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多发性硬化症患者的维生素 D 状况与抑郁呈负相关,但与疲劳无关。

Vitamin D status in patients with MS is negatively correlated with depression, but not with fatigue.

机构信息

School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.

出版信息

Acta Neurol Scand. 2011 Sep;124(3):171-5. doi: 10.1111/j.1600-0404.2010.01447.x. Epub 2010 Sep 29.

Abstract

BACKGROUND

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.

AIM

Assess whether vitamin D status contributes to depressive symptoms and fatigue in MS.

METHODS

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.

RESULTS

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.

DISCUSSION

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.

摘要

背景

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。

目的

评估维生素 D 状态是否与 MS 中的抑郁症状和疲劳有关。

方法

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。

结果

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。

讨论

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。

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