Faculty of Health Sciences, University of Burgundy, F-21000 Dijon, France.
Department of Biochemistry, University Hospital of Dijon, F-21000 Dijon, France.
Nutrients. 2023 Apr 18;15(8):1945. doi: 10.3390/nu15081945.
The link between vitamin D and multiple sclerosis (MS) has been suggested in epidemiological, genetic, immunological, and clinical studies. The aim of the present systematic review of the literature was to assess the effects of vitamin D supplementation on clinical and imaging outcomes in patients with MS. The outcomes we assessed included relapse events, disability progression, and magnetic resonance imaging (MRI) lesions. The search was conducted using PubMed, ClinicalTrials.gov, and EudraCT databases, and it included records published up until 28 February 2023. The systematic review was reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines. Nineteen independent clinical studies (corresponding to 24 records) were included in the systematic review. The risk of bias in randomized controlled trials (RCTs) was analyzed using the Cochrane risk-of-bias tool. Fifteen trials investigated relapse events, and most of them reported no significant effect of vitamin D supplementation. Eight of 13 RCTs found that vitamin D supplementation had no effect on disability [assessed by Expanded Disability Status Scale (EDSS) scores] compared to controls. Interestingly, recent RCTs reported a significant reduction in new MRI lesions in the central nervous system of MS patients during supplementation with vitamin D3.
维生素 D 与多发性硬化症（MS）之间的联系已在流行病学、遗传学、免疫学和临床研究中得到证实。本系统综述文献的目的是评估维生素 D 补充剂对 MS 患者的临床和影像学结局的影响。我们评估的结局包括复发事件、残疾进展和磁共振成像（MRI）病变。检索使用了 PubMed、ClinicalTrials.gov 和 EudraCT 数据库，并包括截至 2023 年 2 月 28 日发表的记录。系统评价按照系统评价和荟萃分析的首选报告项目（PRISMA）2020 指南进行报告。19 项独立的临床研究（对应 24 项记录）被纳入系统评价。使用 Cochrane 偏倚风险工具分析随机对照试验（RCT）的偏倚风险。15 项试验研究了复发事件，其中大多数试验报告维生素 D 补充剂没有显著效果。13 项 RCT 中的 8 项发现，与对照组相比，维生素 D 补充剂对残疾（通过扩展残疾状况量表 [EDSS] 评分评估）没有影响。有趣的是，最近的 RCT 报告称，在补充维生素 D3 期间，MS 患者的中枢神经系统中新的 MRI 病变显著减少。
