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

Giulio Disanto, George Chaplin, Julia M. Morahan, Gavin Giovannoni, Elina Hyppönen, George C. Ebers, Sreeram V. Ramagopalan

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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.

Original languageEnglish (US)
Article number69
JournalBMC Medicine
Volume10
DOIs
StatePublished - Jul 6 2012

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Immune System Diseases
Vitamin D
Case-Control Studies
Parturition
Vitamin B Complex
Crohn Disease
Multiple Sclerosis
Odds Ratio
Confidence Intervals
Pregnancy
Third Pregnancy Trimester
Second Pregnancy Trimester
Ultraviolet Rays
Type 1 Diabetes Mellitus
Ulcerative Colitis
Causality
Systemic Lupus Erythematosus
Population
Rheumatoid Arthritis
Radiation

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Disanto, G., Chaplin, G., Morahan, J. M., Giovannoni, G., Hyppönen, E., Ebers, G. C., & Ramagopalan, S. V. (2012). Month of birth, vitamin D and risk of immune-mediated disease: A case control study. BMC Medicine, 10, [69]. https://doi.org/10.1186/1741-7015-10-69
Disanto, Giulio ; Chaplin, George ; Morahan, Julia M. ; Giovannoni, Gavin ; Hyppönen, Elina ; Ebers, George C. ; Ramagopalan, Sreeram V. / Month of birth, vitamin D and risk of immune-mediated disease : A case control study. In: BMC Medicine. 2012 ; Vol. 10.
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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.",
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Disanto, G, Chaplin, G, Morahan, JM, Giovannoni, G, Hyppönen, E, Ebers, GC & Ramagopalan, SV 2012, 'Month of birth, vitamin D and risk of immune-mediated disease: A case control study', BMC Medicine, vol. 10, 69. https://doi.org/10.1186/1741-7015-10-69

Month of birth, vitamin D and risk of immune-mediated disease : A case control study. / Disanto, Giulio; Chaplin, George; Morahan, Julia M.; Giovannoni, Gavin; Hyppönen, Elina; Ebers, George C.; Ramagopalan, Sreeram V.

In: BMC Medicine, Vol. 10, 69, 06.07.2012.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Month of birth, vitamin D and risk of immune-mediated disease

T2 - A case control study

AU - Disanto, Giulio

AU - Chaplin, George

AU - Morahan, Julia M.

AU - Giovannoni, Gavin

AU - Hyppönen, Elina

AU - Ebers, George C.

AU - Ramagopalan, Sreeram V.

PY - 2012/7/6

Y1 - 2012/7/6

N2 - 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.

AB - 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.

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