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A gestational dose of vitamin D per day keeps the MS doctor away (2X reduction) – Nov 2016

Editorial at Neurology journal

Neurology 10.1212/WNL.0000000000003469, http:/ / dx. doi. org/ 10. 1212/ WNL. 0000000000003469
Ruth Ann Marrie, MD, PhD and Martin Daumer, PhD
Correspondence to Dr. Marrie: rmarrie at exchange.hsc.mb.ca

Excerpt (free)
Interest in identifying the cause of multiple sclerosis (MS) remains intense. Two nested case-control studies showed that in young, predominantly white adults in whom samples were collected before clinical disease onset, higher serum levels of 25(OH)D were associated with a reduced risk of developing MS.1,2 In the Nurses' Health Study cohorts, higher dietary intake of vitamin D was associated with a lower risk of developing MS among American nurses; supplemental intake of more than 400 IU daily was associated with a 40% reduced risk. A more recent mendelian randomization study, which included 14,498 MS cases and 24,091 healthy controls with European ancestry, showed that alleles related to lower vitamin D levels were associated with increased MS risk.2,3 This study design increases the confidence that the preceding observations reflect a causal association rather than confounding. However, the time period when vitamin D exposure is relevant to reducing MS risk remains uncertain, including whether early-life exposure to vitamin D influences MS risk.2,4

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In same Issue

Neonatal vitamin D status and risk of multiple sclerosis: A population-based case-control study - Nov 2016

Neurology 10.1212/WNL.0000000000003454, doi: http:/ / dx. doi. org/ 10. 1212/ WNL.
Nete Munk Nielsen, MD, MSc, PhD*, Kassandra L. Munger, MSc, ScD*, Nils Koch-Henriksen, MD, DMSc, David M. Hougaard, MD, DMSc, Melinda Magyari, MD, PhD, Kristian T. Jørgensen, MSc, PhD, Marika Lundqvist, MSc, Jacob Simonsen, MSc, PhD, Tine Jess, MD, DMSc, Arieh Cohen, MSc, PhD, Egon Stenager, MD, DMSc‡ and Alberto Ascherio, MD, DrPH‡ Correspondence to Dr. Nielsen: NMN at ssi.dk

Objective: As previous research has suggested that exposure to vitamin D insufficiency in utero may have relevance for the risk of multiple sclerosis (MS), we aimed to examine the direct association between level of neonatal vitamin D and risk of MS.

Methods: We carried out a matched case-control study. Dried blood spots samples (DBSS) belonging to 521 patients with MS were identified in the Danish Newborn Screening Biobank. For every patient with MS, 1–2 controls with the same sex and birth date were retrieved from the Biobank (n = 972). Level of 25-hydroxyvitamin D (25[OH]D) in the DBSS was measured using liquid chromatography tandem mass spectroscopy. The association between different levels of 25(OH)D and risk of MS was evaluated by odds ratios (OR) calculated in conditional logistic regression models.

Results: We observed that lower levels of 25(OH)D in neonates were associated with an increased risk of MS. In the analysis by quintiles, MS risk was highest among individuals in the bottom quintile (<20.7 nmol/L) and lowest among those in the top quintile of 25(OH)D (=48.9 nmol/L), with an OR for top vs bottom of 0.53 (95% confidence interval [CI] 0.36–0.78). In the analysis treating 25(OH)D as a continuous variable, a 25 nmol/L increase in neonatal 25(OH)D resulted in a 30% reduced risk of MS (OR 0.70, 95% CI 0.57–0.84).

Conclusion: Low concentrations of neonatal vitamin D are associated with an increased risk of MS. In light of the high prevalence of vitamin D insufficiency among pregnant women, our observation may have importance for public health.

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