Table 4.

Epidemiologic Studies of Vitamin D Intake and Risk of Developing Autoimmune Disease

Autoimmune Disease	Population	Study Design	Subjects	Controls	Vitamin D Intake	Follow-up Period/Duration of Study	Confounders Considered	Results	Year	Reference
Rheumatoid Arthritis	North America (Nurses’ Health Study)	Prospective cohort	722 who developed RA	186,389	Dietary and supplement intake	Up to 22 years	Age, all women, race, age at menarche, oral contraceptive use, parity, duration of breastfeeding, menopausal status, postmenopausal hormone use, cigarette smoking, latitude of residence at age 15 (North, Middle or South U.S.), physical activity, body mass index	No association; highest quintile intake RR 1.0 (95%CI 0.8, 1.3)	2008	Costenbader et al, (200)
Rheumatoid Arthritis	North America (Iowa Women's Health Study)	Prospective Cohort	152 who developed RA	29,386	Diet and supplement intake	11 years	Age, all women, all postmenopausal,	Higher intake at baseline associated with lower risk up to 11 years later: RR 0.67 (95%CI 0.44,1.00)	2004	Merlino et al, (199)
Systemic Lupus Erythematosus	North America (Nurses’ Health Study)	Prospective Cohort	190 who developed SLE	186,389	Diet and supplement intake	Up to 22 years	Age, all women, race, age at menarche, oral contraceptive use, parity, duration of breastfeeding, menopausal status, postmenopausal hormone use, cigarette smoking, latitude of residence at age 15 (North, Middle or South U.S.), physical activity, body mass index	No association; highest quintile intake RR 1.4 (95%CI 0.8, 2.3)	2008	Costenbader et al, (200)
Type I Diabetes Mellitus	Finland (Diabetes Prediction and Prevention Study)	Birth Cohort	165 children who developed TID or advanced beta-cell autoimmunity	3723 infants	Maternal vitamin D intake and at 1 and 3 months post partum.	Mean of 4.3 years	familial diabetes and genetic risk factors for T1D, sex, gestational age, maternal age, maternal education, delivery hospital, route of delivery, number of earlier deliveries and smoking during pregnancy	Maternal intake of vitamin D from food RR 1.25 (95%CI 0.80,1.95), and from supplements RR 1.05 (95%CI 0.95-1.16) for risk of advanced beta cell autoimmunity/type 1 diabetes in offspring	2010	Marjamaki et al, (208)
Type I Diabetes Mellitus	Italy	Case-control	83 T1D ages 0-14	166 age and sex-matched, same region	Vitamin D administration during lactation as baby (recall)	Recall as adults	medical history of severe infections nor history of surgical operations	OR 0.31 (95% CI 0.11, 0.8) for vitamin D administration during lactation and risk type 1 DM	2007	Tenconi et al, (202)
Type I Diabetes Mellitus	Sweden	Cohort-retrospective and prospective	8.7% at 1 year and 8.9% at 2.5 years + for glutamic acid decarboxylase or islet antigen-2 autoantibodies	18,886 infants	Questionnaire: Vitamin D supplementation during pregnancy, at 1 year and 2.5 years	2.5 years	familial type 1 diabetes, maternal education, maternal age, delivery type, weight increase from birth, breastfeeding duration, introduction of cow's-milk protein, fish intake	OR 0.71 (95% CI 0.52-0.96) for reduced islet-cell autoimmunity at 1 year, but OR 1.25 (95%CI 0.91, 1.73) at 2.5 years. Surrogate measure for type 1 diabetes used.	2007	Brekke et al, (221)
Type I Diabetes Mellitus	North America (Diabetes Autoimmunity Study in the Young)	High-risk cohort	16 children who developed islet-cell autoimmunity	206 children without islet-cell autoimmunity	Maternal dietary and supplemental vitamin D intake during pregnancy-recalled after birth	Average 4 years	HLA genotype, family history of type 1 diabetes, presence of GDM, and ethnicity	HR 0.37 (95% CI 0.17-0.78) for increased maternal vitamin D intake and risk for islet-cell autoimmunity. Surrogate measure for type 1 diabetes used.	2003	Fronczak et al, (207)
Type I Diabetes Mellitus	Norway	Case-control	545 cases (children mean age 10.9)	1668 controls population (children mean age 9.3)	Questionnaire: vitamin D supplement use during pregnancy and the first year of life (recalled)		maternal use of cod liver oil during pregnancy, child's use of cod liver oil during the first year of life, duration of exclusive breastfeeding, child's age at introduction of solid foods, maternal education, maternal smoking during pregnancy, maternal age at delivery, child's number of siblings, type 1 diabetes among child's siblings or parents, and the child's age and sex	OR 0.98 (95% CI 0.73, 1.31) for maternal use of vitamin D ≥ 5 times/week vs. none during pregnancy and OR 0.97 (0.73, 1.29) for vitamin D use ≥ 5 times/week during first year of life	2003	Stene et al, (203)
Type I Diabetes Mellitus	Finland	Birth cohort	81 developed T1D	10366 newborns	Vitamin D supplementation during first year of life	31 years	Sex, maternal parity, gestational and maternal age, maternal education, social status, birth weight, and growth rate in infancy and suspected rickets	RR 0.12 (95% CI 0.03-0.51) for regular versus no supplementation	2001	Hypponen et al, (206)
Type I Diabetes Mellitus	Norway	Case-control	78 cases	980 controls	Questionnaire: Maternal itamin D intake during pregnancy (recall)	-	Age, sex, breastfeeding and maternal education	OR 1.27 (95 % CI 0.70, 2.31) for vitamin D supplementation in 1st year life	2000	Stene et al, (204)
Type I Diabetes Mellitus	Europe (7 centers)	Case-control	820 cases	2335 controls-population-based, age-group matched	Questionnaire or interview: recalled infancy vitamin D intake	-	Age, birth weight, duration of breast feeding, maternal age and study center	OR 0.67 (95% CI 0.53, 0.86) for vitamin D supplementation in infancy	1999	EURODIAB Substudy 2 study group, (222)
Multiple Sclerosis	North America (Nurses’ Health Study)	Prospective Cohort study	173 MS cases	92,253 women	Dietary and supplemental vitamin D	Up to 20 years	Age, all women, smoking and latitude at birth	RR 0.67 (95% CI 0.40,1.12); p trend 0.006; for highest quintile	2004	Munger et al,(201)