Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Br J Gen Pract. 2022 Oct 27;72(724):e842-e848. doi: 10.3399/BJGP.2021.0623. Print 2022 Nov.
Vitamin D has immunomodulatory effects, but any association with herpes zoster (HZ) is unclear.
To explore the association between vitamin D status and risk of incident HZ in adults in the UK.
A cohort study involving participants of UK Biobank (a database containing the health information from half a million individuals) across England, Wales, and Scotland, who had at least one vitamin D testing result with linked primary care electronic health records.
The primary exposure was vitamin D status, categorised as deficient (<25 nmol/L), insufficient (25-49 nmol/L), or sufficient (≥50 nmol/L). The secondary exposures were self-reported vitamin D supplementation at baseline assessment and vitamin D prescription records. The outcome was diagnosed incident HZ, identified from linked primary care or hospital inpatient records. Weibull regression was used, adjusting for potential confounders, including demographic factors, comorbidities, and immunosuppression.
In total, 177 572 eligible participants were included in the analysis, with a mean follow-up time of 10.1 years (standard deviation 1.9 years). No evidence showed that low vitamin D was associated with a higher incidence of HZ, compared with people with sufficient vitamin D (deficient: adjusted hazard ratio [HR] 0.99, 95% confidence interval [CI] = 0.90 to 1.10; insufficient: HR 1.03, 95% CI = 0.96 to 1.10). No evidence was found that supplementing vitamin D or receiving vitamin D prescription was associated with HZ incidence (supplementation: HR 0.88, 95% CI = 0.67 to 1.16; prescription: HR 1.11, 95% CI = 0.91 to 1.34).
No association of vitamin D status, supplementation, or prescription with incident HZ was observed. No evidence supported vitamin D supplementation as a strategy to prevent HZ.
维生素 D 具有免疫调节作用，但它与带状疱疹（HZ）的任何关联尚不清楚。
探索英国成年人维生素 D 状况与 HZ 发病风险之间的关系。
这是一项基于英国生物银行（一个包含来自英格兰、威尔士和苏格兰的 50 多万人健康信息的数据库）参与者的队列研究，这些参与者至少有一次维生素 D 检测结果与初级保健电子健康记录相关联。
主要暴露因素是维生素 D 状况，分为缺乏（<25 nmol/L）、不足（25-49 nmol/L）或充足（≥50 nmol/L）。次要暴露因素是基线评估时的自我报告维生素 D 补充情况和维生素 D 处方记录。结果是从初级保健或住院患者记录中确定的诊断性 HZ 发病。使用 Weibull 回归，调整了潜在的混杂因素，包括人口统计学因素、合并症和免疫抑制。
共有 177572 名符合条件的参与者纳入分析，平均随访时间为 10.1 年（标准差为 1.9 年）。与维生素 D 充足的人相比，没有证据表明低维生素 D 与 HZ 发病率较高相关（缺乏：调整后的危险比 [HR] 0.99，95%置信区间 [CI] = 0.90 至 1.10；不足：HR 1.03，95% CI = 0.96 至 1.10）。没有证据表明补充维生素 D 或开具维生素 D 处方与 HZ 发病率相关（补充：HR 0.88，95% CI = 0.67 至 1.16；处方：HR 1.11，95% CI = 0.91 至 1.34）。
没有观察到维生素 D 状况、补充或处方与 HZ 发病之间存在关联。没有证据支持维生素 D 补充作为预防 HZ 的策略。
