title: Vitamin D status and age of onset of demyelinating disease.
abstract: OBJECTIVE
  To evaluate the prevalence of and associated factors impacting vitamin D insufficiency and deficiency in childhood versus adult-onset demyelinating disease.
  
  
  METHODS
  We conducted a retrospective, cross-sectional, chart-review, cohort study on geographically-similar pediatric, young adult, and adult patients with a diagnosis of demyelinating disease identified at the University of Virginia from 2008 to 2013. Group prevalence of vitamin D insufficiency and deficiency as well as relevant factors associated with vitamin D status was analyzed and compared.
  
  
  RESULTS
  We identified 24 childhood-onset (CO), 33 young adult-onset (Y-AO), and 59 adult-onset (AO) cases. There was no difference in the prevalence of vitamin D insufficiency or deficiency between the cohorts. Non-Caucasian race and elevated body mass index were significantly associated with low vitamin D levels, regardless of age of onset. In regression models, race and obesity were independent predictors of vitamin D status. The prevalence of obesity was significantly higher in the childhood-onset cohort (CO=58.5%; Y-AO=31%; AO=34%; p=0.02).
  
  
  CONCLUSIONS
  Our findings demonstrate no difference in the prevalence of vitamin D insufficiency/deficiency between childhood and adult-onset demyelinating disease, suggesting age at disease onset is irrelevant to vitamin D status in demyelinating disease. Both race and obesity are independent factors associated with vitamin D insufficiency/deficiency, regardless of age of disease onset. Obesity, independent of gender, is significantly higher in children compared to adult patients diagnosed with multiple sclerosis and may have a role in the development of childhood-onset demyelinating disease.
authors.affiliation: University of Virginia, UVA Department of Neurology, PO Box 800394, Charlottesville, VA 22908, USA. Electronic address: jnb8h@virginia.edu.
authors.forename: J Nicholas
authors.initials: JN
authors.lastname: Brenton
authors.affiliation: University of Virginia, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Koenig
authors.affiliation: University of Virginia, UVA Department of Neurology, PO Box 800394, Charlottesville, VA 22908, USA. Electronic address: mdg3n@virginia.edu.
authors.forename: Myla D
authors.initials: MD
authors.lastname: Goldman
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D003430:Cross-Sectional Studies; D003711:Demyelinating Diseases / Q000453:epidemiology* / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014807:Vitamin D / Q000032:analysis; D014808:Vitamin D Deficiency / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D014807:Vitamin D
keywords: Demyelinating disease; Multiple sclerosis; Obesity; Pediatric; Vitamin D