Rigshospitalet, Copenhagen University Hospital, Danish Multiple Sclerosis Center, Department of Neurology, Blegdamsvej 9, 2100 Copenhagen, Denmark.
Rigshospitalet, Copenhagen University Hospital, Danish Multiple Sclerosis Center, Department of Neurology, Blegdamsvej 9, 2100 Copenhagen, Denmark.
Mult Scler Relat Disord. 2016 Nov;10:169-173. doi: 10.1016/j.msard.2016.10.005. Epub 2016 Oct 26.
Vitamin D insufficiency is common among multiple sclerosis patients, and hypovitaminosis D has been associated with multiple sclerosis (MS) risk and disease activity.
To investigate how recommendations on vitamin D3 supplements affect 25-hydroxyvitamin D (25(OH)D) levels in patients with relapsing-remitting MS (RRMS) and to examine the clinical effects associated with changes in 25(OH)D levels.
In this prospective cohort study, baseline blood samples were collected from 170 natalizumab-treated RRMS patients during winter 2009-2010 and were repeated the following winter. Vitamin D supplements were recommended according to standard clinical practice in our clinic to patients with serum 25(OH)D<50nmol/l at baseline. Information was obtained on annualized relapse-rate (ARR) the year prior to baseline and the following year.
We found that recommending vitamin D supplements in patients with vitamin D insufficiency was associated with a significant increase in serum 25(OH)D concentrations (p=5.1×10), which was significantly related with decreases in ARR; for each nmol/l increase in Δ25(OH)D a -0.014 (95% CI -0.026 to -0.003) decrease in ΔARR was observed, p=0.02.
Correction of hypovitaminosis D in clinical practice by recommending oral D3 supplements resulted in increases in 25(OH)D levels in serum, which were associated with decreases in ARR in RRMS.
维生素 D 不足在多发性硬化症患者中很常见，维生素 D 缺乏与多发性硬化症（MS）的风险和疾病活动有关。
研究补充维生素 D3 对复发缓解型多发性硬化症（RRMS）患者 25-羟维生素 D（25（OH）D）水平的影响，并探讨与 25（OH）D 水平变化相关的临床效果。
在这项前瞻性队列研究中，于 2009-2010 年冬季从 170 名接受那他珠单抗治疗的 RRMS 患者中采集基线血样，并于次年冬季重复采集。根据我们诊所的标准临床实践，建议基线血清 25（OH）D<50nmol/l 的患者补充维生素 D。在基线前一年和后一年获得年复发率（ARR）的信息。
我们发现，在维生素 D 不足的患者中推荐补充维生素 D 与血清 25（OH）D 浓度的显著增加相关（p=5.1×10），这与 ARR 的降低显著相关；每增加 1nmol/l 的 Δ25（OH）D，ARR 就会降低 0.014（95%CI-0.026 至-0.003），p=0.02。
通过推荐口服 D3 补充剂纠正临床实践中的维生素 D 缺乏症，导致血清 25（OH）D 水平升高，与 RRMS 的 ARR 降低相关。
