Does vitamin D mediate the protective effects of time outdoors on myopia? Findings from a prospective birth cohort
Date
2014
Authors
Guggenheim, J.
Williams, C.
Northstone, K.
Howe, L.
Tilling, K.
St Pourcain, B.
McMahon, G.
Lawlor, D.
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Journal article
Citation
Investigative Ophthalmology and Visual Science, 2014; 55(12):8550-8558
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Jeremy A. Guggenheim, Cathy Williams, Kate Northstone, Laura D. Howe, Kate Tilling, Beate St Pourcain, George McMahon and Debbie A. Lawlor
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Abstract
Purpose: More time outdoors is associated with a lesser risk of myopia, but the underlying mechanism is unclear. We tested the hypothesis that 25-hydroxyvitamin D (vitamin D) mediates the protective effects of time outdoors against myopia. Methods: We analyzed data for children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC) population-based birth cohort: noncycloplegic autorefraction at age 7 to 15 years; maternal report of time outdoors at age 8 years and serum vitamin D2 and D3 at age 10 years. A survival analysis hazard ratio (HR) for incident myopia was calculated for children spending a high- versus low-time outdoors, before and after controlling for vitamin D level (N = 3677). Results: Total vitamin D and D3, but not D2, levels were higher in children who spent more time outdoors (mean [95% confidence interval (CI)] vitamin D in nmol/L: Total, 60.0 [59.4-60.6] vs. 56.9 [55.0-58.8], P = 0.001; D3, 55.4 [54.9-56.0] vs. 53.0 [51.3-54.9], P = 0.014; D2, 5.7 [5.5-5.8] vs. 5.4 [5.1-5.8], P = 0.23). In models including both time outdoors and sunlight-exposure-related vitamin D, there was no independent association between vitamin D and incident myopia (Total, HR = 0.83 [0.66-1.04], P = 0.11; D3, HR = 0.89 [0.72-1.10], P = 0.30), while time outdoors retained the same strong negative association with incident myopia as in unadjusted models (HR = 0.69 [0.55-0.86], P = 0.001). Conclusions:Total vitamin D and D3 were biomarkers for time spent outdoors, however there was no evidence they were independently associated with future myopia.
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© 2014 The Association for Research in Vision and Ophthalmology, Inc.