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.

项目概要 尽管治疗取得了进展并且新药很有前景，但多发性硬化症 (MS) 仍然是一种慢性疾病 进行性疾病对受影响者及其家庭和社会的生活质量产生重大影响。更远， 美国黑人和世界多个地区所有种族的女性中多发性硬化症的发病率正在增加。 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， 可能是可修改的，有助于确定多发性硬化症风险。维生素 D 可能是这些因素之一，但是 关于维生素 D 在多发性硬化症（尤其是黑人）中的作用仍然存在疑问。十年前，我们发表了 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中 25- 与水平较低的人相比，羟基维生素 D (25(OH)D) 患 MS 的风险降低 62%。这一发现， 后来多项研究证实，它具有重大的公共卫生影响，因为它支持 认为可以通过增加维生素 D 水平来阻止或逆转多发性硬化症发病率的持续增加。一个 然而，重要的限制是，维生素 D 与 MS 风险之间的负相关关系不能被证实。 普遍适用于黑人。此外，目前尚不清楚维生素 D 水平是否仅在儿童时期和 青春期还是成年期，男性和女性在维生素方面是否有差异 预防 MS 所需的 D 水平。回答这些问题对于转化研究结果至关重要 纳入健全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 从超过 1000 万人在美国军队现役期间收集的样本以及超过 60 国防部血清库中储存了 100 万份血清样本。多种血液的可用性 MS 发病前每个人的样本可以准确估计长期平均值 25(OH)D 水平以及研究人群的多样化构成将首次获得准确的估计 研究美国黑人中维生素 D 与多发性硬化症风险之间的关系，以确定两者之间的关系是否 25(OH)D 和 MS 风险因年龄或性别而改变，并探索基因与环境的相互作用 潜在的重要公共卫生影响。