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Sun exposure and vitamin D are independent risk factors for CNS demyelination

Citation

Lucas, RM and Ponsonby, AL and Dear, K and Valery, PC and Pender, MP and Taylor, BV and Kilpatrick, TJ and Dwyer, T and Coulthard, A and Chapman, C and van der Mei, I and Williams, D and McMichael, AJ, Sun exposure and vitamin D are independent risk factors for CNS demyelination, Neurology, 76, (6) pp. 540-548 . ISSN 0028-3878 (2011) [Refereed Article]


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Copyright Statement

Copyright © 2011 Lippincott Williams & Wilkins

Official URL: http://www.lww.com/

DOI: doi:10.1212/WNL.0b013e31820af93d

Abstract

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/m2 (range 508–6,397 kJ/m2). Higher actinic skin damage (AOR0.39 [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.

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:Taylor, BV (Professor Bruce Taylor)
Author:van der Mei, I (Associate Professor Ingrid van der Mei)
ID Code:69680
Year Published:2011
Web of Science® Times Cited:171
Deposited By:Menzies Institute for Medical Research
Deposited On:2011-05-12
Last Modified:2017-10-31
Downloads:13 View Download Statistics

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