Sun exposure and vitamin D are independent risk factors for CNS demyelination
Lucas RM, Ponsonby AL, Dear K, Valery PC, Pender MP, Taylor BV, Kilpatrick TJ, Dwyer T, Coulthard A, Chapman C, van der Mei I, Williams D, McMichael AJ
Neurology · 276 citas
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2011-02-07 · Neurology · vol. 76 · número 6 · págs. 540–548
- Editorial
- Lippincott Williams & Wilkins
- Citado
- 358 citas · más que el 100% de estudios similares · 25.4× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 32 trabajos
- Acceso
- Acceso abierto (copia en repositorio) · CC-BY
- Áreas de investigación
- Multiple Sclerosis Research Studies · Vitamin D Research Studies · Skin Protection and Aging
- Palabras clave
- sun exposure, vitamin D, 25-hydroxyvitamin D, central nervous system demyelination, multiple sclerosis, first demyelinating event, actinic skin damage, skin phenotype, latitudinal gradient, ultraviolet radiation
- MeSH
- humans, multiple sclerosis, demyelinating diseases, vitamin d deficiency, vitamin d, risk factors, case-control studies, sunlight, adolescent, adult, middle aged, south australia, tasmania, victoria, female, male, young adult
13 autores
- Robyn Marjorie Lucas🇦🇺Australian National University; The University of Queensland; The University of Melbourne; QIMR Berghofer Medical Research Institute; Royal Brisbane and Women's Hospital; Murdoch Children's Research Institute
- Anne‐Louise Ponsonby🇦🇺Australian National University; The University of Queensland; The University of Melbourne; QIMR Berghofer Medical Research Institute; Royal Brisbane and Women's Hospital; Murdoch Children's Research Institute
- Keith B. G. Dear🇦🇺Australian National University; The University of Queensland; The University of Melbourne; QIMR Berghofer Medical Research Institute; Royal Brisbane and Women's Hospital; Murdoch Children's Research Institute
- Patricia Casarolli Valery🇦🇺Australian National University; The University of Queensland; The University of Melbourne; QIMR Berghofer Medical Research Institute; Royal Brisbane and Women's Hospital; Murdoch Children's Research Institute
- Michael P. Pender🇦🇺Australian National University; The University of Queensland; The University of Melbourne; QIMR Berghofer Medical Research Institute; Royal Brisbane and Women's Hospital; Murdoch Children's Research Institute
- Bruce V. Taylor🇦🇺Australian National University; The University of Queensland; The University of Melbourne; QIMR Berghofer Medical Research Institute; Royal Brisbane and Women's Hospital; Murdoch Children's Research Institute
- Trevor John Kilpatrick🇦🇺Australian National University; The University of Queensland; The University of Melbourne; QIMR Berghofer Medical Research Institute; Royal Brisbane and Women's Hospital; Murdoch Children's Research Institute
- Terence Dwyer🇦🇺Australian National University; The University of Queensland; The University of Melbourne; QIMR Berghofer Medical Research Institute; Royal Brisbane and Women's Hospital; Murdoch Children's Research Institute
- Alan Coulthard🇦🇺Australian National University; The University of Queensland; The University of Melbourne; QIMR Berghofer Medical Research Institute; Royal Brisbane and Women's Hospital; Murdoch Children's Research Institute
- C. Chapman🇦🇺Australian National University; The University of Queensland; The University of Melbourne; QIMR Berghofer Medical Research Institute; Royal Brisbane and Women's Hospital; Murdoch Children's Research Institute
- Ingrid A.F. van der Mei🇦🇺Australian National University; The University of Queensland; The University of Melbourne; QIMR Berghofer Medical Research Institute; Royal Brisbane and Women's Hospital; Murdoch Children's Research Institute
- David Michael Williams🇦🇺Australian National University; The University of Queensland; The University of Melbourne; QIMR Berghofer Medical Research Institute; Royal Brisbane and Women's Hospital; Murdoch Children's Research Institute
- Anthony John McMichael🇦🇺Australian National University; The University of Queensland; The University of Melbourne; QIMR Berghofer Medical Research Institute; Royal Brisbane and Women's Hospital; Murdoch Children's Research Institute
Resumen
El texto original del estudio, en el idioma en que se publicó.
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.
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