Prospective Study of Vitamin D and Multiple Sclerosis

维生素 D 与多发性硬化症的前瞻性研究

• 批准号: 8286426
• 负责人: ALBERTO ASCHERIO
• 金额: $ 50.33万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-03-01 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8286426
• 关键词: 14 year old; 20 year old; 25-hydroxyvitamin D; Address; Adolescence; Affect; Age; Air; Air Force Personnel; Antibodies; Army Personnel; Autoimmune Diseases; Blood; Blood specimen; Child; Chronic Disease; Collection; Cotinine; Data; Department of Defense; Dependence; Diabetes prevention; Disease; Dose; Epidemiology; Ethnic group; Etiology; Funding; Grant; Hispanics; Housing; Human Herpesvirus 4; Incidence; Individual; Infection; Insulin-Dependent Diabetes Mellitus; Intervention; Investigation; Lead; Life; Marines; Measures; Methods; Military Personnel; Multiple Sclerosis; Nature; Navy Personnel; Nested Case-Control Study; Not Hispanic or Latino; Outcome; Phase; Population; Population Study; Prevention; Prospective Studies; Public Health; Race; Reporting; Respiratory Tract Infections; Risk; Risk Factors; Role; Sample Size; Sampling; Seasons; Serum; Smoking; Supplementation; Testing; Time; United States; Vitamin D; base; case control; critical period; design; diabetes risk; economic cost; follow-up; non-genetic; prevent; prospective; protective effect; randomized trial; repository; response; young adult

DESCRIPTION (provided by applicant): We propose to continue and expand our ongoing prospective study on serum 25-hydroxyvitamin D (25(OH)D) levels and risk of multiple sclerosis (MS) among US military personnel. During the first phase of this project, we found that non-Hispanic white individuals with higher levels of serum 25(OH)D have a markedly reduced risk of developing MS. Results of dose-response analyses seemed to suggest a threshold effect -- at levels above 100 nmol/L MS risk was reduced by half as compared with levels below 100 nmol/L, whereas no significant changes in MS risk were observed at lower levels -- however, a moderate protective effect of lower levels of 25(OH)D could not be excluded because of the insufficient sample size. Further, risk of MS was ten times lower among individuals with 25(OH)D levels above 100 nmol/L before the age of 20 -- a result that supports the notion that adolescence could be a critical period for MS etiology. We now propose to expand this study by increasing our MS cases from 315 to 775 by extending our ongoing follow-up through 2011 in the US Army and Navy and including cases of MS occurring among Air Force personnel. This will allow us to explore more closely the potentially important associations with age and the nature of the dose-response relationship. We will also increase our sample size among blacks, increasing our power to examine these associations in this group. We also propose to expand our study to include examining the association between serum 25(OH)D and type 1 diabetes (T1D)-another autoimmune disease for which studies suggest a protective effect of vitamin D-among Army and Navy personnel. We expect to have 730 T1D cases for the analysis. The proposed investigation will continue to take advantage of the Department of Defense Serum Repository, which houses over 30 million serum samples from over 7 million US military personnel. Strengths of this study include not only the prospective design, but that multiple serum samples are available for most individuals, so that we can estimate long-term 25(OH)D status, as well as examine more closely potential age and seasonal effects of 25(OH)D on risk of MS or T1D. We propose to examine whether blood levels of vitamin D in healthy young adults predict their risk of developing multiple sclerosis and type 1 diabetes, which are disabling, chronic diseases primarily affecting individuals early in life, causing substantial personal and economic costs. This project, which takes advantage of a unique repository harboring over 30 million blood samples collected from healthy young adults, has the potential to identify interventions that could lead to the prevention of a significant number of cases of these diseases.

描述（由申请人提供）：我们建议继续并扩大我们正在进行的关于美国军事人员血清 25-羟基维生素 D (25(OH)D) 水平和多发性硬化症 (MS) 风险的前瞻性研究。在该项目的第一阶段，我们发现血清 25(OH)D 水平较高的非西班牙裔白人患 MS 的风险显着降低。剂量反应分析的结果似乎表明存在阈值效应——与低于 100 nmol/L 的水平相比，在高于 100 nmol/L 的水平下，MS 风险降低了一半，而在较低水平下，未观察到 MS 风险的显着变化。 - 然而，由于样本量不足，不能排除较低水平的 25(OH)D 的中等保护作用。此外，20 岁之前 25(OH)D 水平高于 100 nmol/L 的个体患 MS 的风险要低十倍——这一结果支持了青春期可能是 MS 病因学的关键时期的观点。现在，我们建议扩大这项研究，将美国陆军和海军的多发性硬化症病例从 315 例增加到 775 例，并将我们在美国陆军和海军的持续随访时间延长至 2011 年，并将空军人员中发生的多发性硬化症病例纳入其中。这将使我们能够更密切地探索与年龄和剂量反应关系性质的潜在重要关联。我们还将增加黑人的样本量，从而增强我们检查该群体中这些关联的能力。我们还建议扩大我们的研究范围，包括检查血清 25(OH)D 与 1 型糖尿病 (T1D) 之间的关联——另一种自身免疫性疾病，研究表明维生素 D 对陆军和海军人员具有保护作用。我们预计有 730 个 T1D 病例用于分析。拟议的调查将继续利用国防部血清库，该库保存有来自超过 700 万美国军人的超过 3000 万份血清样本。这项研究的优点不仅包括前瞻性设计，还包括大多数人可以获得多个血清样本，因此我们可以估计长期 25(OH)D 状态，并更仔细地检查 25 的潜在年龄和季节影响。 (OH)D 罹患 MS 或 T1D 的风险。我们建议检查健康年轻人血液中的维生素 D 水平是否可以预测他们患多发性硬化症和 1 型糖尿病的风险，这些疾病是致残性慢性疾病，主要影响个人生命早期，造成巨大的个人和经济损失。该项目利用了一个独特的存储库，其中包含从健康年轻人收集的超过 3000 万份血液样本，有可能确定可以预防大量此类疾病病例的干预措施。

项目成果

Preclinical serum 25-hydroxyvitamin D levels and risk of type 1 diabetes in a cohort of US military personnel.

一组美国军事人员的临床前血清 25-羟基维生素 D 水平和 1 型糖尿病风险。

• 发表时间: 2013-03-01
• 影响因子: 5
• 作者: Munger, Kassandra L;Levin, Lynn I;Massa, Jennifer;Horst, Ronald;Orban, Tihamer;Ascherio, Alberto
• 通讯作者: Ascherio, Alberto

Childhood body mass index and multiple sclerosis risk: a long-term cohort study.

儿童体重指数和多发性硬化症风险：一项长期队列研究。

• 发表时间: 2013-09
• 作者: Munger, Kassandra L;Bentzen, Joan;Laursen, Bjarne;Stenager, Egon;Koch;Sørensen, Thorkild I A;Baker, Jennifer L
• 通讯作者: Baker, Jennifer L

Neonatal vitamin D status and risk of multiple sclerosis: A population-based case-control study.

新生儿维生素 D 状态和多发性硬化症风险：一项基于人群的病例对照研究。

• 发表时间: 2017-01-03
• 影响因子: 9.9
• 作者: Nielsen, Nete Munk;Munger, Kassandra L;Koch;Hougaard, David M;Magyari, Melinda;Jørgensen, Kristian T;Lundqvist, Marika;Simonsen, Jacob;Jess, Tine;Cohen, Arieh;Stenager, Egon;Ascherio, Alberto
• 通讯作者: Ascherio, Alberto

XVI European Charcot Foundation lecture: nutrition and environment: can MS be prevented?

第十六届欧洲夏科基金会讲座：营养与环境：多发性硬化症可以预防吗？

• 发表时间: 2011-12-15
• 影响因子: 4.4
• 作者: Simon, Kelly Claire;Munger, Kassandra L;Ascherio, Alberto
• 通讯作者: Ascherio, Alberto

Increased risk of multiple sclerosis among women with migraine in the Nurses' Health Study II.

护士健康研究 II 中患有偏头痛的女性患多发性硬化症的风险增加。

• 发表时间: 2012-01
• 作者: Kister, Ilya;Munger, Kassandra L;Herbert, Joseph;Ascherio, Alberto
• 通讯作者: Ascherio, Alberto