Prospective Study of Vitamin D and MS Risk in African Americans

非裔美国人维生素 D 和多发性硬化症风险的前瞻性研究

• 批准号: 10242084
• 负责人: ALBERTO ASCHERIO
• 金额: $ 42.66万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-15 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10242084
• 关键词: 20 year old; 25-hydroxyvitamin D; Address; Adolescence; Adolescent and Young Adult; Adult; Affect; African American population; Age; Army Personnel; Black Populations; Blood specimen; Certification; Childhood; Chronic; Country; Data; Department of Defense; Environmental Risk Factor; Etiology; Family; Finland; Future; Gender; Genes; Genetic; Guidelines; HLA-DRB1; Hispanic Populations; Incidence; Individual; Intervention; Investigation; Knowledge; Laboratories; Life; Longitudinal Studies; Measures; Mendelian randomization; Military Personnel; Multiple Sclerosis; Navy Personnel; Not Hispanic or Latino; Paper; Prevention; Progressive Disease; Prospective Studies; Public Health; Public Health Practice; Publishing; Quality of life; Race; Recommendation; Reporting; Research; Risk; Risk Factors; Role; Sampling; Serum; Societies; Solid; Standardization; Sweden; Testing; Time; Translating; Translational Research; Translations; Uncertainty; Variant; Vitamin D; Vitamin D-Binding Protein; Woman; active duty; evidence base; gene environment interaction; men; modifiable risk; nervous system disorder; novel therapeutics; prevent; programs; prospective; public health intervention; repository; risk variant; sound; study population; young adult

PROJECT SUMMARY In spite of progress in treatment and promising new drugs multiple sclerosis (MS) continues to be a chronic progressive disease with a high impact on the quality of life of those affected, their families, and society. Further, MS incidence is increasing among US Blacks and among women of all races in several regions in the world. These rapid increases cannot be explained by genetic factors, and strongly suggest that environmental factors, possibly modifiable, are contributing to determine MS risk. Vitamin D is likely to be one of these factors, but questions remain on the role of vitamin D in MS particularly among blacks. Ten years ago, we published a landmark paper reporting that young healthy non-Hispanic white adults with higher serum levels of 25- hydroxyvitamin D (25(OH)D) had a 62% lower risk of developing MS than those with lower levels. This finding, which has been later confirmed in multiple studies, has major public health implications because it supports the notion that the ongoing increase in MS incidence could be halted or reversed by increasing vitamin D levels. An important limitation, however, is that this inverse association between vitamin D and MS risk cannot be generalized to blacks. Further, it remains unclear whether vitamin D levels important only during childhood and adolescence or also during adult life, and whether there are differences between men and women in the vitamin D levels needed to prevent MS. Answering these questions is critical to be able to translate the research findings into sound and effective public health interventions. The proposed study relies on the unique data and blood samples collected from over 10 million individuals during their active duty within the US military and over 60 million serum samples stored in the Department of Defense Serum Repository. The availability of multiple blood samples from each individual prior to MS onset allows an accurate estimate of long term average 25(OH)D levels, and the diverse composition of the study population will allow for the first time to obtain accurate estimates of the relation between vitamin D and MS risk among US blacks, to determine whether the relation between 25(OH)D and MS risk is modified by age or gender, and to explore gene-environment interactions that have potentially important public health implications.

项目摘要 尽管在治疗和有希望的新药中取得了进展，多发性硬化症（MS）仍然是慢性 进行性疾病，对受影响者，家庭和社会的生活质量产生很大影响。更远， 美国黑人和世界上所有种族的妇女中的发病率正在增加。 这些快速增加不能用遗传因素来解释，并强烈表明环境因素， 可能可修改，有助于确定MS风险。维生素D可能是这些因素之一，但 关于维生素D在MS中的作用，尤其是黑人中的问题。十年前，我们出版了 具有里程碑意义的论文，报道年轻健康的非西班牙裔白人成年人，血清水平较高25-- 羟基维生素D（25（OH）D）比水平较低的MS的风险低62％。这个发现， 后来在多项研究中得到了证实，具有重大的公共卫生影响，因为它支持 观点是，通过增加维生素D水平可以阻止MS发病率的持续增加或逆转。一个 然而，重要的限制是，维生素D和MS风险之间的这种反相关性不可能是 概括为黑人。此外，尚不清楚维生素D含量仅在儿童时期和 青春期或成人生活，以及维生素中男女之间的差异 d级别以防止MS。回答这些问题对于能够翻译研究结果至关重要 进入合理有效的公共卫生干预措施。拟议的研究依赖于独特的数据和血液 在美国军方的现役期间，从超过1000万个人和60多人中收集了样本 国防部血清存储库中存储的百万血清样品。多血的可用性 MS发作之前每个人的样本允许精确估计长期平均25（OH）D 水平，研究人群的多样化组成将首次获得准确的估计 美国黑人中维生素D和MS风险之间的关系，以确定是否之间 25（OH）D和MS风险通过年龄或性别来改变，并探索具有的基因环境相互作用 潜在的重要公共卫生影响。