Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY 14260, USA.
J Neurol Neurosurg Psychiatry. 2011 Feb;82(2):189-95. doi: 10.1136/jnnp.2010.227942. Epub 2010 Nov 3.
The associations between vitamin D and MRI measures of brain tissue injury have not been previously investigated in multiple sclerosis (MS). This research evaluates the significance of vitamin D and its active metabolites in brain tissue injury and clinical disability in MS patients.
The study population consisted of 193 MS patients (152 women and 41 men; mean age 46.1 (SD 8.4) years; disease duration 13.8 (SD 8.4) years). Serum levels of 25-hydroxyvitamin D(3) (25(OH)VD(3)), 25-hydroxyvitamin D(2) (25(OH)VD(2)), 1α, 25-dihydroxyvitamin D(3) (1, 25(OH)(2)VD(3)) and 24(R), 25-dihydroxyvitamin D(3) (24, 25(OH)(2)VD(3)) were measured using a novel capillary liquid-chromatography-mass spectrometry method. Disability was assessed with the Expanded Disability Status Scale (EDSS) and the MS Severity Scale (MSSS). MRI measures included T2 lesion volume (LV), T1-LV and brain parenchymal fraction. The associations between deseasonalised levels of vitamin D metabolites and clinical and MRI measurements were assessed using regression analyses.
Lower deseasonalised levels of total 25(OH)VD (p=0.029), 25(OH)VD(3) (p=0.032) and 24, 25(OH)(2)VD(3) (p=0.005) were associated with higher MSSS. Similarly, lower deseasonalised levels of 24, 25(OH)(2)VD(3) (p=0.012) were associated with higher EDSS. Higher values of the 25(OH)VD(3) to 24, 25(OH)(2)VD(3) ratio were associated with higher MSSS (p=0.041) and lower brain parenchymal fraction (p=0.008).
Vitamin D metabolites have protective associations with disability and brain atrophy in MS. In particular, the results indicate strong associations for the 24, 25(OH)(2)VD(3) metabolite, which has not been extensively investigated in MS patients.
维生素 D 与多发性硬化症（MS）患者脑组织结构损伤的 MRI 测量值之间的关联尚未被研究。本研究评估了维生素 D 及其活性代谢物在 MS 患者脑组织结构损伤和临床残疾中的意义。
研究人群包括 193 名 MS 患者（152 名女性和 41 名男性；平均年龄 46.1（8.4）岁；疾病持续时间 13.8（8.4）年）。采用新型毛细管液相色谱-质谱法测量血清 25-羟维生素 D(3)（25(OH)VD(3)）、25-羟维生素 D(2)（25(OH)VD(2)）、1α, 25-二羟维生素 D(3)（1, 25(OH)(2)VD(3)）和 24(R), 25-二羟维生素 D(3)（24, 25(OH)(2)VD(3)）的水平。采用扩展残疾状况量表（EDSS）和多发性硬化严重程度量表（MSSS）评估残疾情况。MRI 测量包括 T2 病变体积（LV）、T1-LV 和脑实质分数。采用回归分析评估去季节性维生素 D 代谢物水平与临床和 MRI 测量值之间的关联。
较低的去季节性总 25(OH)VD（p=0.029）、25(OH)VD(3)（p=0.032）和 24, 25(OH)(2)VD(3)（p=0.005）水平与较高的 MSSS 相关。同样，较低的去季节性 24, 25(OH)(2)VD(3)（p=0.012）水平与较高的 EDSS 相关。25(OH)VD(3)与 24, 25(OH)(2)VD(3)比值较高与 MSSS（p=0.041）和脑实质分数较低（p=0.008）相关。
维生素 D 代谢物与 MS 患者的残疾和脑萎缩具有保护相关性。特别是，结果表明，24, 25(OH)(2)VD(3)代谢物与残疾和脑萎缩具有很强的相关性，而该代谢物在 MS 患者中尚未得到广泛研究。
