Neonatal Vitamin D Related to Multiple Sclerosis Risk

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Low levels of neonatal vitamin D may be linked with risk of developing multiple sclerosis.
Low levels of neonatal vitamin D may be linked with risk of developing multiple sclerosis.

Low levels of neonatal vitamin D could be associated with a higher risk of developing multiple sclerosis (MS) later in life, suggests a study published in Neurology.1

Higher serum 25-hydroxyvitamin D (25[OH]D) levels and higher dietary intake of vitamin D have been suggested to be linked with a lower risk of developing MS. In addition, among individuals of European descent, alleles related to lower vitamin D levels correlated with greater risk of MS. However, the time period in which individuals are susceptible to the effects that vitamin D levels have on MS risk has not been determined.2

“Although some controversy does exist, patients with MS from the Northern hemisphere seem to be more likely to be born in April and May, just after the very low winter levels of vitamin D, which could suggest that in utero exposure to vitamin D insufficiency could be relevant for the risk of MS,” study author Nete Munk Nielsen, MD, MSc, PhD, of Statens Serum Institut in Denmark told Neurology Advisor in an interview.

A Swedish study found no relationship between neonatal 25(OH)D levels and MS risk, but the results may have been affected by degradation of dried blood spot samples due to storage methods.3,4 In a Finnish study, the MS risk was nearly doubled among individuals whose mothers had vitamin D deficiency during early pregnancy.5

Dr Nielsen and colleagues evaluated the relationship between neonatal vitamin D levels and MS risk in a case-control study based on data from the Danish MS registry and the Danish Newborn Screening Biobank (DNSB).1

Concentrations of 25(OH)D were measured in dried blood spot samples from the DNSB for 521 patients with MS and 972 sex- and age-matched controls. Levels of 25(OH)D were quantified using liquid chromatography tandem mass spectroscopy. Individuals were then stratified into quintiles based on 25(OH)D concentration, with the bottom and top quintiles defined as <20.7 nmol/L and ≥48.9 nmol/L, respectively.1

The risk of MS appeared to be lowest among individuals in the top quintile and highest among individuals in the bottom quintile (top vs bottom odds ratio [OR], 0.53).

The  results of this study suggest that low neonatal vitamin D levels appear to be  associated with a higher risk of MS later in life. “The mechanism behind this possible association is, however, unknown. It is important to point out that this study does not prove that increasing vitamin D levels reduces the risk of MS and that further studies are needed to confirm our results,” Dr Nielsen told Neurology Advisor.

This study does have several important limitations to consider. We only looked at individuals who developed MS at a young age. Thus, our results may not apply to all MS cases,” Dr Nielsen said. “The Danish population is predominantly white, so our results may not be generalizable to other populations. Furthermore, we cannot exclude that the observed association could be mediated through other factors or vitamin D levels later in life.”

Dr Nielsen noted that pregnant women, infants, children, and adults should always follow vitamin D recommendations from health authorities; vitamin D levels should be within recommended levels, neither too low nor too high. 

References

  1. Nielsen NM, Munger KL, Koch-Henriksen N, et al. Neonatal vitamin D status and risk of multiple sclerosis: A population-based case-control study. Neurology. Published online: November 30, 2016. pii: 10.1212/WNL.0000000000003454.
  2. Marrie RA, Daumer M. A gestational dose of vitamin D per day keeps the MS doctor away. Neurology. Published online: November 30, 2016. pii: 10.1212/WNL.0000000000003469.
  3. Ueda P, Rafatnia F, Bäärnhielm M, et al. Neonatal vitamin D status and risk of multiple sclerosis. Ann Neurol. 2014;76(3):338-46. doi: 10.1002/ana.24210.
  4. Ascherio A, Munger KL. Not too late to take vitamin D supplements. Ann Neurol. 2014;76(3):321-2. doi: 10.1002/ana.24239.
  5. Munger KL, Åivo J, Hongell K, et al. Vitamin D Status During Pregnancy and Risk of Multiple Sclerosis in Offspring of Women in the Finnish Maternity Cohort. JAMA Neurol. 2016;73(5):515-9. doi: 10.1001/jamaneurol.2015.4800.
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