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Open Access Thesis
Master of Science (M.S.)
Year Degree Awarded
Month Degree Awarded
Multiple sclerosis (MS) is a progressive, autoimmune neurodegenerative disorder affecting nearly 350,000 people in the United States and resulting in significant disability. As an immunomodulator, vitamin D may play a role in the development of MS. Previous studies have observed an inverse association of 25-hydroxyvitamin D (25(OH)D) levels and MS risk in younger populations; however, whether this relationship persists in older adults remains unclear. We prospectively investigated the association between predicted 25(OH)D level and incident MS in the Nurses’ Health Study (NHS) (n=121,701) and NHS II (n=116,430). 25(OH)D levels were predicted using validated regression models that include important determinants of vitamin D status, including race, UV-B flux (based on state of residence), physical activity, body mass index, dietary vitamin D intake, alcohol consumption and post-menopausal hormone use. Data on these factors were self-reported on NHS and NHS II questionnaires starting in 1986 and 1991, respectively, and updated every 2-4 years. MS diagnoses were ascertained by self-report and confirmed by medical records. Cox proportional hazards models adjusted for age, ethnicity, latitude of residence at age 15, and BMI at age 18 were used to estimate hazard ratios (HR)s and 95% confidence intervals (CI)s in each cohort. During up to 18 years of follow-up, we documented 179 definite/probable cases of MS with first symptoms after baseline. Multivariable HRs comparing highest and lowest quintiles of predicted 25(OH)D were 1.09 (95% CI: 0.40-2.96) in the NHS and 0.52 (95% CI: 0.28-0.95) in the NHS II. Higher predicted plasma 25(OH)D may be modestly associated with lower risk of MS, primarily in younger women.
Elizabeth R Bertone-Johnson
Susan E Hankinson
Purdue-Smithe, Alexandra, "Predicted 25-hydroxyvitamin D Score and Risk of Multiple Sclerosis in U.S. Women" (2015). Masters Theses. 235.