Mellen Center for Multiple Sclerosis, Cleveland Clinic Foundation, Cleveland, OH, USA.
Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, OH, USA.
Mult Scler Relat Disord. 2019 Oct;35:276-282. doi: 10.1016/j.msard.2019.08.014. Epub 2019 Aug 13.
Vitamin D deficiency is a proposed risk factor for multiple sclerosis (MS), but its role in progressive MS is not well understood.
To examine the association between vitamin D levels and MRI features in primary progressive (PPMS) and secondary progressive MS (SPMS).
Serum 25-hydroxyvitamin D (25[OH]D) and 25-hydroxyvitamin D (25[OH]D) levels were obtained from 267 subjects enrolled into the Secondary and Primary Progressive Ibudilast NeuroNEXT Trial in Multiple Sclerosis (SPRINT-MS). Associations between imaging data and vitamin D levels was determined using Pearson or Spearman correlation and multivariate regression analyses.
267 patients (age 55.6 ± 7.4, 47.2% male, and 51.3% PPMS) were evaluated with quantitative MRI and vitamin D levels. 25(OH)D and 25(OH)D were similar between PPMS and SPMS. There was no significant association between vitamin D and T1/2 lesion volume and brain parenchymal fraction. Modest associations were found between 25(OH)D and whole brain-magnetization transfer ratio (WB-MTR, r = 0.17, p = 0.007) and normal appearing grey matter MTR (NAGM-MTR, r = 0.15, p = 0.02).
25(OH)D levels were not associated with brain volume or lesional measures in progressive MS contrary to what has been described in relapsing remitting MS. An association between WB-MTR and NAGM-MTR suggest higher vitamin D levels may exert a protective role on myelin content in progressive MS.
维生素 D 缺乏被认为是多发性硬化症(MS)的一个危险因素,但它在进展型 MS 中的作用尚不清楚。
研究原发性进展型(PPMS)和继发性进展型 MS(SPMS)中维生素 D 水平与 MRI 特征之间的关系。
从参加多发性硬化症继发和原发进展型 Ibudilast 神经 NEXT 试验(SPRINT-MS)的 267 名受试者中获得血清 25-羟维生素 D(25[OH]D)和 25-羟维生素 D(25[OH]D)水平。使用 Pearson 或 Spearman 相关分析和多元回归分析来确定影像学数据与维生素 D 水平之间的关系。
对 267 名患者(年龄 55.6±7.4,47.2%为男性,51.3%为 PPMS)进行了定量 MRI 和维生素 D 水平评估。PPMS 和 SPMS 之间的 25(OH)D 和 25(OH)D 相似。维生素 D 与 T1/2 病变体积和脑实质分数之间没有显著的相关性。在 25(OH)D 与全脑磁化传递率(WB-MTR,r=0.17,p=0.007)和正常外观灰质 MTR(NAGM-MTR,r=0.15,p=0.02)之间存在适度的相关性。
与复发缓解型 MS 中描述的情况相反,25(OH)D 水平与进展型 MS 中的脑容量或病变指标无关。WB-MTR 和 NAGM-MTR 之间的相关性表明,较高的维生素 D 水平可能对进展型 MS 中的髓鞘含量起到保护作用。