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      Epidemiology of multiple sclerosis and vitamin D levels in Lanzarote, Canary Islands, Spain

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          Abstract

          Background

          Low levels of 25-hydroxyvitamin D (25(OH)D) have been described as one of the possible environmental factors involved in multiple sclerosis (MS) etiopathogenesis.

          Objectives

          To study epidemiology of MS and 25(OH)D serum levels of patients in Lanzarote (29°02′06″N), a region with high ultraviolet radiation values during the whole year which is located far apart from Iberian Peninsula (36°–43°N), but without genetic/ethnic differences with it.

          Methods

          Incidence in Lanzarote was assessed according to McDonald 2005 criteria between January 2008 and December 2015 and prevalence date was 12/31/15. For 25(OH)D serum levels analyses, samples from 60 MS patients and 60 healthy donors (HD) were collected monthly in a one-year prospective study.

          Results

          The prevalence of MS in Lanzarote was 50.0/100,000 and the incidence per year was 2.5/100,000. Median 25(OH)D levels values were 29.1 ng/ml for MS patients (maximum = 36.1 ng/ml, minimum = 22.5 ng/ml) and 27.1 ng/ml for HD (maximum = 34.8 ng/ml, minimum = 22.8 ng/ml). There were no significant differences between 25(OH)D serum levels between MS patients and HD.

          Conclusions

          Lanzarote possesses lower prevalence and incidence values than peninsular Spain. Moreover, 25(OH)D serum levels do not differ between MS patients and HD.

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          Most cited references17

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          Update in vitamin D.

          The past decade, particularly the last 18 months, witnessed a vigorous increase in interest in vitamin D from both the lay and biomedical worlds. Much of the growing interest in vitamin D is powered by new data being extracted from the National Health and Nutrition Examination Survey (NHANES). The newest statistics demonstrate that more than 90% of the pigmented populace of the United States (Blacks, Hispanics, and Asians) now suffer from vitamin D insufficiency (25-hydroxyvitamin D <30 ng/ml), with nearly three fourths of the white population in this country also being vitamin D insufficient. This represents a near doubling of the prevalence of vitamin D insufficiency seen just 10 yr ago in the same population. This review attempts to provide some explanation for: 1) the rapid decline in vitamin D status in the United States; 2) the adverse impact of vitamin D insufficiency on skeletal, infectious/inflammatory, and metabolic health in humans; and 3) the therapeutic rationale and reliable means for vigorous supplementation of our diets with vitamin D.
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            Temporal trends in the incidence of multiple sclerosis: a systematic review.

            Multiple sclerosis (MS) has been traditionally considered to be more frequent in women and in regions more distant from the equator. However, recent reports suggest that the latitude gradient could be disappearing and that the female-to-male ratio among patients with MS has increased in the last decades. We have conducted a systematic review of incidence studies of MS to assess the overall incidence of MS and explore possible changes in the latitude gradient and the female-to-male ratio over time. Systematic review of incidence studies of MS published in Medline between 1966 and February 2007. Age- and sex-specific incidence rates were collected from eligible publications. We computed age-adjusted rates using the world population as standard, and assessed differences in rates according to latitude and period of case ascertainment. Additionally, we evaluated the association between period of case ascertainment and the female-to-male ratio. The overall incidence rate of MS was 3.6 cases per 100,000 person-years (95% CI 3.0, 4.2) in women and 2.0 (95% CI 1.5, 2.4) in men. Higher latitude was associated with higher MS incidence, though this latitude gradient was attenuated after 1980, apparently due to increased incidence of MS in lower latitudes. The female-to-male ratio in MS incidence increased over time, from an estimated 1.4 in 1955 to 2.3 in 2000. The latitude gradient present in older incidence studies of multiple sclerosis (MS) is decreasing. The female-to-male MS ratio has increased in the last five decades.
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              Past exposure to sun, skin phenotype, and risk of multiple sclerosis: case-control study.

              To examine whether past high sun exposure is associated with a reduced risk of multiple sclerosis. Population based case-control study. Tasmania, latitudes 41-3 degrees S. 136 cases with multiple sclerosis and 272 controls randomly drawn from the community and matched on sex and year of birth. Multiple sclerosis defined by both clinical and magnetic resonance imaging criteria. Higher sun exposure when aged 6-15 years (average 2-3 hours or more a day in summer during weekends and holidays) was associated with a decreased risk of multiple sclerosis (adjusted odds ratio 0.31, 95% confidence interval 0.16 to 0.59). Higher exposure in winter seemed more important than higher exposure in summer. Greater actinic damage was also independently associated with a decreased risk of multiple sclerosis (0.32, 0.11 to 0.88 for grades 4-6 disease). A dose-response relation was observed between multiple sclerosis and decreasing sun exposure when aged 6-15 years and with actinic damage. Higher sun exposure during childhood and early adolescence is associated with a reduced risk of multiple sclerosis. Insufficient ultraviolet radiation may therefore influence the development of multiple sclerosis.
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                Author and article information

                Contributors
                Journal
                PeerJ
                PeerJ
                peerj
                peerj
                PeerJ
                PeerJ Inc. (San Diego, USA )
                2167-8359
                18 December 2019
                2019
                : 7
                : e8235
                Affiliations
                [1 ]Grupo de Investigación de Factores Ambientales en Enfermedades Degenerativas, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos , Madrid, Spain
                [2 ]Servicio de Neurología, Hospital Doctor José Molina Orosa , Lanzarote, Spain
                [3 ]Servicio de Análisis Clínicos, Hospital Doctor José Molina Orosa , Lanzarote, Spain
                [4 ]Servicio de Análisis Clínicos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos , Madrid, Spain
                [5 ]Servicio de Neurología, Hospital Universitario Quirónsalud Madrid , Madrid, Spain
                Article
                8235
                10.7717/peerj.8235
                6966995
                7cb2bfc2-981a-49fb-86d8-7a2c56913dd1
                ©2019 Pérez-Pérez et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited.

                History
                : 6 August 2019
                : 18 November 2019
                Funding
                Funded by: ISCIII-Feder
                Award ID: PI15/00821
                Funded by: Fundación Mutua Madrileña
                Funded by: Fundación Ramón Areces
                Funded by: Fundación LAIR
                This work was financially supported by ISCIII-Feder (PI15/00821), “Fundación Mutua Madrileña”, “Fundación Ramón Areces”, and “Fundación LAIR” grants. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Epidemiology
                Neurology
                Public Health

                multiple sclerosis,vitamin d,prevalence,incidence,lanzarote,spain

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