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Higher 25-hydroxyvitamin D Is Associated with Lower Relapse Risk in Multiple Sclerosis

Citation

Simpson, S and Taylor, B and Blizzard, L and Ponsonby, AL and Pittas, F and Tremlett, H and Dwyer, T and Gies, P and van der Mei, I, Higher 25-hydroxyvitamin D Is Associated with Lower Relapse Risk in Multiple Sclerosis, Annals of Neurology, 68, (2) pp. 193-203. ISSN 0364-5134 (2010) [Refereed Article]


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The definitive published version is available online at: http://interscience.wiley.com

DOI: doi:10.1002/ana.22043

Abstract

Objective: A protective association between higher vitamin D levels and the onset of multiple sclerosis (MS) has been demonstrated; however, its role in modulating MS clinical course has been little studied. We investigated whether higher levels of serum 25-hydroxyvitamin D (25-OH-D) were associated with a lower risk of relapses in people with MS. Methods: We conducted a prospective cohort study of 145 participants with relapsing-remitting MS from 2002 to 2005. Serum 25-OH-D levels were measured biannually, and the hazard of relapse was assessed using survival analysis. Results: There was an inverse linear relationship between 25-OH-D levels and the hazard of relapse over the subsequent 6 months, with hazard ratio (HR) 0.91 (95% confidence interval [CI]: 0.85–0.97) per 10nmol/l increase in 25-OH-D level (p  0.006). When variation due to timing of blood collection was removed by estimating 25-OH-D at the start of each season, this association persisted, with HR 0.90 (95% CI, 0.83–0.98) per 10nmol/l increase (p  0.016). Taking into account the biological half-life of 25-OH-D, we estimated 25-OH-D at monthly intervals, resulting in a slightly enhanced association, with HR 0.88 (95% CI, 0.82–0.95) per 10nmol/l increase (p  0.001). Adjusting for potential confounders did not alter these findings. Interpretation: In this prospective population-based cohort study, in a cohort largely on immunomodulatory therapy, higher 25-OH-D levels were associated with a reduced hazard of relapse. This occurred in a dosedependent linear fashion, with each 10nmol/l increase in 25-OH-D resulting in up to a 12% reduction in risk of relapse. Clinically, raising 25-OH-D levels by 50nmol/l could halve the hazard of a relapse.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Public Health and Health Services
Research Field:Epidemiology
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Nervous System and Disorders
Author:Simpson, S (Dr Steve Simpson JR)
Author:Taylor, B (Professor Bruce Taylor)
Author:Blizzard, L (Professor Leigh Blizzard)
Author:Pittas, F (Dr Fotini Pittas)
Author:van der Mei, I (Associate Professor Ingrid van der Mei)
ID Code:64809
Year Published:2010
Web of Science® Times Cited:244
Deposited By:Menzies Institute for Medical Research
Deposited On:2010-09-02
Last Modified:2011-05-02
Downloads:3 View Download Statistics

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