scholarly journals Low sun exposure increases multiple sclerosis risk both directly and indirectly

2019 ◽  
Vol 267 (4) ◽  
pp. 1045-1052 ◽  
Author(s):  
Anna Karin Hedström ◽  
Tomas Olsson ◽  
Ingrid Kockum ◽  
Jan Hillert ◽  
Lars Alfredsson
Keyword(s):  
Multiple Sclerosis ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Sun Exposure ◽  
Population Based ◽  
Total Effect ◽  
Mediation Effect ◽  
Vitamin D Status ◽  
Case Control Studies ◽  
Vitamin D Levels

Abstract Objective We aimed to study (1) to what extent the influence of low sun exposure on multiple sclerosis (MS) risk is mediated by low vitamin D levels; (2) whether low sun exposure or vitamin D deficiency act synergistically with HLA-DRB1*15:01 and absence of HLA-A*02:01. Methods We used two population-based case–control studies (7069 cases, 6632 matched controls). Subjects with different HLA alleles, sun exposure habits and vitamin D status were compared regarding MS risk, by calculating odds ratios (OR) with 95% confidence intervals (CI) employing logistic regression. Mediation analysis was used to identify the potential mediation effect of vitamin D on the relationship between low sun exposure and MS risk. Results Low sun exposure increased MS risk directly as well as indirectly, by affecting vitamin D status. The direct effect, expressed as OR, was 1.26 (95% CI 1.04–1.45) and the indirect effect, mediated by vitamin D deficiency, was 1.10 (95% CI 1.02–1.23). Of the total effect, nearly 30% was mediated by vitamin D deficiency. There was a significant interaction between low sun exposure and vitamin D deficiency (attributable proportion due to interaction 0.3, 95% CI 0.04–0.5) accounting for about 12% of the total effect. Further, both factors interacted with HLA-DRB1*15:01 to increase MS risk. Interpretation Our findings indicate that low sun exposure acts both directly on MS risk as well as indirectly, by leading to low vitamin D levels. The protective effect of sun exposure thus seems to involve both vitamin D and non-vitamin D pathways, which is of relevance for prevention, in particular for those with a genetic susceptibility to MS.

scholarly journals Low fish consumption is associated with a small increased risk of MS

2020 ◽  
Vol 7 (3) ◽  
pp. e717
Author(s):  
Anna Karin Hedström ◽  
Tomas Olsson ◽  
Ingrid Kockum ◽  
Jan Hillert ◽  
Lars Alfredsson
Keyword(s):  
Vitamin D ◽  
Fish Consumption ◽  
Sun Exposure ◽  
Potential Effect ◽  
Population Based ◽  
Mediation Effect ◽  
Case Control Studies ◽  
Fatty Fish ◽  
Logistic Regression Models ◽  
Increased Risk

ObjectiveWe aimed to investigate the influence of lean and fatty fish consumption on MS risk and to what extent a potential effect may be mediated by vitamin D. We also studied the interplay between fish consumption, sun exposure, DRB1*15:01, and A*02:01.MethodsWe used 2 population-based case-control studies (6,914 cases and 6,590 controls). Subjects with different fish consumption habits were compared regarding MS risk by calculating ORs with 95% CIs using logistic regression models. The mediation effect of vitamin D on the relationship between fish consumption and MS risk was assessed. Potential interactions between fish consumption, sun exposure, and MS-associated HLA genes were assessed on the additive scale.ResultsIrrespective of sun exposure habits, low fish consumption, including both lean and fatty fish, was associated with increased MS risk (OR 1.2, 95% CI 1.1–1.4) and interacted with the DRB1*15:01 allele (AP 0.3, p < 0.0001). The mediation analysis did not support vitamin D as a mediator of the association between fish consumption and MS risk. There was no interaction between fish consumption and sun exposure habits with regard to MS risk.ConclusionsLow fish consumption and low sun exposure seem to be separate risk factors for MS. Our findings suggest that fish consumption predominantly influences MS risk by other means than by effecting vitamin D status, which is of relevance for prevention, in particular for those with a genetic susceptibility to MS.

scholarly journals Sun exposure, dressing habits, and vitamin D status in Morocco

2021 ◽  
Vol 319 ◽  
pp. 01097
Author(s):  
Sakhr Dadda ◽  
Karima Azekour ◽  
Fouzia Sebbari ◽  
Brahim El Houate ◽  
Bachir El Bouhali
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Sun Exposure ◽  
Vitamin D Insufficiency ◽  
Activity Level ◽  
Vitamin D Status ◽  
Vitamin D Levels ◽  
High Prevalence ◽  
Daily Sunshine ◽  
Local Healthcare

Sunlight is the main source of vitamin D. Almost 80% of vitamin D3 is produced in the skin. The region of Draa Tafilalet benefits from long daily sunshine time. As such, vitamin D deficiency should be low in this region. However, dressing habits can highly influence vitamin D status. This study aimed to evaluate sun exposure and its relation to vitamin D status among the general population in the region of Draa-Tafilalet, Morocco. Clinical, biological, and sociodemographic data were obtained from 331 adults visiting local healthcare units during the summers of 2019 and 2020. Plasma 25(OH)D2/D3 was measured by immunofluorescence. The prevalence of vitamin D deficiency was 37.5%, while Vitamin D insufficiency represented 56.5%. Most of the studied population (76.4%) had restricting dressing habits and exposed only their faces. statistic tests showed a correlation of vitamin D levels with daily sun exposure (r= 0.308, p<0.001), dressing habits (p<0.001), age (r= -0.141, p=0.01), sex (p<0.001), physical activity level (p=0.003), and BMI (r= -0.298, p<0.001). The study showed a high prevalence of vitamin D deficiency in this region. Similarly, it exposed the effects of restricting clothes and low daily sun exposure on vitamin D status.

Association of vitamin D and multiple sclerosis in India

2013 ◽  
Vol 19 (12) ◽  
pp. 1592-1596 ◽  
Author(s):  
Lekha Pandit ◽  
Sreeram V Ramagopalan ◽  
Chaithra Malli ◽  
Anitha D’Cunha ◽  
Ramya Kunder ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Inverse Relationship ◽  
Sun Exposure ◽  
Vitamin D Status ◽  
Reverse Causality ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Lower Vitamin

Background: Vitamin D deficiency is widely prevalent in India. The association between vitamin D status and multiple sclerosis (MS) has not been previously studied in Indians. Objective: The objective of this paper is to determine whether vitamin D status is associated with MS in India. Methods: In this study 110 MS patients and 108 matched controls were included. Serum 25-hydroxyvitamin D (25(OH)D) was measured in 63 patients in relapse, 77 patients in remission and all controls. Quantity of sun exposure in childhood and body mass index (BMI) were calculated. Patients and controls were genotyped for HLA-DRB1*1501. Results: Patients had significantly lower 25(OH)D levels than matched controls ( p = 0.003), and patients in relapse had a significantly lower vitamin D level as compared to those in remission ( p = 0.001). Vitamin D deficiency (< 50 nmol/l) was seen in a higher proportion of cases (71.8%) than controls (53.7%) ( p = 0.01). Higher quartiles of vitamin D (> 58 nmol/l) showed an inverse relationship with MS (OR = 0.28, CI = 0.11–0.68, p= 0.005). This effect persisted after adjusting for sun exposure. Conclusion: The results of our study indicated that serum 25(OH)D shows an inverse relationship with MS in the Indian population. Reverse causality cannot be excluded.

scholarly journals Poor Vitamin D Status in Healthy Populations in India: A Review of Current Evidence

2015 ◽  
Vol 85 (3-4) ◽  
pp. 185-201 ◽  
Author(s):  
Geeta Trilok Kumar ◽  
Reema Chugh ◽  
Manfred Eggersdorfer
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Age Groups ◽  
Sun Exposure ◽  
Population Level ◽  
Current Data ◽  
Current Evidence ◽  
Vitamin D Status ◽  
Large Country ◽  
Vitamin D Levels

Abstract. Vitamin D deficiency is associated with rickets in children, with osteoporosis in the elderly, is thought to increase the risk of certain cancers and of cardiovascular diseases, and may have an impact on many other health conditions. Asians are reported to have a poor vitamin D status despite adequate sunshine in their regions. Data on the extent of vitamin D deficiency at the population level from most Asian countries, including India, are limited. Part of the reason for paucity regarding vitamin D status is the absence of clear recommendations on optimal vitamin D intakes and status, as well as clear consensus on the cut-offs for deficiency. With a large country covering several latitudes, ethnicities, cultures, traditions, and attitudes, the current data on vitamin D status in India is inadequate and classified in different ways, making interpretation difficult, and is unrepresentative as it comes only from four states, with about half the data from Delhi. Poor vitamin D status is almost universally reported across all age groups with as many as 95.7 % neonates, 75 % adults and 67 % pregnant women having serum 25 hydroxy vitamin D levels < 50 nmol/L (deficient). Children and adults exposed to sunlight, living in rural or less polluted areas have been reported to have a better vitamin D status, especially in summer months. Lack of conclusive information emphasizes the need for state-specific data on the vitamin D status and the extent of sun exposure to issue recommendations for vitamin D intake in the country.

Vitamin D Deficiency in Patients with Acute Myocardial Infarction: An Italian Single-Center Study

2015 ◽  
Vol 85 (1-2) ◽  
pp. 23-30 ◽  
Author(s):  
Aneta Aleksova ◽  
Rita Belfiore ◽  
Cosimo Carriere ◽  
Salam Kassem ◽  
Salvatore La Carrubba ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Primary Source ◽  
Sun Exposure ◽  
Female Gender ◽  
Developed Countries ◽  
Vitamin D Status ◽  
High Exposure

Abstract. Background: Hypovitaminosis D is a vitamin deficiency that has been increasing in developed countries; it was also suggested as an emerging risk factor for developing of atherosclerosis and acute myocardial infarction. The primary source of vitamin D is its cutaneous synthesis under exposure to sunlight. It has been suggested that 30 min of sun exposure twice weekly leads to sufficient vitamin D synthesis. The residents of Trieste (Italy) are well-known for their high exposure to sunlight in all seasons. We aimed to investigate the vitamin D status in subjects with acute myocardial infarction living in this area. Methods: Vitamin D status was identified in 478 subjects diagnosed with acute myocardial infarction. Results: The median serum 25-hydroxyvitamin D concentration was 14.5 [7.8 - 22.7] ng/mL. Vitamin D deficiency and insufficiency were present in 324 (68 %) and 107 (22 %) subjects, respectively. Vitamin D deficiency was less frequent among subjects enrolled in the period from July to the end of September (p < 0.001). In a multivariate analysis vitamin D deficiency was predicted by older age (p = 0.02), female gender (p = 0.002), higher body mass index (p = 0.05), autumn/winter sampling (p < 0.001), increased parathyroid hormone (p = 0.03) and alkaline phosphatase (p = 0.003). Conclusions: We observed very high prevalence of vitamin D deficiency among subjects with myocardial infarction in all seasons of enrollment. However, it was lower in the summer when sun exposure is higher. The exposure to sunlight may be a cost-saving therapeutic strategy for the management of vitamin D deficiency.

scholarly journals Comparison of Antioxidant Status and Vitamin D Levels between Multiple Sclerosis Patients and Healthy Matched Subjects

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Ehsan Hejazi ◽  
Reza Amani ◽  
Naser SharafodinZadeh ◽  
Bahman Cheraghian
Keyword(s):  
Multiple Sclerosis ◽  
Vitamin D ◽  
Dietary Intake ◽  
Antioxidant Status ◽  
Sun Exposure ◽  
Total Antioxidant Status ◽  
Serum Levels ◽  
Study Groups ◽  
Vitamin D Levels ◽  
Multiple Sclerosis Patients

Objective. The aim of the present study was to compare the serum levels of total antioxidant status (TAS) and 25(OH) D3 and dietary intake of multiple sclerosis (MS) patients with those of normal subjects.Method. Thirty-seven MS patients (31 women) and the same number of healthy matched controls were compared for their serum levels and dietary intake of 25(OH) D3 and TAS. Sun exposure and the intake of antioxidants and vitamin D rich foods were estimated through face-to-face interview and food frequency questionnaire.Results. Dietary intake of antioxidants and vitamin D rich foods, vitamin C, vitamin A, and folate was not significantly different between the two groups. There were also no significant differences in the mean levels of 25(OH) D3 and TAS between the study groups. Both groups had low serum levels of 25(OH) D3 and total antioxidants.Conclusion. No significant differences were detected in serum levels and dietary intake of vitamin D and antioxidants between MS patients and healthy controls. All subjects had low antioxidant status and vitamin D levels.

Past environmental sun exposure and risk of multiple sclerosis: a role for the Cdx-2 Vitamin D receptor variant in this interaction

2009 ◽  
Vol 15 (5) ◽  
pp. 563-570 ◽  
Author(s):  
JL Dickinson ◽  
DI Perera ◽  
AF van der Mei ◽  
A-L Ponsonby ◽  
AM Polanowski ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Vitamin D ◽  
Vitamin D Receptor ◽  
Significant Interaction ◽  
Important Determinant ◽  
Sun Exposure ◽  
Population Based ◽  
Vdr Gene ◽  
Increased Risk ◽  
Group 2

Multiple studies have provided evidence for an association between reduced sun exposure and increased risk of multiple sclerosis (MS), an association likely to be mediated, at least in part, by the vitamin D hormonal pathway. Herein, we examine whether the vitamin D receptor ( VDR), an integral component of this pathway, influences MS risk in a population-based sample where winter sun exposure in early childhood has been found to be an important determinant of MS risk. Three polymorphisms within the VDR gene were genotyped in 136 MS cases and 235 controls, and associations with MS and past sun exposure were examined by logistic regression. No significant univariate associations between the polymorphisms, rs11574010 ( Cdx-2A > G), rs10735810 ( Fok1T >  C), or rs731236 ( Taq1C > T) and MS risk were observed. However, a significant interaction was observed between winter sun exposure during childhood, genotype at rs11574010, and MS risk ( P = 0.012), with the ‘G’ allele conferring an increased risk of MS in the low sun exposure group (≤2 h/day). No significant interactions were observed for either rs10735810 or rs731236, after stratification by sun exposure. These data provide support for the involvement of the VDR gene in determining MS risk, an interaction likely to be dependent on past sun exposure.

scholarly journals Vitamin D status in pregnant women and their newborns in a tertiary care hospital

2018 ◽  
Vol 7 (12) ◽  
pp. 5071
Author(s):  
Harleen Kour ◽  
Shashi Gupta ◽  
Swarn K. Gupta ◽  
Bawa Ram Bhagat ◽  
Gagan Singh
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Vitamin D Deficiency ◽  
Tertiary Care ◽  
North India ◽  
Care Hospital ◽  
Vitamin D Status ◽  
Pregnant Females ◽  
Vitamin D Levels ◽  
Maternal And Newborn

Background: In the recent years there has been an increased understanding of the role that vitamin D plays in regulation of cell growth, calcium absorption and immunity and its impact on the developing fetus and maternal health is of significant concern. This study aims at evaluating the Vitamin D status in pregnant women and their newborns.Methods: A cross sectional study was done on 100 pregnant females according to inclusion and exclusion criteria. At the time of delivery, maternal blood was collected, and newborn samples were taken from newborn side of umbilical cord and sent for analysis.Results: The prevalence of Vitamin D deficiency has been found to be 85% of pregnant females and 91% of the newborns. Only 5% of pregnant females and 1% of the newborns showed Vitamin D sufficiency. Maternal and newborn vitamin D levels show a positive correlation. Mean maternal and newborn Vitamin D levels were found to be 16.78±7.04 ng/mL and 11.29±5.75 ng/ml.Conclusions: Vitamin D deficiency is highly prevalent among pregnant women in north India. Low maternal vitamin D levels lead to vitamin D deficiency in the newborns also.

scholarly journals Levels of vitamin D among overweight and obese adolescents: an observational study

2017 ◽  
Vol 4 (6) ◽  
pp. 1934
Author(s):  
T. Prashanth Reddy ◽  
Kishore Reddy ◽  
Madhu Sudhan Reddy ◽  
Manjunath G. A.
Keyword(s):  
Vitamin D ◽  
Observational Study ◽  
Vitamin D Deficiency ◽  
Overweight And Obesity ◽  
Dietary Factors ◽  
Vitamin D Status ◽  
Obese Adolescents ◽  
Vitamin D Levels ◽  
Study Results ◽  
Wide Range

Background: Normal growth and development requires vitamin D, and its deficiency compromises long term health and increases the risk of chronic disease. Severe vitamin D deficiency include rickets, osteomalacia, osteoporosis, increased risk of fracture, tooth loss. Studies indicate that vitamin D insufficiency (less severe than deficiency) is associated with a wide range of illnesses and chronic conditions, including type 1 diabetes, hypertension, multiple sclerosis and many types of cancer. Currently world is facing an unrecognized and untreated pandemic of vitamin D deficiency. This study aims at showing the relation between Vitamin D status and obesity in adolescent children and to know the dietary factors, life style factors like physical activity contributing to overweight and obesity in adolescents.Methods: Study design: This is an observational study of 30 overweight and obese adolescents based on BMI were studied and their Vitamin D levels were assessed.Results: A total of 14(46.7%) overweight and 16(53.3%) obese adolescents Vitamin D levels were assessed. 20(66.7%) had vitamin D levels <20ng/ml that is in the deficiency range.4(13.3%) had in the insufficiency range (21-30ng/ml), 6(20%) had in the sufficient range. Results shows vitamin D levels were significantly less in obese and overweight adolescents.Conclusions: Study results confirm that Vitamin D deficiency or insufficiency is common to obese and overweight adolescents, this may help to explain the relationship between obesity and several chronic diseases that are associated with poor Vitamin D status.

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