Hartl Christina, Obermeier Viola, Gerdes Lisa Ann, Brügel Mathias, von Kries Rüdiger, Kümpfel Tania
Institute of Clinical Neuroimmunology, Ludwig-Maximilians University, Munich, Germany.
Institute of Social Pediatrics, Ludwig-Maximilians University, Munich, Germany.
J Neurol Sci. 2017 Apr 15;375:160-164. doi: 10.1016/j.jns.2017.01.059. Epub 2017 Jan 21.
Low 25-hydroxy vitamin D (25-[OH]-D) serum concentrations have been associated with higher disease activity in multiple sclerosis (MS) patients. In a large cross-sectional study we assessed the vitamin D status in MS patients in relation to seasonality and relapse rate. 415 MS-patients (355 relapsing-remitting MS and 60 secondary-progressive, 282 female, mean age 39.1years) of whom 25-(OH)-D serum concentrations were determined at visits between 2010 and 2013 were included in the study. All clinical data including relapse at visit and expanded disability status scale were recorded in a standardized manner by an experienced neurologist. Seasonal variations of 25-(OH)-D serum concentrations were modelled by sinusoidal regression and seasonal variability in the prevalence of relapse by cubic regression. The mean 25-(OH)-D serum concentration was 24.8ng/ml (range 8.3-140ng/ml) with peak levels of 32.2ng/ml in July/August and nadir in January/February (17.2ng/ml). The lowest modelled prevalence of relapse was in September/October (28%) and the highest modelled prevalence in March/April (47%). The nadir of 25-(OH)-D serum concentrations preceded the peak in prevalence of relapses by two months. In summary, seasonal variation of 25-(OH)-D serum levels were inversely associated with clinical disease activity in MS patients. Future studies should investigate whether vitamin D supplementation in MS patients may decrease the seasonal risk for MS relapses.
血清25-羟基维生素D（25-[OH]-D）浓度较低与多发性硬化症（MS）患者较高的疾病活动度相关。在一项大型横断面研究中，我们评估了MS患者的维生素D状态与季节性和复发率的关系。该研究纳入了415例MS患者（355例复发缓解型MS和60例继发进展型，282例女性，平均年龄39.1岁），他们在2010年至2013年就诊期间测定了25-(OH)-D血清浓度。所有临床数据，包括就诊时的复发情况和扩展残疾状态量表，均由经验丰富的神经科医生以标准化方式记录。通过正弦回归对25-(OH)-D血清浓度的季节性变化进行建模，通过三次回归对复发患病率的季节性变化进行建模。25-(OH)-D血清浓度的平均值为24.8ng/ml（范围8.3-140ng/ml），7月/8月达到峰值32.2ng/ml，1月/2月达到最低点（17.2ng/ml）。复发患病率的最低建模值出现在9月/10月（28%），最高建模值出现在3月/4月（47%）。25-(OH)-D血清浓度的最低点比复发患病率的峰值提前两个月出现。总之，MS患者中25-(OH)-D血清水平的季节性变化与临床疾病活动度呈负相关。未来的研究应调查MS患者补充维生素D是否可降低MS复发的季节性风险。
