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ABSTRACT
Objective: To examine the association between 25-hydroxyvitamin D (25[OH]D) levels and the risk of multiple sclerosis (MS) in blood samples collected prospectively and during gestation.
Methods: In this nested case-control study, 2 population-based biobanks with 291,500 samples from 164,000 persons collected since 1975 in the northern half of Sweden were used. We identified prospectively collected blood samples from MS cases (n = 192, controls matched 2:1) and gestational samples from pregnant mothers where the offspring had later developed MS (n = 37, control mothers matched 5:1). 25(OH)D levels were measured using an ELISA, and the risk of MS was analyzed using matched logistic regression.
Results: Levels of 25(OH)D ≥75 (vs <75) nmol/L in prospectively collected blood samples were associated with a decreased risk of MS (odds ratio [OR] 0.39, 95% confidence interval [CI] 0.16–0.98). No decrease in MS risk was found in the offspring exposed to gestational 25(OH)D levels ≥75 (vs <75) nmol/L (OR 1.8, 95% CI 0.53–5.8). The prevalence of 25(OH)D levels ≥75 nmol/L in female controls decreased gradually during 1976–2005 (p trend = 0.005).
Conclusion: This study supports the presence of an association between high 25(OH)D levels during the years preceding disease onset and a decreased risk of MS. In the very limited material with samples drawn in early pregnancy, where month-of-birth effects were controlled for, we found no association between gestational 25(OH)D levels and MS risk in the offspring. Decreasing 25(OH)D levels in the population may contribute to explain the increasing MS incidence that is suggested from epidemiologic studies.
Glossary
- 25(OH)D=
- 25-hydroxyvitamin D;
- CI=
- confidence interval;
- DIS=
- dissemination in space;
- DIT=
- dissemination in time;
- EBV=
- Epstein-Barr virus;
- GRoMS=
- Gestational Risk factors of Multiple Sclerosis;
- ICD=
- International Classification of Diseases;
- MBR=
- Medical Birth Registry;
- MS=
- multiple sclerosis;
- NBHW=
- National Board of Health and Welfare;
- NSHDS=
- Northern Sweden Health and Disease Study;
- NSMC=
- Northern Sweden Maternity Cohort;
- OR=
- odds ratio;
- RoMS=
- Risk factors of Multiple Sclerosis
Footnotes
Study funding: This study was funded by research grants from Biogen Idec, Merck Serono, and the Swedish Association of Neurologically Disabled. Financial support was also provided through regional agreement between Umeå University and Västerbotten County Council on cooperation in the fields of medicine, odontology, and health (A.L.F.).
Go to Neurology.org for full disclosures. Disclosures deemed relevant by the authors, if any, are provided at the end of this article.
Supplemental data at www.neurology.org
- Received May 15, 2012.
- Accepted July 23, 2012.
- © 2012 American Academy of Neurology
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