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Month of birth, vitamin D and risk of immune mediated disease: a case control study

Disanto, G; Chaplin, G; Morahan, JM; Giovannoni, G; Hypponen, E; Ebers, GC; Ramagopalan, SV; (2012) Month of birth, vitamin D and risk of immune mediated disease: a case control study. BMC Medicine , 10 (1) , Article 69. 10.1186/1741-7015-10-69. Green open access

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Abstract

ABSTRACT: BACKGROUND: A season of birth effect in immune-mediated diseases (ID) such as multiple sclerosis and type 1 diabetes has been consistently reported. We aimed to investigate whether season of birth influences the risk of rheumatoid arthritis, Crohn's disease, ulcerative colitis and systemic lupus erythematosus in addition to multiple sclerosis, and to explore the correlation between the risk of ID and predicted ultraviolet B (UVB) light exposure and vitamin D status during gestation. METHODS: The monthly distribution of births of patients with ID from the UK (n = 115,172) was compared to that of the general population using the Cosinor test. Predicted UVB radiation and vitamin D status in different time windows during pregnancy were calculated for each month of birth and correlated with risk of ID using the Spearman's correlation coefficient. RESULTS: The distributions of ID births significantly differed from that of the general population (P = 5e-12) with a peak in April (odds ratio = 1.045, 95% confidence interval = 1.024, 1.067, P <0.0001) and a trough in October (odds ratio = 0.945, 95% confidence interval = 0.925, 0.966, P <0.0001). Stratification by disease subtype showed seasonality in all ID but Crohn's disease. The risk of ID was inversely correlated with predicted second trimester UVB exposure (Spearman's rho = -0.49, P = 0.00005) and third trimester vitamin D status (Spearman's rho = -0.44, P = 0.0003). CONCLUSIONS: The risk of different ID in the UK is significantly influenced by the season of birth, suggesting the presence of a shared seasonal risk factor or factors predisposing to ID. Gestational UVB and vitamin D exposure may be implicated in the aetiology of ID.

Type: Article
Title: Month of birth, vitamin D and risk of immune mediated disease: a case control study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/1741-7015-10-69
Publisher version: http://dx.doi.org/10.1186/1741-7015-10-69
Language: English
Additional information: PMCID: PMC3395583 © 2012 Disanto et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
UCL classification: UCL
URI: https://discovery.ucl.ac.uk/id/eprint/1378001
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