School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
Acta Neurol Scand. 2011 Sep;124(3):171-5. doi: 10.1111/j.1600-0404.2010.01447.x. Epub 2010 Sep 29.
Depressive symptoms and fatigue are frequent and disabling symptoms of multiple sclerosis (MS). Depression and fatigue have been associated with a poor vitamin D status, and a poor vitamin D status is often found in MS.
Assess whether vitamin D status contributes to depressive symptoms and fatigue in MS.
Patients with MS that participated in previous studies in which depression and fatigue were assessed and of whom serum 25-hydroxyvitamin D (25(OH)D) levels were available within a timeframe of less than one half-life of 25(OH)D were included. Depression and fatigue were assessed with the Hospital Anxiety and Depression Scale and the Multidimensional Fatigue Inventory.
Fifty-nine patients were included. Mean scores of fatigue and depression were 14.6 (SD 4.2) and 6.2 (SD 4.4), respectively. The mean vitamin D status was 62.3 nm (SD 27.8). Vitamin D status correlated negatively with depression (r=-0.326, P=0.006). No significant correlation was found between vitamin D status and fatigue. In a multiple regression model, vitamin D status was not a significant contributor to depression, after controlling for age Expanded Disability Status Scale score and fatigue (P=0.078). Alternatively, depression and fatigue did not contribute to vitamin D status.
This study shows a negative correlation between vitamin D status and depressive symptoms in patients with MS. Although multiple confounders exist, we observed an indication that vitamin D status might contribute to the presence of depressive symptoms in MS. Therefore, further studies on vitamin D in MS should include depressive symptoms as outcome measures to confirm these findings.
抑郁症状和疲劳是多发性硬化症(MS)的常见且致残症状。抑郁和疲劳与维生素 D 状态不佳有关,而 MS 患者中常发现维生素 D 状态不佳。
评估维生素 D 状态是否与 MS 中的抑郁症状和疲劳有关。
纳入了参与先前研究的 MS 患者,这些研究评估了抑郁和疲劳,并且在 25-羟维生素 D(25(OH)D)半衰期的一半以内获得了血清 25(OH)D 水平。使用医院焦虑和抑郁量表和多维疲劳量表评估抑郁和疲劳。
共纳入 59 例患者。疲劳和抑郁的平均评分分别为 14.6(SD 4.2)和 6.2(SD 4.4)。平均维生素 D 状态为 62.3nm(SD 27.8)。维生素 D 状态与抑郁呈负相关(r=-0.326,P=0.006)。维生素 D 状态与疲劳之间未发现显著相关性。在控制年龄、扩展残疾状况量表评分和疲劳后,多元回归模型显示,维生素 D 状态不是抑郁的重要决定因素(P=0.078)。相反,抑郁和疲劳不会影响维生素 D 状态。
本研究表明 MS 患者的维生素 D 状态与抑郁症状之间存在负相关。尽管存在多种混杂因素,但我们观察到维生素 D 状态可能与 MS 中抑郁症状的存在有关。因此,MS 中维生素 D 的进一步研究应将抑郁症状作为结局指标,以确认这些发现。