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. 2017 Jan 3;88(1):44-51.
doi: 10.1212/WNL.0000000000003454. Epub 2016 Nov 30.

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

Nete Munk Nielsen  1 , Kassandra L Munger  2 , Nils Koch-Henriksen  2 , David M Hougaard  2 , Melinda Magyari  2 , Kristian T Jørgensen  2 , Marika Lundqvist  2 , Jacob Simonsen  2 , Tine Jess  2 , Arieh Cohen  2 , Egon Stenager  2 , Alberto Ascherio  2
Affiliations

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

Nete Munk Nielsen et al. Neurology. .

Abstract

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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Figures

Figure 1
Figure 1. Study flowchart
Flowchart shows the identification of patients with multiple sclerosis (MS) and controls.
Figure 2
Figure 2. Mean levels of 25-hydroxyvitamin D (25[OH]D) according to year of birth
Mean levels of 25(OH)D by year of birth among patients with multiple sclerosis (MS) and controls. Ninety-five percent confidence intervals are shown on the figure. *Based on very few cases: in 1994, 7 cases and 13 controls; in 1995, 4 cases and 8 controls; in 1996, 6 cases and 13 controls; and in 1997, 3 cases and 6 controls. One case and 2 controls were born in 2000 (not shown).
Figure 3
Figure 3. Mean levels of 25-hydroxyvitamin D (25[OH]D) according to month of birth
Mean levels of 25(OH)D by month of birth among patients with multiple sclerosis (MS) and controls. Ninety-five percent confidence intervals are shown on the figure.
See this image and copyright information in PMC

Comment in

References

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