Timing of use of cod liver oil, a vitamin D source, and multiple sclerosis risk: The EnvIMS study.
Timing of use of cod liver oil, a vitamin D source, and multiple sclerosis risk: The EnvIMS study.
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DOI：
10.1177/1352458515578770
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发表时间：
2015-12
期刊：
影响因子：
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通讯作者：
Myhr KM
中科院分区：
文献类型：
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作者：
Cortese M;Riise T;Bjørnevik K;Holmøy T;Kampman MT;Magalhaes S;Pugliatti M;Wolfson C;Myhr KM
维生素 D 水平低与多发性硬化症 (MS) 风险增加有关，但这种关系是否因年龄而异仍不清楚。本文的目的是探讨不同产后年龄通过鱼肝油补充维生素 D3 与 MS 风险之间的关系。在多发性硬化症的环境因素多国病例对照研究 (EnvIMS) 的挪威部分中，共有 953 名最长病程为 10 年的多发性硬化症患者和 1717 名对照者报告了他们从儿童期到成年期的鱼肝油使用情况。自我报告的 13-18 岁补充剂使用与 MS 风险降低相关（OR 0.67，95% CI 0.52-0.86），而儿童时期的补充剂并未发现改变 MS 风险（OR 1.01，95% CI 0.81-1.26），与相应时期不使用补充剂相比。研究发现，MS 风险与青春期鱼肝油剂量之间存在负相关关系，表明存在剂量反应关系（p 趋势 = 0.001），估计维生素 D3 摄入量为 600–800 IU/d 时效果最强（OR 0.46，95% CI 0.31–0.70）。这些发现不仅支持低维生素 D 作为多发性硬化症危险因素的假设，还进一步指出青春期是成年发病多发性硬化症的重要易感期。
Low vitamin D levels have been associated with an increased risk of multiple sclerosis (MS), although it remains unknown whether this relationship varies by age. The objective of this paper is to investigate the association between vitamin D3 supplementation through cod liver oil at different postnatal ages and MS risk. In the Norwegian component of the multinational case-control study Environmental Factors In Multiple Sclerosis (EnvIMS), a total of 953 MS patients with maximum disease duration of 10 years and 1717 controls reported their cod liver oil use from childhood to adulthood. Self-reported supplement use at ages 13–18 was associated with a reduced risk of MS (OR 0.67, 95% CI 0.52–0.86), whereas supplementation during childhood was not found to alter MS risk (OR 1.01, 95% CI 0.81–1.26), each compared to non-use during the respective period. An inverse association was found between MS risk and the dose of cod liver oil during adolescence, suggesting a dose-response relationship (p trend = 0.001) with the strongest effect for an estimated vitamin D3 intake of 600–800 IU/d (OR 0.46, 95% CI 0.31–0.70). These findings not only support the hypothesis relating to low vitamin D as a risk factor for MS, but further point to adolescence as an important susceptibility period for adult-onset MS.