School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands; Academic MS Center Limburg, Orbis Medical Center, Sittard, The Netherlands; Department of Internal Medicine, Division of Clinical and Experimental Immunology, Maastricht University Medical Center, Maastricht, The Netherlands.
Acta Neurol Scand. 2014 Feb;129(2):123-31. doi: 10.1111/ane.12155. Epub 2013 Jun 13.
Insufficient sun exposure and vitamin D deficiency have both been associated with increased risk of multiple sclerosis (MS). Depressi on, anxiety, fatigue and cognitive impairment are prevalent and disabling symptoms in MS. Our objective was to examine the associations between personal sun exposure and serum 25-hydroxyvitamin D (25(OH)D), and depression, anxiety, fatigue and cognition.
A total of 198 participants with multiple sclerosis were followed prospectively for an average of 2.3 years. Assessments of serum 25(OH)D, sun exposure, depression, anxiety and fatigue were carried out biannually; cognition was assessed annually.
Personal reported sun exposure was inversely associated with depression scores (β -0.26 (95%CI -0.40, -0.12);P ≤ 0.001) and fatigue scores (β -0.65 (95%CI -1.23, -0.07); P = 0.028). Only high levels of 25(OH)D (>80 nm) were inversely associated depression scores (β -0.64 (95%CI -1.15, -0.13); P = 0.015), but this was not significant after adjustment for reported sun exposure. No associations were seen between reported sun exposure or serum 25(OH)D levels and anxiety or cognition scores.
We found that higher levels reported sun exposure, rather than 25(OH)D levels, were associated with less depressive symptoms and levels of fatigue. The role of UV or light therapy will need to be evaluated in randomized controlled trials to confirm an effect on these symptoms in MS.
阳光照射不足和维生素 D 缺乏均与多发性硬化症（MS）风险增加有关。抑郁、焦虑、疲劳和认知障碍是 MS 中常见且致残的症状。我们的目的是研究个体阳光照射与血清 25-羟维生素 D（25（OH）D）之间的关系，以及与抑郁、焦虑、疲劳和认知之间的关系。
198 名多发性硬化症患者前瞻性随访平均 2.3 年。每半年评估一次血清 25（OH）D、阳光照射、抑郁、焦虑和疲劳；每年评估一次认知。
个体报告的阳光照射与抑郁评分呈负相关（β-0.26（95%CI-0.40，-0.12）；P ≤ 0.001）和疲劳评分（β-0.65（95%CI-1.23，-0.07）；P = 0.028）。只有高水平的 25（OH）D（>80nm）与抑郁评分呈负相关（β-0.64（95%CI-1.15，-0.13）；P = 0.015），但在调整报告的阳光照射后，这并不显著。报告的阳光照射或血清 25（OH）D 水平与焦虑或认知评分之间无相关性。
我们发现，较高水平的报告阳光照射，而不是 25（OH）D 水平，与较少的抑郁症状和疲劳水平相关。需要在随机对照试验中评估紫外线或光照疗法的作用，以确认其对 MS 中这些症状的影响。
