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复发缓解型多发性硬化症中维生素D与神经丝轻链的自然变异

Natural Variation of Vitamin D and Neurofilament Light Chain in Relapsing-Remitting Multiple Sclerosis.

作者信息

Røsjø Egil, Lindstrøm Jonas C, Holmøy Trygve, Myhr Kjell-Morten, Varhaug Kristin N, Torkildsen Øivind

机构信息

Volvat Medical Center, Oslo, Norway.

Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

出版信息

Front Neurol. 2020 Apr 30;11:329. doi: 10.3389/fneur.2020.00329. eCollection 2020.

Abstract

High serum levels of 25-hydroxyvitamin D (25(OH)D) have been found among patients with a favorable disease course in relapsing-remitting MS (RRMS), indicating that this may limit clinical deterioration. Clinical deterioration in RRMS correlates with increasing serum levels of neurofilament light chain (NfL). To examine the association between physiological variations in serum 25(OH)D and NfL levels in RRMS patients before and during disease modifying therapy (DMT). Serum 25(OH)D and NfL concentrations were measured in 85 newly diagnosed RRMS patients enrolled in a 24-month randomized double-blinded placebo-controlled trial of ω-3 fatty acid supplementation without vitamin D. Patients were without DMT until interferon β-1a (IFN-β) initiation at study month 6. Longitudinal serum measurements and brain magnetic resonance imaging (MRI) were obtained. Associations between 25(OH)D and NfL levels were analyzed with linear regression models for the whole study period and the periods before and during IFN-β treatment. Analyses with adjustment for inflammatory MRI disease activity were also performed. No significant associations were found between variations in 25(OH)D and NfL levels during the whole study period ( = 0.95), or the periods without ( = 0.78) or with ( = 0.33) IFN-β therapy. Patients with inflammatory MRI disease activity had significantly higher serum NfL levels than patients without inflammatory MRI disease activity [mean (SD) difference 12.6 (2.0) pg/mL, < 0.01]. Adjustment for this did not change the relationship between 25(OH)D and NfL concentrations. Natural variations in serum 25(OH)D values do not seem to be associated with alterations in serum NfL concentrations in RRMS patients.

摘要

在复发缓解型多发性硬化症(RRMS)中,病情转归良好的患者血清25-羟基维生素D(25(OH)D)水平较高,这表明其可能会限制临床病情恶化。RRMS的临床病情恶化与血清神经丝轻链(NfL)水平升高相关。为了研究RRMS患者在疾病修饰治疗(DMT)之前及期间血清25(OH)D的生理变化与NfL水平之间的关联。对85例新诊断的RRMS患者进行了血清25(OH)D和NfL浓度测定,这些患者参加了一项为期24个月的ω-3脂肪酸补充(不含维生素D)随机双盲安慰剂对照试验。在研究第6个月开始使用干扰素β-1a(IFN-β)之前,患者未接受DMT治疗。进行了纵向血清检测和脑磁共振成像(MRI)检查。使用线性回归模型分析了整个研究期间以及IFN-β治疗之前和期间25(OH)D与NfL水平之间的关联。还进行了针对炎症性MRI疾病活动的校正分析。在整个研究期间(r = 0.95)、未使用IFN-β治疗期间(r = 0.78)或使用IFN-β治疗期间(r = 0.33),均未发现25(OH)D变化与NfL水平之间存在显著关联。有炎症性MRI疾病活动的患者血清NfL水平显著高于无炎症性MRI疾病活动的患者[平均(标准差)差异为12.6(2.0)pg/mL,P < 0.01]。对此进行校正并未改变25(OH)D与NfL浓度之间的关系。RRMS患者血清25(OH)D值的自然变化似乎与血清NfL浓度的改变无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d47/7205013/12624c7ca39a/fneur-11-00329-g0001.jpg

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