Vol. 36, No. 1, 2011
Tzu-Yun McDowella, b, Sania Amrb, William J. Culpeppera, d, Patricia Langenbergb, Walter Royala, c, Christopher Bevera, c, Douglas D. Bradhama, e
aMS Center of Excellence-East, Baltimore VAMC tycmcdowell at hotmail.com
bEpidemiology and Public Health and
cNeurology, School of Medicine, and
dDepartment of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, Md., and
eDepartment of Preventive Medicine and Public Health, School of Medicine-Wichita, University of Kansas, Wichita, Kans., USA
Neuroepidemiology 2011;36:39-45 (DOI: 10.1159/000322512)
Background: Current evidence suggests that sun exposure and vitamin D intake, during childhood and adolescence, are associated with a reduced risk of multiple sclerosis (MS). However, the role of these environmental agents in the timing of disease symptom onset remains to be investigated.
Methods: Using a cross-sectional study design, we recruited participants from the Veterans Health Administration – Multiple Sclerosis Surveillance Registry. Self-reported histories of residential locations, sun exposure and intake of vitamin D were used to estimate vitamin-D-related exposures. Multivariable linear regression analysis was used to examine the associations between these variables and age at MS onset.
Results: Among veterans with relapsing MS who resided in low-to-medium solar radiation areas (n = 540), low sun exposure in the fall/winter during the ages of 6–15 years was significantly associated with earlier symptom onset by 2.1 years (p = 0.02). Intake of cod liver oil during the same age period was associated with later onset of MS symptoms by 4 years (p = 0.02).
Conclusions: The current study provides evidence for an association between vitamin-D-related exposures during childhood and early adolescence and the timing of MS symptom onset, and supports vitamin D as a potential modulator of the clinical course of this disease.
Copyright © 2010 S. Karger AG, Basel, Received: August 27, 2010, Accepted: October 28, 2010, Published online: December 16, 2010
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See also at VitaminDWiki: Overview of MS and vitamin D
This study, along with the dissertation by the same author which proceeded it, are the primary documents being used by the VHA to examine MS treatment options. Heavy emphasis on vitamin D to treat MS.
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Previous publication by author (May 2010) is also a reference for the VHA investigation into Vitamin D and MS - CLICK HERE for full text
Neuroepidemiology. 2010 May; 34(4): 238–244. Published online 2010 March 18. doi: 10.1159/000297749.
Copyright © 2010 by S. Karger AG, Basel
Tzu-Yun McDowell,ab* Sania Amr,b Patricia Langenberg,b Walter Royal,ac Christopher Bever,ac William J. Culpepper,ab and Douglas D. Bradhamad
a MS Center of Excellence-East, Baltimore VAMC, Baltimore, Md., USA
b Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Md., USA
c Department of Neurology, University of Maryland School of Medicine, Baltimore, Md., USA
d Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, Wichita, Kans., USA
- Tzu-Yun McDowell, MS Center of Excellence-East, Baltimore VAMC, 10 N. Green Street, Baltimore, MD 21201 (USA), Tel. +1 410 605 7414, Fax +1 410 605 7705, E-Mail Tzu-Yun.Chang-McDowell at va.gov
Received September 14, 2009; Accepted January 26, 2010.
Gestational and early life events have been suggested to contribute to multiple sclerosis (MS) susceptibility. We assessed the effects of time and place of birth on the age at onset of MS symptoms.
We selected a national cohort of 967 veterans from the Multiple Sclerosis Surveillance Registry for whom month and season (time) of birth, and birthplace (city and state) were available. Multiple linear regression analyses were used to examine the association between time of birth, birthplace latitude and solar radiation, and the age at onset of MS symptoms among the study sample.
Patients with a relapsing form of the disease (R-MS), who were born in winter and whose birthplace was in low solar radiation areas, had disease symptom onset on average 2.8 years earlier than those born in seasons other than winter and in medium- and high-solar radiation areas (p = 0.02).
These results suggest that exposure early in life to geographical and seasonal factors, possibly related to the protective effect of sunlight, and thus vitamin D, is associated with a delay in MS symptom onset. Other larger studies are required to examine the period-specific (from conception to adulthood) environmental factors that are associated with MS susceptibility.
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