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British Journal of General Practice

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Article

The Association between Vitamin D and Incident Herpes Zoster: A UK Biobank Study

Liang-Yu Lin, Rohini Mathur, Amy Mulick, Liam Smeeth, Sinéad Langan and Charlotte Warren-Gash
British Journal of General Practice 4 April 2022; BJGP.2021.0623. DOI: https://doi.org/10.3399/BJGP.2021.0623
Liang-Yu Lin
1London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, Non-Communicable Disease Epidemiology, London, United Kingdom
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  • For correspondence: liang-yu.lin@lshtm.ac.uk
Rohini Mathur
1London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, Non-Communicable Disease Epidemiology, London, United Kingdom
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Amy Mulick
1London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, Non-Communicable Disease Epidemiology, London, United Kingdom
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Liam Smeeth
1London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, Non-Communicable Disease Epidemiology, London, United Kingdom
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Sinéad Langan
1London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, Non-Communicable Disease Epidemiology, London, United Kingdom
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Charlotte Warren-Gash
1London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, Non-Communicable Disease Epidemiology, London, United Kingdom
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Abstract

Background: Although vitamin D has immunomodulatory effects, any association with herpes zoster (HZ) is unclear. Aim: To explore the association between vitamin D status and the risk of incident HZ in adults in the UK. Design and setting: We conducted a cohort study including participants from UK Biobank, who had at least one vitamin D testing result with linked primary care electronic health records. Methods: The primary exposure was vitamin D status, categorised as deficient (< 25 nmol/L), insufficient (25–50 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. We used Weibull regression, adjusting for potential confounders including demographic factors, comorbidities and immunosuppression. Results: We included 177,572 eligible participants in our analysis with mean follow-up time of 10.1 (SD=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] = 0.90–1.10; insufficiency: RR = 1.03, CI = 0.96–1.10.) We found no evidence that vitamin D supplementations or receiving vitamin D prescription was associated with HZ incidence (supplementation: HR = 0.88, CI = 0.67–1.16; prescription: HR = 1.11, CI = 0.91–1.34.) Conclusion: We observed no association of vitamin D status, supplementation or prescription with incident HZ. No evidence supported vitamin D supplementation as a strategy to prevent HZ.

  • Vitamin D
  • Herpes zoster
  • Electronic Health Records
  • primary health care
  • UK
  • Biobank
  • Received November 2, 2021.
  • Accepted March 30, 2022.
  • Copyright © 2022, The Authors

This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)

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Accepted Manuscript
The Association between Vitamin D and Incident Herpes Zoster: A UK Biobank Study
Liang-Yu Lin, Rohini Mathur, Amy Mulick, Liam Smeeth, Sinéad Langan, Charlotte Warren-Gash
British Journal of General Practice 4 April 2022; BJGP.2021.0623. DOI: 10.3399/BJGP.2021.0623

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Accepted Manuscript
The Association between Vitamin D and Incident Herpes Zoster: A UK Biobank Study
Liang-Yu Lin, Rohini Mathur, Amy Mulick, Liam Smeeth, Sinéad Langan, Charlotte Warren-Gash
British Journal of General Practice 4 April 2022; BJGP.2021.0623. DOI: 10.3399/BJGP.2021.0623
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Keywords

  • Vitamin D
  • Herpes zoster
  • Electronic Health Records
  • primary health care
  • UK
  • Biobank

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Print ISSN: 0960-1643
Online ISSN: 1478-5242