Schwartz G G
Department of Clinical, Epidemiology and Preventive Medicine, University of Pittsburgh School of Medicine, PA 15261.
Neuroepidemiology. 1992;11(4-6):244-54. doi: 10.1159/000110937.
Mortality rates from multiple sclerosis show a well-known north-south gradient, both within the United States and internationally. Mortality rates from prostate cancer show a similar gradient and are significantly correlated with multiple sclerosis (MS) mortality and MS prevalence. This finding adds prostate cancer to the set of diseases whose geographic distributions are significantly correlated with MS and whose members include colon cancer, dental caries, and Parkinson's disease. Review of the literature indicates that these clinically dissimilar diseases may share an aberration in vitamin (hormone) D. Recent evidence demonstrating a multi-faceted role for vitamin D in immunoregulation suggests that a vitamin D aberration may also contribute to the etiology of MS. A vitamin D hypothesis can illuminate several unexplained features of the epidemiology of MS and suggests opportunities for epidemiologic, laboratory, and clinical investigation.
在美国国内以及国际上,多发性硬化症的死亡率呈现出一种广为人知的南北梯度差异。前列腺癌的死亡率也呈现出类似的梯度差异,并且与多发性硬化症(MS)的死亡率及MS患病率显著相关。这一发现使前列腺癌加入到了一组疾病之中,这些疾病的地理分布与MS显著相关,其成员包括结肠癌、龋齿和帕金森病。文献综述表明,这些临床症状各异的疾病可能在维生素(激素)D方面存在异常。最近有证据表明维生素D在免疫调节中具有多方面作用,这表明维生素D异常也可能促成MS的病因。维生素D假说可以阐明MS流行病学中几个无法解释的特征,并为流行病学、实验室和临床研究提供机会。