维生素D影响了多发性硬化症中疾病活动的风险
Antonino Giordano1,2,3, Ferdinando Clarelli1, Béatrice Pignolet4,5
1Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Journal of neurology, neurosurgery, and psychiatry
|July 14, 2024
概括
在开始治疗之前的维生素D水平会影响多发性硬化症 (MS) 疾病的活性. 较高的维生素D水平,包括遗传倾向的个体,与较低的MS疾病活动风险有关.
科学领域:
- 神经学 神经学
- 内分泌学 在内分泌学.
- 遗传学 是一个遗传学.
背景情况:
- 维生素D (VitD) 影响多发性硬化症 (MS) 风险,但其对疾病活动的影响仍在争论中.
- 评估VitD水平与MS患者疾病活性之间的关联对于了解疾病进展至关重要.
- 研究VitD和遗传倾向在MS活动中的因果作用至关重要.
研究的目的:
- 为了确定维生素D (VitD) 水平是否与治疗开始两年后的无疾病活性-3 (NEDA-3) 状态有关.
- 确定这种关联是否因果关系或受混因素的影响.
- 探索对更高维特D水平的遗传倾向对MS疾病活动风险的影响.
主要方法:
- 在230名未经治疗的复发性复发性MS患者中测量了血清25-OH-维生素-D水平.
- 从GWAS数据中建模了多基因风险评分,以评估在1408名多发性硬化症患者中对更高的VitD的遗传倾向.
- 采用双样本的门德尔随机化 (MR) 来确定VitD和MS疾病活动之间的因果关系.
主要成果:
- 较低的基线VitD水平与在两年内获得NEDA-3地位的可能性降低相关 (p=0.019).
- 维生素D水平低于20 ng/mL显著增加了疾病活动的风险 (OR2.36,p=0.0037).
- 对更高VitD的遗传倾向与延迟MS发病 (p=0.018) 和增加NEDA-3状态的可能性 (p=0.034) 相关;MR证实了因果关系 (p=0.041).
结论:
- 治疗前的维生素D水平是MS疾病活动风险的重要因素.
- 对更高维生素D水平的遗传倾向与减少MS疾病活性和延迟发病有关.
- 进一步研究维生素D补充剂和生活方式干预措施是有必要的,以管理MS活动.
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