Vitamin D: A Candidate for the Environmental Effect in Multiple Sclerosis – Observations from Norway

Kampman, Margitta T.; Brustad, Magritt

doi:10.1159/000122330

Cited by 95 publications

(55 citation statements)

References 119 publications

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“…Changes in lifestyle and environmental factors, that may trigger or influence MS development, have been increasingly defined. Habits that reduce the availability of vitamin D, such as abuse of sunscreen and rare fatty fish consumption, might account for the increased prevalence of MS [22][23]. Indeed, increased outdoor activity during summer and rare consumption of fish (both sources of vitamin D) are associated with a decreased risk of MS [24], the latter observation being confirmed also in a more recent study [25].…”

Section: Discussionmentioning

confidence: 72%

Multiple Sclerosis Incidence and Prevalence Trends in the Province of Padua, Northeast Italy, 1965–2018

et al. 2018

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Background: Previous studies, dating back to the 1960s disclosed a progressive increase in multiple sclerosis (MS) incidence and prevalence in the Province of Padua. To further analyze whether this trend is the effect of the improved diagnostic procedures or is primarily related to a real increase risk of MS, we analyzed MS incidence and prevalence of the 5-year period 2011–2015. Methods: Patients with a diagnosis of MS or clinically isolated syndrome highly suggestive of MS were included in the study. All available sources of clinical and administrative information were evaluated. Mean annual incidence in the 5-year period 2011–2015 and the prevalence on December 31, 2015 were calculated. Results: The 2011–2015 mean incidence was 6.5/100,000/year, 7.9 for females, 4.1 for males. The overall prevalence was 182/100,000, 241 for females, 116 for males. Compared to the 2000–2009 period, mean age at onset, onset-diagnosis delay and F/M ratio did not significantly change. Since the 1960s, incidence and prevalence of MS linearly increased with no interposed plateau periods. Conclusions: MS incidence and prevalence further and significantly increased in the period 2011–2015. Our 1965–2015 data indicate a real increased risk of MS and stress a role of exogenous factors in MS susceptibility.

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Section: Discussionmentioning

confidence: 72%

Multiple Sclerosis Incidence and Prevalence Trends in the Province of Padua, Northeast Italy, 1965–2018

et al. 2018

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“…Also, vitamin D deficiency or insufficiency has been reported to be prevalent in MS patients, especially those with higher disability [6,24,26,36]. Evidence is accumulating that poor vitamin D status may play a role in the etiology and pathogenesis of MS [14,23], which might put persons with MS also at risk for low peak bone mass.…”

Section: Introductionmentioning

confidence: 99%

Predictors and prevalence of low bone mineral density in fully ambulatory persons with multiple sclerosis

2009

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The implications of having multiple sclerosis (MS) for bone health are incompletely understood. The aim of this population-based study is to identify past and current exposures that are associated with bone mass in fully ambulatory persons with MS up to age 50 years and to determine the prevalence of low bone mineral density (BMD) in this group. We measured BMD (hips, lumbar spine, forearms), physical function, BMI, and serum 25(OH) vitamin D in 55 women and 25 men with MS. Patients provided information on demographic variables and medical history, as well as past and current vitamin D and calcium intake, physical activity, and lifestyle habits. In regression analyses, BMD levels were adjusted for age, sex, and BMI. At the femoral neck, strong associations were found for walking distance (beta = 0.152; P < 0.001) and age (beta = -0.004; P = 0.003), and less certain associations for male sex (beta = 0.055; P = 0.014) and 10-foot timed tandem walk (-0.008; P = 0.013). At the lumbar spine, walking distance (beta = 0.013; P = 0.006) and possibly physical activity growing up (beta = 0.035; P = 0.028) and male sex (beta = -0.057; P = 0.042), were associated with BMD. At the ultradistal radius, strength of grip (beta = 0.001; P = 0.002), and, less certainly, summer outdoor activities age 16-20 (beta = 0.021; P = 0.009), and age at MS onset (beta = 0.002; P = 0.036) were associated with BMD. Low BMD (z score < or = -2) was present in 19 out of 80 patients. This study shows that MS-related variables as well as past exposures differentially affect BMD at three clinically important skeletal sites. Low BMD is prevalent in these young patients. Bone health should receive attention in care for persons with MS.

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“…The pattern of its distribution across the globe is believed to be irregular with several exceptions; however, it shows higher prevalence in regions away from the equator (higher altitudes) where there is lower sunlight exposure (46,47). A recent study has provided substantial evidence in support of latitude gradient shown by MS prevalence (48).…”

Section: Ms Risk and Vitamin Dmentioning

confidence: 99%

Vitamin D and Multiple Sclerosis: An Update

Zahoor

Haq

2017

Multiple Sclerosis: Perspectives in Treatment and Pathogenesis

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Multiple sclerosis (MS) is a long-lasting inflammatory neurodegenerative disease of the central nervous system caused by an inappropriate attack of the body' s immune system on its own cells. To date, its etiology remains highly enigmatic, with insufficient evidence on the exact cause triggering the disease. Many studies have highlighted the role of different environmental and genetic factors in its etiopathogenesis, each adding a new wedge to MS conundrum and therefore making it a multifactorial and polygenic disease. One of the entrants in the risk factor category for MS is vitamin D, and there is sufficient evidence to suggest its role in increasing the risk of MS development. MS patients have lower levels of vitamin D, and in conjunction with other factors like low sunlight intensity and genetic variations in vitamin D metabolic pathway genes, vitamin D has been adjudged as a potent risk factor for MS. The biological effects of vitamin D in the body are mediated by the vitamin D receptor that acts as a transcription factor after activation by vitamin D and subsequent heterodimerization with the retinoid-X receptor. This allows regulation of protein expression of target genes involved in diverse cellular processes including immune response and vitamin D metabolism. It clearly suggests use of vitamin D supplementation as an unconventional option for MS treatment; however, much work needs to be done to precisely determine the level and/or dosage of vitamin D required for achieving optimum therapeutic response in patients without causing adverse effects.

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Vitamin D: A Candidate for the Environmental Effect in Multiple Sclerosis – Observations from Norway

Cited by 95 publications

References 119 publications

Multiple Sclerosis Incidence and Prevalence Trends in the Province of Padua, Northeast Italy, 1965–2018

Multiple Sclerosis Incidence and Prevalence Trends in the Province of Padua, Northeast Italy, 1965–2018

Predictors and prevalence of low bone mineral density in fully ambulatory persons with multiple sclerosis

Vitamin D and Multiple Sclerosis: An Update

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