Vitamin D intake is inversely associated with rheumatoid arthritis - Results from the Iowa Women's Health Study
Vitamin D intake is inversely associated with rheumatoid arthritis - Results from the Iowa Women's Health Study
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DOI：
10.1002/art.11434
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发表时间：
2004-01-01
影响因子：
--
通讯作者：
Saag, KG
中科院分区：
文献类型：
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作者：
Merlino, LA;Curtis, J;Saag, KG
Objective.维生素D是钙稳态的有效调节剂，并可能具有免疫调节作用。维生素D对人类自身免疫性疾病的影响尚未得到很好的定义。本研究的目的是评估膳食和补充维生素D摄入与类风湿关节炎（RA）发病率的关系。我们分析了一项前瞻性队列研究的数据，该研究包括29,368名年龄在55-69岁之间的女性，在1986年的研究基线时没有RA病史。饮食是使用自我管理，127项验证的食物频率问卷，其中包括补充维生素D的使用确定。采用考克斯比例风险回归估计风险比（RR）和95%置信区间（95% CI），调整潜在的混杂因素。通过11年的随访，152例RA病例与医疗记录进行了验证。维生素D摄入量增加（最高与最低三分位数）与RA风险呈负相关（RR 0.67，95%CI 0.44-1.00，趋势P = 0.05）。膳食（RR 0.72，95% CI 0.46-1.14，趋势P = 0.16）和补充（RR 0.66，95% CI 0.43-1.00，趋势P = 0.03）维生素D的负相关性明显。维生素D含量和/或钙含量高的食物与RA风险没有强相关性，但乳制品的综合指标提示与RA风险呈负相关（RR 0.66，95%CI 0.42-1.01，P = 0.06）。更多的维生素D摄入量可能与老年妇女患RA的风险较低有关，尽管这一发现是假设产生的。
Objective. Vitamin D is a potent regulator of calcium homeostasis and may have immunomodulatory effects. The influence of vitamin D on human autoimmune disease has not been well defined. The purpose of this study was to evaluate the association of dietary and supplemental vitamin D intake with rheumatoid arthritis (RA) incidence.Methods. We analyzed data from a prospective cohort study of 29,368 women of ages 55-69 years without a history of RA at study baseline in 1986. Diet was ascertained using a self-administered, 127-item validated food frequency questionnaire that included supplemental vitamin D use. Risk ratios (RRs) and 95% confidence intervals (95% CIs) were estimated using Cox proportional hazards regression, adjusting for potential confounders.Results. Through 11 years of followup, 152 cases of RA were validated against medical records. Greater intake (highest versus lowest tertile) of vitamin D was inversely associated with risk of RA (RR 0.67, 95% CI 0.44-1.00, P for trend = 0.05). Inverse associations were apparent for both dietary (RR 0.72, 95% CI 0.46-1.14, P for trend = 0.16) and supplemental (RR 0.66, 95% CI 0.43-1.00, P for trend = 0.03) vitamin D. No individual food item high in vitamin D content and/or calcium was strongly associated with RA risk, but a composite measure of milk products was suggestive of an inverse association with risk of RA (RR 0.66, 95% CI 0.42-1.01, P for trend = 0.06).Conclusion. Greater intake of vitamin D may be associated with a lower risk of RA in older women, although this finding is hypothesis generating.