Multiple sclerosis prevalence in Ireland: relationship to vitamin D status and HLA genotype

Lonergan, Roisin; Kinsella, Katie; Fitzpatrick, Patricia; Brady, Jennifer J.; Murray, Barbara; Dunne, Ciaran; Hagan, Richard; Duggan, Marguerite; Jordan, Shawn S.; McKenna, Malachi J.; Hutchinson, Michael; Tubridy, Niall

doi:10.1136/jnnp.2010.220988

Cited by 64 publications

(47 citation statements)

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“…These estimates of risk of vitamin D deficiency are substantially higher than prevalence estimate of 7% in healthy Irish adults in the National Adult Nutrition Survey [6]. While we have noted a marked improvement in vitamin D status in our studies over the past three decades, there are still at-risk groups in Ireland such as pregnant women especially during wintertime [25,[37][38][39][40][41]. We found that birthweight was negatively associated with early pregnancy and neonatal 25OHD.…”

Section: Discussioncontrasting

confidence: 47%

An examination of whether associations exist between maternal and neonatal 25OHD and infant size and adiposity at birth, 6–9 months and 2–2.5 years of age – a longitudinal observational study from the ROLO study

Horan¹,

Donnelly²,

McKenna³

et al. 2017

BMC Nutr

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Section: Discussioncontrasting

confidence: 47%

An examination of whether associations exist between maternal and neonatal 25OHD and infant size and adiposity at birth, 6–9 months and 2–2.5 years of age – a longitudinal observational study from the ROLO study

Horan¹,

Donnelly²,

McKenna³

et al. 2017

BMC Nutr

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“…Other biochemical indices " The serum concentrations of 25OHD were measured by a competitive RIA (Immunodiagnostic Systems Ltd) as described previously (26). The serum concentrations of PTH were measured using an electrochemiluminescence immunoassay on the Elecsys 2010 analyser (Roche Diagnostics) with intra-assay CV values of 2.7, 1.6 and 1.5% and inter-assay CV values of 6.5, 3.9 and 3.0% at concentration values of 26.7, 52.5 and 261 ng/l respectively.…”

Section: Laboratory Methodsmentioning

confidence: 99%

Low-dose hydrocortisone replacement therapy is associated with improved bone remodelling balance in hypopituitary male patients

Behan

Kelleher²,

Hannon³

et al. 2014

European Journal of Endocrinology

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Objective: Glucocorticoid (GC) therapy is associated with adverse effects on bone metabolism, yet the effects of different GC physiological replacement regimens in hypopituitarism are not well characterised. We aimed to assess the effect of three hydrocortisone (HC) replacement dose regimens on bone turnover. Study design: An open cross-over study randomising ten hypopituitary men with severe ACTH deficiency to three commonly used HC dose regimens: dose A (20 mg mane and 10 mg tarde), dose B (10 mg mane and 10 mg tarde) and dose C (10 mg mane and 5 mg tarde). Methods: Following 6 weeks of each regimen, the participants underwent 24-h serum cortisol sampling and measurement of bone turnover markers: bone-specific alkaline phosphatase, procollagen type I N-propeptide (PINP), intact osteocalcin (OC(1-49)), C-terminal cross-linking telopeptide (CTX-I) and tartrate-resistant acid phosphatase 5b (TRACP5b). Bone remodelling balance was estimated as an absolute ratio (PINP:CTX-I) and as an index using standardised scores derived from the matched controls. Results: There were significant increases in the concentrations of the formation markers PINP (PZ0.045) and OC(1-49) (PZ0.006) and in the PINP:CTX-I ratio (PZ0.015), and a more positive bone remodelling balance index (PZ0.03) was observed in patients on the lowest dose C than in those on the highest dose A. Mean 24-h cortisol concentrations correlated negatively with CTX-I (rZK0.66 and PZ0.04) and TRACP5b (rZK0.74 and PZ0.01) in patients on dose B and with OC(1-49) (rZK0.66 and PZ0.04) and CTX-I (rZK0.81 and P!0.01) in patients on dose C. In patients receiving the lower-dose regimen, trough cortisol concentrations correlated with increased bone formation and resorption. Conclusion: Low-dose HC replacement (10 mg mane and 5 mg tarde) is associated with increased bone formation and a positive bone remodelling balance. This may have a long-term beneficial effect on bone health.

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“…In patients with MS living in temperate and Nordic countries, as in the general populations of these countries, vitamin D insufficiency is widespread, whatever the cutoff (50 or 75 nmol/ liter) for the lower limit of the 25-OH-D serum level ( Figure 3): indeed, as early as the earliest stages of the disease, that is, in patients with clinically isolated syndrome (CIS) or with RRMS, average serum levels are between 42 and 74 nmol/ liter, depending on the studies and the seasons, with a general mean close to 60 nmol/liter [SoiluHänninen et al 2005[SoiluHänninen et al , 2012Smolders et al 2008b;Hiremath et al 2009;Kragt et al 2009;Mowry et al 2010;Pierrot-Deseilligny andSouberbielle, 2010, 2012;Simpson et al 2010;Banwell et al 2011;Dabbaghmanesh and Yousefipour, 2011;Lonergan et al 2011;Neau et al 2011;Steffensen et al 2011;Yildiz et al 2011; Bäärnhielm Kampman et al 2012;Kirbas et al 2012;Løken-Amsrud et al 2012;Moen et al 2012;Runia et al 2012;SoiluHänninen et al 2012;Šaltyte . Benth et al 2012;Triantafyllou et al 2012] (Table 1).…”

Section: Vitamin D Requirements and Insufficiencymentioning

confidence: 99%

Contribution of vitamin D insufficiency to the pathogenesis of multiple sclerosis

Pierrot‐Deseilligny

Souberbielle

2013

Ther Adv Neurol Disord

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Abstract:The contribution of vitamin D insufficiency to the pathogenesis of multiple sclerosis (MS) is reviewed. Among the multiple recently discovered actions of vitamin D, an immunomodulatory role has been documented in experimental autoimmune encephalomyelitis and in humans. This action in the peripheral immune system is currently the main known mechanism through which vitamin D might influence MS, but other types of actions could be involved within the central nervous system. Furthermore, vitamin D insufficiency is widespread in temperate countries and in patients with MS at the earliest stages of the disease, suggesting that the deleterious effects related to vitamin D insufficiency may be exerted in these patients. In fact, many genetic and environmental risk factors appear to interact and contribute to MS. In genetics, several human leukocyte antigen (HLA) alleles (more particularly HLA-DRB1*1501) could favour the disease whereas some others could be protective. Some of the genes involved in vitamin D metabolism (e.g. CYP27B1) also play a significant role. Furthermore, three environmental risk factors have been identified: past Epstein-Barr virus infection, vitamin D insufficiency and cigarette smoking. Interactions between genetic and environmental risk or protective factors may occur during the mother's pregnancy and could continue during childhood and adolescence and until the disease is triggered in adulthood, therefore possibly modulating the MS risk throughout the first decades of life. Furthermore, some clinical findings already strongly suggest that vitamin D status influences the relapse rate and radiological lesions in patients with MS, although the results of adequately powered randomized clinical trials using vitamin D supplementation have not yet been reported. While awaiting these incontrovertible results, which might be long in coming, patients with MS who are currently in vitamin D insufficiency should be supplemented, at least for their general health status, using moderate doses of the vitamin.

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Multiple sclerosis prevalence in Ireland: relationship to vitamin D status and HLA genotype

Cited by 64 publications

References 46 publications

An examination of whether associations exist between maternal and neonatal 25OHD and infant size and adiposity at birth, 6–9 months and 2–2.5 years of age – a longitudinal observational study from the ROLO study

An examination of whether associations exist between maternal and neonatal 25OHD and infant size and adiposity at birth, 6–9 months and 2–2.5 years of age – a longitudinal observational study from the ROLO study

Low-dose hydrocortisone replacement therapy is associated with improved bone remodelling balance in hypopituitary male patients

Contribution of vitamin D insufficiency to the pathogenesis of multiple sclerosis

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