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Published on: June 30, 2014
Vitamin D Status Does Not Affect Disability Progression of Patients with Multiple Sclerosis over Three Year Follow-Up
Anne-Hilde Muris1,2, Joost Smolders2, Linda Rolf1,2
1School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands.
Background And Objective:
The risk of developing multiple sclerosis (MS) as well as MS disease activity is associated with vitamin D (25(OH)D) status. The relationship between the main functional disability hallmark of MS, disability progression, and 25(OH)D status is less well established though, especially not in MS patients with progressive disease.
Methods:
This retrospective follow-up study included 554 MS patients with a serum baseline 25(OH)D level and Expanded Disability Status Scale (EDSS) with a minimum follow-up of three years. Logistic regressions were performed to assess the effect of baseline 25(OH)D status on relapse rate. Repeated measures linear regression analyses were performed to assess the effect on disability and disability progression.
Results:
Baseline deseasonalized 25(OH)D status was associated with subsequent relapse risk (yes/no), but only in the younger MS patients (≤ 37.5 years; OR = 0.872, per 10 nmol/L 25(OH)D, p = 0.041). Baseline 25(OH)D status was not significantly associated with either disability or disability progression, irrespective of MS phenotype.
Conclusion:
Within the physiological range, 25(OH)D status is just significantly associated with the occurrence of relapses in younger MS patients, but is not associated with disability or disability progression over three years follow-up. Whether high dose supplementation to supra physiological 25(OH)D levels prevents disability progression in MS should become clear from long term follow-up of supplementation studies.
Insights
Vitamin D levels are linked to fewer relapses in younger multiple sclerosis (MS) patients. However, vitamin D status did not significantly impact disability or disease progression in this MS patient cohort.
Area of Science:
- Neurology
- Endocrinology
- Immunology
Background:
- Vitamin D (25(OH)D) status is associated with multiple sclerosis (MS) risk and disease activity.
- The impact of 25(OH)D on MS disability progression remains less understood, particularly in progressive MS.
- Understanding this relationship is crucial for managing MS patients.
Purpose of the Study:
- To investigate the association between serum 25(OH)D levels and disability progression in MS patients.
- To determine if 25(OH)D status influences relapse rates and disability accumulation over time.
- To clarify the role of vitamin D in the long-term management of multiple sclerosis.
Main Methods:
- Retrospective follow-up study of 554 MS patients.
- Analysis of serum baseline 25(OH)D levels and Expanded Disability Status Scale (EDSS) scores.
- Minimum three-year follow-up period with logistic and linear regression analyses.
Main Results:
- Baseline 25(OH)D status was associated with reduced relapse risk in younger MS patients (≤ 37.5 years).
- No significant association was found between baseline 25(OH)D status and disability or disability progression.
- These findings held true irrespective of the MS phenotype.
Conclusions:
- Within physiological ranges, 25(OH)D status significantly correlates with relapse occurrence only in younger MS patients.
- Vitamin D levels were not associated with disability or disability progression over a three-year follow-up.
- Further research on high-dose vitamin D supplementation is needed to ascertain its effect on preventing disability progression in MS.
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