Lower 25-Hydroxyvitamin D Is Associated with Higher Relapse Risk in Patients with Relapsing-Remitting Multiple Sclerosis

Overview

Journal J Nutr Health Aging

Specialties Geriatrics
Nutritional Sciences

Date 2018 Jan 5

PMID 29300420

Citations 6

Authors

C Wang

Z Zeng

B Wang

S Guo

Affiliations

Soon will be listed here.

Abstract

Objectives: To investigate the association between serum circulating 25-hydroxyvitamin D [25(OH) D] concentrations and exacerbation risk in Chinese patients with relapsing-remitting multiple sclerosis (RR-MS).

Methods: From January 2014 to December 2014, consecutive RR-MS patients admitted to the Department of Neurology of our hospital were identified. Blood samples for 25(OH) D measurements were taken at admission. All included patients visited the outpatient clinic of our hospital 1 year after admission. The influence of serum 25[OH] D levels on exacerbation was performed by binary logistic regression analysis.

Results: In this study, 109 patients finished the follow-up. Median follow-up time was 1 year (range 1.0-1.1). Twenty-one out of the 109 was at risk period for infection. A total of 32 patients experienced a total of 76 exacerbations during the study. In the follow-up, a total of 32 patients experienced exacerbations. Thus, the exacerbation rate was 29.4% (95%CI: 20.8%-37.9%). Exacerbation rates were found to decrease with increasing levels of serum 25-OH-D concentrations. For the quartiles category, the risk of an exacerbation was significantly increased in the group with first quartile compared to the group with fourth. Rate ratios for the first, second and third group were 4.2, 3.3 and 2.0, respectively (p for trend =0.011) when compared with the fourth group. Simultaneous evaluation of quartile categories of levels of serum 25(OH) D and infections showed that both factors were related to the exacerbation rate.

Conclusion: The data demonstrates that lower vitamin D status is a sign of more active disease in patients with RR-MS and suggests a beneficial effect of vitamin D on disease course in MS.

Citing Articles

Macronutrients, vitamins and minerals in the diet of multiple sclerosis patients.

Zielinska M, Michonska I Postep Psychiatr Neurol. 2023; 31(3):128-137.

PMID: 37082222 PMC: 9946369. DOI: 10.5114/ppn.2022.121730.

Radiological Benefits of Vitamin D Status and Supplementation in Patients with MS-A Two-Year Prospective Observational Cohort Study.

Galus W, Chmiela T, Walawska-Hrycek A, Krzystanek E Nutrients. 2023; 15(6).

PMID: 36986195 PMC: 10052720. DOI: 10.3390/nu15061465.

Factors associated with relapses in relapsing-remitting multiple sclerosis: A systematic review and meta-analysis.

Xie Y, Tian Z, Han F, Liang S, Gao Y, Wu D Medicine (Baltimore). 2020; 99(27):e20885.

PMID: 32629678 PMC: 7337585. DOI: 10.1097/MD.0000000000020885.

Environmental Influencers, MicroRNA, and Multiple Sclerosis.

Mohammed E J Cent Nerv Syst Dis. 2020; 12:1179573519894955.

PMID: 32009827 PMC: 6971968. DOI: 10.1177/1179573519894955.

Editorial: Vitamin D: Does the Emperor Have No Clothes?.

Morley J J Nutr Health Aging. 2019; 23(4):316-317.

PMID: 30932128 DOI: 10.1007/s12603-019-1178-x.

References

Schumacher G, BEEBE G, KIBLER R, Kurland L, Kurtzke J, McDowell F . PROBLEMS OF EXPERIMENTAL TRIALS OF THERAPY IN MULTIPLE SCLEROSIS: REPORT BY THE PANEL ON THE EVALUATION OF EXPERIMENTAL TRIALS OF THERAPY IN MULTIPLE SCLEROSIS. Ann N Y Acad Sci. 1965; 122:552-68. DOI: 10.1111/j.1749-6632.1965.tb20235.x. View

Gold R, Wolinsky J, Amato M, Comi G . Evolving expectations around early management of multiple sclerosis. Ther Adv Neurol Disord. 2010; 3(6):351-67. PMC: 3002639. DOI: 10.1177/1756285610385608. View

Lucchinetti C, Bruck W, Parisi J, Scheithauer B, Rodriguez M, Lassmann H . Heterogeneity of multiple sclerosis lesions: implications for the pathogenesis of demyelination. Ann Neurol. 2000; 47(6):707-17. DOI: 10.1002/1531-8249(200006)47:6<707::aid-ana3>3.0.co;2-q. View

Smolders J, Thewissen M, Peelen E, Menheere P, Cohen Tervaert J, Damoiseaux J . Vitamin D status is positively correlated with regulatory T cell function in patients with multiple sclerosis. PLoS One. 2009; 4(8):e6635. PMC: 2721656. DOI: 10.1371/journal.pone.0006635. View

Compston A, Coles A . Multiple sclerosis. Lancet. 2008; 372(9648):1502-17. DOI: 10.1016/S0140-6736(08)61620-7. View

McDonald W, Compston A, Edan G, Goodkin D, Hartung H, Lublin F . Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol. 2001; 50(1):121-7. DOI: 10.1002/ana.1032. View

Frota E, Rodrigues D, Donadi E, Brum D, Maciel D, Teixeira A . Increased plasma levels of brain derived neurotrophic factor (BDNF) after multiple sclerosis relapse. Neurosci Lett. 2009; 460(2):130-2. DOI: 10.1016/j.neulet.2009.05.057. View

Loken-Amsrud K, Holmoy T, Bakke S, Beiske A, Bjerve K, Bjornara B . Vitamin D and disease activity in multiple sclerosis before and during interferon-β treatment. Neurology. 2012; 79(3):267-73. DOI: 10.1212/WNL.0b013e31825fdf01. View

Pandit L, Ramagopalan S, Malli C, Dcunha A, Kunder R, Shetty R . Association of vitamin D and multiple sclerosis in India. Mult Scler. 2013; 19(12):1592-6. DOI: 10.1177/1352458513482375. View

10.

Cantorna M, Zhao J, Yang L . Vitamin D, invariant natural killer T-cells and experimental autoimmune disease. Proc Nutr Soc. 2011; 71(1):62-6. PMC: 3733090. DOI: 10.1017/S0029665111003193. View

11.

Munger K, Levin L, Hollis B, Howard N, Ascherio A . Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA. 2006; 296(23):2832-8. DOI: 10.1001/jama.296.23.2832. View

12.

Pierrot-Deseilligny C, Rivaud-Pechoux S, Clerson P, De Paz R, Souberbielle J . Relationship between 25-OH-D serum level and relapse rate in multiple sclerosis patients before and after vitamin D supplementation. Ther Adv Neurol Disord. 2012; 5(4):187-98. PMC: 3388527. DOI: 10.1177/1756285612447090. View

13.

Buljevac D, Flach H, Hop W, Hijdra D, Laman J, Savelkoul H . Prospective study on the relationship between infections and multiple sclerosis exacerbations. Brain. 2002; 125(Pt 5):952-60. DOI: 10.1093/brain/awf098. View

14.

Smolders J, Schuurman K, van Strien M, Melief J, Hendrickx D, Hol E . Expression of vitamin D receptor and metabolizing enzymes in multiple sclerosis-affected brain tissue. J Neuropathol Exp Neurol. 2013; 72(2):91-105. DOI: 10.1097/NEN.0b013e31827f4fcc. View

15.

Mokry L, Ross S, Ahmad O, Forgetta V, Davey Smith G, Goltzman D . Vitamin D and Risk of Multiple Sclerosis: A Mendelian Randomization Study. PLoS Med. 2015; 12(8):e1001866. PMC: 4549308. DOI: 10.1371/journal.pmed.1001866. View

16.

Smolders J, Menheere P, Kessels A, Damoiseaux J, Hupperts R . Association of vitamin D metabolite levels with relapse rate and disability in multiple sclerosis. Mult Scler. 2008; 14(9):1220-4. DOI: 10.1177/1352458508094399. View

17.

Salzer J, Hallmans G, Nystrom M, Stenlund H, Wadell G, Sundstrom P . Vitamin D as a protective factor in multiple sclerosis. Neurology. 2012; 79(21):2140-5. DOI: 10.1212/WNL.0b013e3182752ea8. View

18.

Ascherio A, Munger K, White R, Kochert K, Simon K, Polman C . Vitamin D as an early predictor of multiple sclerosis activity and progression. JAMA Neurol. 2014; 71(3):306-14. PMC: 4000029. DOI: 10.1001/jamaneurol.2013.5993. View

19.

Kampman M, Steffensen L, Mellgren S, Jorgensen L . Effect of vitamin D3 supplementation on relapses, disease progression, and measures of function in persons with multiple sclerosis: exploratory outcomes from a double-blind randomised controlled trial. Mult Scler. 2012; 18(8):1144-51. DOI: 10.1177/1352458511434607. View

20.

Hewison M . An update on vitamin D and human immunity. Clin Endocrinol (Oxf). 2011; 76(3):315-25. DOI: 10.1111/j.1365-2265.2011.04261.x. View