Association between vitamin D and incident herpes zoster: a UK Biobank study.
Level 3 - non-randomized controlled study
Prospective cohort study with linked electronic health records
PubMed 35940884 · doi:10.3399/BJGP.2021.0623
What was done
A prospective cohort study evaluated 177,572 UK Biobank participants with at least one baseline serum vitamin D measurement and linked primary care or inpatient electronic health records. Baseline vitamin D was categorized as deficient (<25 nmol/L), insufficient (25–49 nmol/L), or sufficient (≥50 nmol/L); secondary exposures were self-reported supplementation and prescription records. Weibull regression models adjusted for demographics, comorbidities, and immunosuppression to assess risk of incident herpes zoster over a mean follow-up of 10.1 years (SD 1.9).
What was found
Compared to participants with sufficient vitamin D levels, neither deficiency nor insufficiency was associated with incident herpes zoster: - Deficient: adjusted hazard ratio (aHR) 0.99 (95% CI 0.90 to 1.10) - Insufficient: aHR 1.03 (95% CI 0.96 to 1.10) No association with herpes zoster incidence was found for self-reported supplementation (HR 0.88, 95% CI 0.67 to 1.16) or prescription records (HR 1.11, 95% CI 0.91 to 1.34).
Why it matters
Despite hypotheses regarding vitamin D's immunomodulatory role, these population-scale data show no relationship between vitamin D levels or intake and shingles risk, providing no evidence to support vitamin D supplementation for herpes zoster prevention.
Limits
The observational design cannot exclude residual confounding. Vitamin D status was based on baseline measurement and may not capture long-term fluctuations. Outcome ascertainment depended on diagnostic coding in linked health records, which may miss milder cases, and the UK Biobank cohort is subject to healthy volunteer selection bias.
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