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


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

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DOI: doi:10.1212/WNL.0b013e31820af93d


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 27degreeS to 43degreeS), 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 (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.

Item Details

Item Type:Refereed Article
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Epidemiology not elsewhere classified
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Taylor, BV (Professor Bruce Taylor)
UTAS Author:van der Mei, I (Professor Ingrid van der Mei)
ID Code:69680
Year Published:2011
Web of Science® Times Cited:251
Deposited By:Menzies Institute for Medical Research
Deposited On:2011-05-12
Last Modified:2022-08-24
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