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Higher levels of 25-hydroxyvitamin D are associated with a lower incidence of multiple sclerosis only in women

¹ Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
² Department of Molecular Cell Biology, VU University Medical Center, Amsterdam, the Netherlands
³ Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands; Department of Clinical Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
⁴ Department of Endocrinology, VU University Medical Center, Amsterdam, the Netherlands

^* To whom correspondence should be addressed.

	Abstract

Introduction

Multiple sclerosis (MS) is a chronic inflammatory disease with an as yet not fully understood etiological background. The geographical distribution of MS is striking with a prevalence that increases with latitude. For this reason, vitamin D deficiency is considered a possible pathogenic co-factor in MS.

Materials and methods

To study the role of the vitamin D metabolism in MS, blood samples were taken twice (summer and winter) from 103 patients with MS and 110 healthy controls. Serum concentrations of 25-hydroxyvitamin D (25(OH) D) and 1,25-dihydroxyvitamin D (1,25(OH)₂D) were measured, and detailed information on disease characteristics and environmental factors that might influence the vitamin D metabolite levels was collected.

Results

Mean serum 25(OH)D and 1,25(OH)₂D concentrations were significantly higher in summer compared to winter in both patients and controls. Using logistic regression methods, we found that in women for every 10 nmol/L increase of serum 25(OH)D level the odds of MS was reduced by 19% (odds ratio 0.81; 95% confidence interval: 0.69–0.95), suggesting a "protective" effect of higher 25(OH)D serum levels. In addition, also restricted to women, a negative correlation was found between Expanded Disability Status Scale and 25(OH)D levels (r = -0.29, P = 0.020).

Conclusions

Our data suggest that higher circulating levels of 25(OH)D are associated with a lower incidence of MS and MS-related disability in women. This may imply clues to the pathogenesis of the sex difference in risk and to the nature of the environmental factors involved in MS.

Key Words: 1,25(OH)₂D, 25(OH)D, multiple sclerosis, sex difference, vitamin D

First published on August 13, 2008, doi:10.1177/1352458508095920

Multiple Sclerosis 2009;15:9.

A more recent version of this article appeared on January 1, 2009


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