Vitamin D Deficiency as a Risk Factor for Multiple Sclerosis in Women

by | Mar 5, 2018 | 2017, Autoimmune Disease, Multiple Sclerosis, Vitamin D - General, Vitamins

Written by Angeline A. De Leon, Staff Writer. When comparing women diagnosed with multiple sclerosis to appropriate controls, participating women with multiple sclerosis, who had decreasing levels of vitamin D, had an increasing risk of developing multiple sclerosis.

vitamin DVitamin D, often called the “sunshine vitamin”, is a fat-soluble vitamin and an essential nutrient in the human body. Accumulating evidence suggests a connection between a deficiency in dietary intake of this vitamin, which plays a key role in the immune system, and multiple sclerosis (MS), a disabling disease of the nervous system involving the demyelination (deterioration of the protective covering of neurons) of nerve cells in the brain and spinal cord 1. Many studies point to evidence indicating that the prevalence of MS is higher for populations living further from the equator, presumably due to lower exposure to sunshine (and therefore, greater deficiency in vitamin D). Although a limited number of prospective studies have been conducted using measures of 25-hydroxyvitamin D [25(OH)D], representing the amount of usable vitamin D stored in the body, findings unanimously agree that higher levels of 25(OH)D in healthy young adults are associated with reduced risk of later MS development (by about 60%) 2,3. Using a sample of Finnish women, a population with notably low levels of vitamin D, researchers at the National Institute for Health and Welfare conducted an investigation to confirm whether deficiencies in 25(OH) D levels might be associated with increased risk for MS.

The prospective case-control study 4 involved a total of 1,092 women (average age at diagnosis = 37 years) who were diagnosed with MS between 1983 and 2009. Each MS patient was matched to up to three controls based on birth date (+/- 2 years) and area of residence. Levels of 25(OH) D were assessed in pre-diagnostic cases and control samples using a microparticle assay that was performed on stored serum samples.

Findings showed that women who developed MS had pre-diagnostic serum levels of 25(OH) D that were 1.3 nmol/L lower than controls. Across all cases and controls, a 50 nmol/L increase in 25(OH) D corresponded to a 39% decrease in risk of MS (adjusted r2 = 0.61, 95% CI: 0.44-0.85, p = 0.003). In comparison to women with 25(OH)D levels ≥ 50 nmol/L, those with < 30 nmol/L (deficient) were found to have a 43% increased risk of MS (adjusted r2 = 1.43, 95% CI: 1.02-1.99, p = 0.04). Quintile analyses also revealed that women with extreme deficiency (bottom two quintiles, 25(OH)D < 26.8 nmol/L) had a 53-66% increased risk of MS, as compared to women in the top quintiles (25(OH)D ≥ 41 nmol/L) and that the general trend of increasing MS risk with decreasing 25(OH)D levels was significant (p = 0.0001).

Results of the study directly support the role of vitamin D deficiency, as measured based on 25(OH) D levels, in the potential development of MS. In women of reproductive age, achieving vitamin D sufficiency may be an important strategy to preventing future risk of MS. Separate studies looking at vitamin D status and MS development in men are still needed, however, and future work examining the biological mechanisms associated with vitamin D’s role in neurodegenerative disease would be valuable.

Source: Munger, Kassandra L., Kira Hongell, Julia Åivo, Merja Soilu-Hänninen, Heljä-Marja Surcel, and Alberto Ascherio. “25-Hydroxyvitamin D deficiency and risk of MS among women in the Finnish Maternity Cohort.” Neurology 89, no. 15 (2017): 1578-1583.

© 2017 American Academy of Neurologyª Unauthorized reproduction of this article is prohibited.

Posted March 5, 2018.

Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.

References:

  1. Ascherio A, Munger KL. Epidemiology of multiple sclerosis: from risk factors to prevention—an update. Paper presented at: Seminars in neurology2016.
  2. Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. Jama. 2006;296(23):2832-2838.
  3. Salzer J, Hallmans G, Nyström M, Stenlund H, Wadell G, Sundström P. Vitamin D as a protective factor in multiple sclerosis. Neurology. 2012;79(21):2140-2145.
  4. Munger KL, Hongell K, Åivo J, Soilu-Hänninen M, Surcel H-M, Ascherio A. 25-Hydroxyvitamin D deficiency and risk of MS among women in the Finnish Maternity Cohort. Neurology. 2017;89(15):1578-1583.