Exposure to excessive oral vitamin D in youth: a risk factor for celiac disease in later life?

Bittker, Seth

doi:10.7243/2054-9873-2-2

Cited by 4 publications

(6 citation statements)

References 82 publications

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“…However, in Sweden, CD is more prevalent in the southern latitudes than in the northern latitudes,21 the opposite of the pattern seen in the US. In addition, as one of this study’s authors has highlighted previously, time trends of CD incidence tend to mirror time trends of vitamin D fortification and supplementation 22. For example, the significant increase in incidence of CD in Sweden began in 1984,5 within a year after a program of mandatory vitamin D fortification was instituted in Sweden 23…”

Section: Introductionsupporting

confidence: 55%

Potential risk factors for celiac disease in childhood: a case-control epidemiological survey

Bittker¹,

Bell²

2019

CEG

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Background: Celiac disease (CD) prevalence has increased significantly in recent decades in some developed countries. Yet the environmental factors in the existing literature do not appear to provide a satisfactory explanation for this increase. Objective: To determine whether nine variables are associated with CD in children. These variables are: incidence of ear infection before 2 years old, courses of antibiotics before 2 years old, duration of breastfeeding, vitamin D drop exposure in infancy, vitamin D supplement exposure between 2–3 years old, age at gluten introduction into the diet, fat content of cow’s milk consumed between 2–3 years old, quantity of cow’s milk consumed between 2–3 years old, and type of water consumed at 2 years old. Methods: An Internet-based survey was conducted among parents living in the US with at least one biological child between 3 and 12 years old. Potential participants were informed about the survey through social media, websites, electronic newsletters, and advertisements. Results: After exclusions, there remained 332 responses associated with children with CD (cases), and 241 responses associated with children who do not have CD (controls). In this data set, skim milk as the primary form of liquid cow’s milk consumed between 2–3 years old (adjusted odds ratio [aOR]=3.556, CI=1.430–10.22, P =0.010), vitamin D drops administered for more than 3 months (aOR=1.749, CI=1.079–2.872, P =0.025), courses of antibiotics (aOR=1.133, CI=1.037–1.244, P =0.007), and incidence of ear infection (aOR=1.183, CI=1.041–1.348, P =0.010) are all associated with CD in children. Conclusions: This study is the first to find an association between skim milk consumption and CD and vitamin D drop use for greater than 3 months and CD. It also adds to evidence that early life exposure to antibiotics and early life infection, specifically ear infection, are associated with CD.

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Section: Introductionsupporting

confidence: 55%

Potential risk factors for celiac disease in childhood: a case-control epidemiological survey

Bittker¹,

Bell²

2019

CEG

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“…A remaining possible link to sunlight and vitamin D is that pregnant women who give birth in spring have the lowest levels of vitamin D during late gestation when important programming and development of the fetal immune system takes place 39. Another hypothesis suggests increased CD risk due to high levels of vitamin D; this fits the situation in south Sweden 17. This hypothesis is still new and is based on comparisons between countries.…”

Section: Discussionmentioning

confidence: 97%

“…Vitamin D deficiency might be associated to seasonal variations in birth seen in autoimmune diseases including CD. It has also been suggested that vitamin D supplementation could contribute to increased CD risk 17. Geographically, Sweden stretches about 1570 km from north to south, lying between latitudes 55° and 69° North.…”

Section: Introductionmentioning

confidence: 99%

Season and region of birth as risk factors for coeliac disease a key to the aetiology?

et al. 2016

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BackgroundCoeliac disease (CD) incidence has increased in recent decades, characterised by variations according to sex, age at diagnosis, year of birth, month of birth and region of birth. Genetic susceptibility and exposure to gluten are the necessary factors in CD aetiology, although several environmental factors are considered.MethodsA nationwide prospective cohort longitudinal study was conducted consisting of 1 912 204 children aged 0–14.9 years born in Sweden from 1991 to 2009. A total of 6569 children were diagnosed with biopsy-verified CD from 47 paediatric departments. Using Cox regression, we examined the association between CD diagnosis and season of birth, region of birth and year of birth.ResultsOverall, CD risk was higher for children born during spring, summer and autumn as compared with children born during winter: adjusted HR for spring 1.08 (95% CI 1.01 to 1.16), summer 1.10 (95% CI 1.03 to 1.18) and autumn 1.10 (95% CI 1.02 to 1.18). Increased CD risk was highest if born in the south, followed by central Sweden when compared with children born in northern Sweden. Children diagnosed at <2 years had an increased CD risk if born in spring while those diagnosed at 2–14.9 years the risk was increased for summer and autumn births. The birth cohort of 1991–1996 had increased CD risk if born during spring, for the 1997–2002 birth cohort the risk increased for summer and autumn births, while for the birth cohort of 2003–2009 the risk was increased if born during autumn.ConclusionsSeason of birth and region of birth are independently and jointly associated with increased risk of developing CD during the first 15 years of life. Seasonal variation in infectious load is the likely explanation.

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“…Some of the concepts and evidence explored in the present article were initially proposed in a much less developed form 4 years ago in a paper by the author. 15 Additional evidence was obtained and analyzed as part of a retrospective survey study by the author and a collaborator on risk factors for CD in children. 16 The present article further develops this hypothesis, provides additional evidence for it from the literature, and explores how it may explain a number of features of CD epidemiology.…”

Section: Introductionmentioning

confidence: 99%

Elevated Levels of 1,25-Dihydroxyvitamin D in Plasma as a Missing Risk Factor for Celiac Disease

Bittker¹

2020

CEG

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The prevalence of celiac disease (CD) has increased significantly in some developed countries in recent decades. Potential risk factors that have been considered in the literature do not appear to provide a convincing explanation for this increase. This has led some researchers to hypothesize that there is a "missing environmental factor" that increases the risk of CD. Based on evidence from the literature, the author proposes that elevation in plasma levels of 1,25-dihydroxyvitamin D [1,25(OH) 2 D] is a missing risk factor for CD, and relatedly that significant oral vitamin D exposure is a "missing environmental factor" for CD. First, elevated plasma levels of 1,25(OH) 2 D are common in CD, especially in the newly diagnosed. Second, nine distinct conditions that increase plasma levels of 1,25(OH) 2 D are either associated with CD or have indications of such an association in the literature. Third, a retrospective study shows that sustained oral vitamin D supplementation in infancy is associated with increased CD risk, and other studies on comorbid conditions support this association. Fourth, large doses of oral vitamin D upregulate many of the same cytokines, chemokines, and toll-like receptors that are upregulated in CD. Fifth, epidemiological evidence, such as the timing of the inception of a CD "epidemic" in Sweden, the increased prevalence of CD in Finland and the United States in recent decades, the unusually low prevalence of CD in Germany, and the differential in prevalence between Finnish Karelians and Russian Karelians, may all be explained by oral vitamin D exposure increasing CD risk. The same is true of some seemingly contradictory results in the literature on the effects of breastfeeding on CD risk. If future research validates this hypothesis, adjustments to oral vitamin D consumption among those who have genetic susceptibility may decrease the risk of CD in these individuals.

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Exposure to excessive oral vitamin D in youth: a risk factor for celiac disease in later life?

Abstract: Celiac disease is an autoimmune disease initiated by an allergic reaction to gliadin a component of the protein gluten that is found in wheat and other grains.

Cited by 4 publications

References 82 publications

<p>Potential risk factors for celiac disease in childhood: a case-control epidemiological survey</p>

<p>Potential risk factors for celiac disease in childhood: a case-control epidemiological survey</p>

Season and region of birth as risk factors for coeliac disease a key to the aetiology?

<p>Elevated Levels of 1,25-Dihydroxyvitamin D in Plasma as a Missing Risk Factor for Celiac Disease</p>

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