Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Oct 10;89(15):1578-1583.
doi: 10.1212/WNL.0000000000004489. Epub 2017 Sep 13.

25-Hydroxyvitamin D deficiency and risk of MS among women in the Finnish Maternity Cohort

Kassandra L Munger  1 , Kira Hongell  2 , Julia Åivo  2 , Merja Soilu-Hänninen  2 , Heljä-Marja Surcel  2 , Alberto Ascherio  2
Affiliations

25-Hydroxyvitamin D deficiency and risk of MS among women in the Finnish Maternity Cohort

Kassandra L Munger et al. Neurology. .

Abstract

Objective: To determine whether and to what extent vitamin D deficiency is associated with multiple sclerosis (MS) risk.

Methods: We conducted a prospective nested case-control study among women in the Finnish Maternity Cohort (FMC). The FMC had 1.8 million stored serum samples taken during the pregnancies of over 800,000 women at the time of this study. Through linkages with hospital and prescription registries, we identified 1,092 women with MS diagnosed between 1983 and 2009 with at least 1 serum sample collected prior to date of MS diagnosis; ≥2 serum samples were available for 511 cases. Cases were matched to up to 3 controls (n = 2,123) on date of birth (±2 years) and area of residence. 25-Hydroxyvitamin D (25[OH]D) levels were measured using a chemiluminescence assay. We used conditional logistic regression adjusted for year of sample collection, gravidity, and parity to estimate relative risks (RRs) and 95% confidence intervals (CIs).

Results: A 50 nmol/L increase in 25(OH)D was associated with a 39% reduced risk of MS (RR 0.61, 95% CI 0.44-0.85), p = 0.003. Women with 25(OH)D levels <30 nmol/L had a 43% higher MS risk (RR 1.43, 95% CI 1.02-1.99, p = 0.04) as compared to women with levels ≥50 nmol/L. In women with ≥2 samples, MS risk was 2-fold higher in women with 25(OH)D <30 nmol/L as compared to women with 25(OH)D ≥50 nmol/L (RR 2.02, 95% CI 1.18-3.45, p = 0.01).

Conclusions: These results directly support vitamin D deficiency as a risk factor for MS and strengthen the rationale for broad public health interventions to improve vitamin D levels.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Finnish Maternity Cohort (FMC) multiple sclerosis (MS) study population
Figure 2
Figure 2. Variation in 25-hydroxyvitamin D (25[OH]D) levels by month and year of collection
(A) Variation in 25(OH)D levels by month of serum sample collection. (B) Average 25(OH)D levels by calendar year of sample collection. *Only 1 sample collected in 2009.
Figure 3
Figure 3. Association between 25-hydroxyvitamin D (25[OH]D) a priori categories and multiple sclerosis (MS) risk
(A) Relative risk for MS in women in the Finnish Maternity Cohort (FMC) by a priori category of 25(OH)D in all cases and matched controls. (B) Relative risk for MS in women in the FMC by a priori category of 25(OH)D in all cases and matched controls with 2 or more samples. Error bars indicate 95% confidence intervals.
Figure 4
Figure 4. Association between 25-hydroxyvitamin D (25[OH]D) quintiles and multiple sclerosis (MS) risk
Relative risk for MS in women in the Finnish Maternity Cohort by quintiles of 25(OH)D in all cases and matched controls. Error bars indicate 95% confidence intervals.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ascherio A, Munger KL. Epidemiology of multiple sclerosis: from risk factors to prevention: an update. Semin Neurol 2016;36:103–114. - PubMed
    1. Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA 2006;296:2832–2838. - PubMed
    1. Salzer J, Hallmans G, Nystrom M, Stenlund H, Wadell G, Sundstrom P. Vitamin D as a protective factor in multiple sclerosis. Neurology 2012;79:2140–2145. - PubMed
    1. Viljakainen HT, Saarnio E, Hytinantti T, et al. . Maternal vitamin D status determines bone variables in the newborn. J Clin Endocrinol Metab 2010;95:1749–1757. - PubMed
    1. Poser C, Paty D, Scheinberg L, et al. . New diagnostic criteria for multiple sclerosis. Ann Neurol 1983;13:227–231. - PubMed