Akhtar Ali, Neupane Rajiv, Singh Amandeep, Khan Maham
Internal Medicine, National University of Medical Sciences, Rawalpindi, PAK.
Surgery, Nobel Medical College Teaching Hospital, Biratnagar, NPL.
Cureus. 2022 Nov 23;14(11):e31824. doi: 10.7759/cureus.31824. eCollection 2022 Nov.
The primary aim of this study was to determine a plausible association between the radiological location of multiple sclerosis (MS) lesions and serum 25-hydroxyvitamin D (vitamin D) levels at the time of diagnosis. MS is a common immune-mediated neurological condition mainly affecting the central nervous system. Although the association of vitamin D levels is well established, there have not been many studies to propose a connection between the location of the lesions based on serum vitamin D levels. In this study, we determine the association between serum 25-hydroxyvitamin D and the radiological distribution of lesions in patients with MS.
Twenty patients with a confirmed diagnosis of MS involving new T2-weighted and gadolinium-enhancing T1-weighted lesions in the entire central nervous system (brain and spinal cord) with serum 25-hydroxyvitamin D levels at the time of diagnosis were included in a case group. As a reference, 20 patients with a confirmed diagnosis of MS with isolated new T2-weighted and gadolinium-enhancing T1-weighted lesions (either supratentorial, infratentorial, or spinal cord) with serum 25-hydroxyvitamin D levels at the time of diagnosis were included in the control group.
The mean serum 25-hydroxyvitamin D level was significantly low in the case group compared to the control group (36.2 ± 17.2 vs 62.6 ± 21.0; p-value <0.0001).
There is a plausible inverse relationship between serum vitamin D and the MS lesions involving the entire central nervous system (brain and spinal cord). This evidence may enable clinicians to forecast disease load based on serum vitamin D levels.
本研究的主要目的是确定多发性硬化症(MS)病变的放射学位置与诊断时血清25-羟基维生素D(维生素D)水平之间是否存在合理关联。MS是一种常见的免疫介导的神经系统疾病,主要影响中枢神经系统。尽管维生素D水平的关联已得到充分证实,但尚未有许多研究提出基于血清维生素D水平的病变位置之间的联系。在本研究中,我们确定了MS患者血清25-羟基维生素D与病变的放射学分布之间的关联。
病例组纳入20例确诊为MS的患者,其整个中枢神经系统(脑和脊髓)出现新的T2加权和钆增强T1加权病变,且有诊断时的血清25-羟基维生素D水平。作为对照,对照组纳入20例确诊为MS的患者,其仅有新的T2加权和钆增强T1加权病变(幕上、幕下或脊髓),且有诊断时的血清25-羟基维生素D水平。
与对照组相比,病例组的平均血清25-羟基维生素D水平显著较低(36.2±17.2 vs 62.6±21.0;p值<0.0001)。
血清维生素D与累及整个中枢神经系统(脑和脊髓)的MS病变之间可能存在负相关关系。这一证据可能使临床医生能够根据血清维生素D水平预测疾病负荷。