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Vitamin D intake is inversely associated with rheumatoid arthritis: results from the Iowa Women’s Health Study

Author(s): Merlino LA, Curtis J, Mikuls TR, Cerhan JR, Criswell LA, et al.

Abstract

Objective.Vitamin D is a potent regulator ofcalcium homeostasis and may have immunomodulatoryeffects. The influence of vitamin D on human auto-immune disease has not been well defined. The purposeof this study was to evaluate the association of dietaryand supplemental vitamin D intake with rheumatoidarthritis (RA) incidence.Methods.We analyzed data from a prospectivecohort study of 29,368 women of ages 55–69 yearswithout a history of RA at study baseline in 1986. Dietwas ascertained using a self-administered, 127-itemvalidated food frequency questionnaire that includedsupplemental vitamin D use. Risk ratios (RRs) and 95%confidence intervals (95% CIs) were estimated usingCox proportional hazards regression, adjusting for po-tential confounders.Results.Through 11 years of followup, 152 casesof RA were validated against medical records. Greaterintake (highest versus lowest tertile) of vitamin D wasinversely associated with risk of RA (RR 0.67, 95% CI0.44–1.00,Pfor trend0.05). Inverse associations wereapparent for both dietary (RR 0.72, 95% CI 0.46–1.14,Pfor trend0.16) and supplemental (RR 0.66, 95% CI0.43–1.00,Pfor trend0.03) vitamin D. No individualfood item high in vitamin D content and/or calcium wasstrongly associated with RA risk, but a composite mea-sure of milk products was suggestive of an inverseassociation with risk of RA (RR 0.66, 95% CI 0.42–1.01,Pfor trend0.06).Conclusion.Greater intake of vitamin D may beassociated with a lower risk of RA in older women,although this finding is hypothesis generating.

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