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维生素 D3 补充对多发性硬化症患者复发、疾病进展和功能测量的影响:一项双盲随机对照试验的探索性结果。

Effect of vitamin D3 supplementation on relapses, disease progression, and measures of function in persons with multiple sclerosis: exploratory outcomes from a double-blind randomised controlled trial.

机构信息

Centre for Clinical Research and Education, University Hospital of North Norway, Tromsø, Norway.

出版信息

Mult Scler. 2012 Aug;18(8):1144-51. doi: 10.1177/1352458511434607. Epub 2012 Feb 21.

DOI:10.1177/1352458511434607
PMID:22354743
Abstract

BACKGROUND

High vitamin D levels may reduce the risk of relapses and disease progression in multiple sclerosis.

METHODS

This 96-week randomised controlled trial was designed to assess the effect of vitamin D(3) supplementation on bone mineral density in persons with multiple sclerosis. Supplementation with 20,000 IU vitamin D(3) weekly raised median serum 25-hydroxy vitamin D (25[OH]D) to 121 nmol/L. The modified intention to treat analysis included 35 persons in the vitamin D(3) group and 33 in the placebo group. Participants were age 21 to 50 years and fully ambulatory (median Expanded Disability Status Scale (EDSS) 2.5). We studied the effect of supplementing vitamin D(3) on the exploratory outcomes annualised relapse rate (ARR), EDSS, multiple sclerosis functional composite (MSFC) components, grip strength, and fatigue.

RESULTS

After 96 weeks, there was no significant difference between groups in ARR (absolute difference 0.10, 95% CI -0.07 to 0.27; p = 0.25), EDSS (absolute difference -0.01, 95% CI -0.35 to 0.35; p = 0.97), MSFC components, grip strength, or fatigue.

CONCLUSION

Supplementation with 20,000 IU vitamin D(3) weekly did not result in beneficial effects on the measured multiple sclerosis-related outcomes. This study was not powered to address clinical outcomes, but none of the results were suggestive of an effect in this unselected population of fully ambulatory persons with multiple sclerosis.

摘要

背景

高维生素 D 水平可能降低多发性硬化症的复发和疾病进展风险。

方法

本 96 周随机对照试验旨在评估维生素 D(3)补充剂对多发性硬化症患者骨密度的影响。每周补充 20000IU 维生素 D(3)可将中位血清 25-羟维生素 D(25[OH]D)水平提高至 121nmol/L。改良意向治疗分析纳入了 35 名维生素 D(3)组和 33 名安慰剂组的参与者。参与者年龄为 21 至 50 岁,完全可行走(扩展残疾状况量表(EDSS)中位数为 2.5)。我们研究了补充维生素 D(3)对探索性结局年复发率(ARR)、EDSS、多发性硬化症功能综合(MSFC)成分、握力和疲劳的影响。

结果

96 周后,两组间 ARR(绝对差值 0.10,95%CI-0.07 至 0.27;p=0.25)、EDSS(绝对差值-0.01,95%CI-0.35 至 0.35;p=0.97)、MSFC 成分、握力或疲劳均无显著差异。

结论

每周补充 20000IU 维生素 D(3)并未对测量的多发性硬化症相关结局产生有益影响。本研究没有足够的效力来解决临床结局问题,但没有任何结果表明在这个未选择的完全可行走的多发性硬化症患者人群中存在效果。

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