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BMC Medicine
Published in: BMC Medicine 1/2012

Open Access 01-12-2012 | Research article

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

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

Published in: BMC Medicine | Issue 1/2012

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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.
Appendix
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Metadata
Title
Month of birth, vitamin D and risk of immune-mediated disease: a case control study
Authors
Giulio Disanto
George Chaplin
Julia M Morahan
Gavin Giovannoni
Elina Hyppönen
George C Ebers
Sreeram V Ramagopalan
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2012
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/1741-7015-10-69

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