUSIONS

Sun exposure and vitamin D status may have independent roles in the risk of CNS demyelination. Both will need to be evaluated in clinical trials for multiple sclerosis prevention.

Authors+Show Affiliations

National Centre for Epidemiology and Population Health, The Australian National University, Canberra 0200, Australia. Robyn.Lucas@anu.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21300969

Citation

Lucas, R M., et al. "Sun Exposure and Vitamin D Are Independent Risk Factors for CNS Demyelination." Neurology, vol. 76, no. 6, 2011, pp. 540-8.
Lucas RM, Ponsonby AL, Dear K, et al. Sun exposure and vitamin D are independent risk factors for CNS demyelination. Neurology. 2011;76(6):540-8.
Lucas, R. M., Ponsonby, A. L., Dear, K., Valery, P. C., Pender, M. P., Taylor, B. V., ... McMichael, A. J. (2011). Sun exposure and vitamin D are independent risk factors for CNS demyelination. Neurology, 76(6), pp. 540-8. doi:10.1212/WNL.0b013e31820af93d.
Lucas RM, et al. Sun Exposure and Vitamin D Are Independent Risk Factors for CNS Demyelination. Neurology. 2011 Feb 8;76(6):540-8. PubMed PMID: 21300969.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sun exposure and vitamin D are independent risk factors for CNS demyelination. AU - Lucas,R M, AU - Ponsonby,A-L, AU - Dear,K, AU - Valery,P C, AU - Pender,M P, AU - Taylor,B V, AU - Kilpatrick,T J, AU - Dwyer,T, AU - Coulthard,A, AU - Chapman,C, AU - van der Mei,I, AU - Williams,D, AU - McMichael,A J, PY - 2011/2/9/entrez PY - 2011/2/9/pubmed PY - 2011/3/24/medline SP - 540 EP - 8 JF - Neurology JO - Neurology VL - 76 IS - 6 N2 - OBJECTIVES: To examine whether past and recent sun exposure and vitamin D status (serum 25-hydroxyvitamin D [25(OH)D] levels) are associated with risk of first demyelinating events (FDEs) and to evaluate the contribution of these factors to the latitudinal gradient in FDE incidence in Australia. METHODS: This was a multicenter incident case-control study. Cases (n = 216) were aged 18-59 years with a FDE and resident within one of 4 Australian centers (from latitudes 27°S to 43°S), from November 1, 2003, to December 31, 2006. Controls (n = 395) were matched to cases on age, sex, and study region, without CNS demyelination. Exposures measured included self-reported sun exposure by life stage, objective measures of skin phenotype and actinic damage, and vitamin D status. RESULTS: Higher levels of past, recent, and accumulated leisure-time sun exposure were each associated with reduced risk of FDE, e.g., accumulated leisure-time sun exposure (age 6 years to current), adjusted odds ratio (AOR) = 0.70 (95% confidence interval [CI] 0.53-0.94) for each ultraviolet (UV) dose increment of 1,000 kJ/m(2) (range 508-6,397 kJ/m(2)). Higher actinic skin damage (AOR = 0.39 [95% CI 0.17-0.92], highest grade vs the lowest) and higher serum vitamin D status (AOR = 0.93 [95% CI 0.86-1.00] per 10 nmol/L increase in 25(OH)D) were independently associated with decreased FDE risk. Differences in leisure-time sun exposure, serum 25(OH)D level, and skin type additively accounted for a 32.4% increase in FDE incidence from the low to high latitude regions. CONCLUSIONS: Sun exposure and vitamin D status may have independent roles in the risk of CNS demyelination. Both will need to be evaluated in clinical trials for multiple sclerosis prevention. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/21300969/Sun_exposure_and_vitamin_D_are_independent_risk_factors_for_CNS_demyelination_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=21300969 DB - PRIME DP - Unbound Medicine ER -