Vitamin D is associated with degree of disability in patients with fully ambulatory relapsing-remitting multiple sclerosis

• Published in: European journal of neurology Vol. 22; no. 3; pp. 564 - 569
• Main Authors: Thouvenot, E., Orsini, M., Daures, J.-P., Camu, W.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.03.2015; John Wiley & Sons, Inc; Wiley
• Subjects: Adult; disability; Expanded Disability Status Scale; Female; Human health and pathology; Humans; Life Sciences; Male; Middle Aged; multiple sclerosis; multiple sclerosis severity score; Multiple Sclerosis, Chronic Progressive - blood; Multiple Sclerosis, Chronic Progressive - physiopathology; Multiple Sclerosis, Relapsing-Remitting - blood; Multiple Sclerosis, Relapsing-Remitting - physiopathology; Neurons and Cognition; Retrospective Studies; Severity of Illness Index; vitamin D; Vitamin D - blood; multiple sclerosis severity score; disability; multiple sclerosis; vitamin D; Expanded Disability Status Scale
• ISSN: 1351-5101; 1468-1331
• DOI: 10.1111/ene.12617

Background and purpose Vitamin D deficiency is a recognized risk factor for multiple sclerosis (MS) and is associated with increased disease activity. It has also been proposed that the lower the vitamin D levels are, the higher is the handicap. Methods To refine the links between vitamin D insufficiency and disability in MS patients, a retrospective cohort analysis was performed including 181 patients prospectively followed without previous vitamin D supplementation, and age, gender, age at MS onset, MS type, MS activity, Expanded Disability Status Scale (EDSS) were analysed in correlation with plasma vitamin D levels. Results Vitamin D levels were significantly higher in relapsing–remitting MS than in progressive forms of MS in multivariate analyses adjusted for age, ethnicity, gender, disease duration and season (P = 0.0487). Overall, there was a negative correlation between vitamin D level and EDSS score (P = 0.0001, r = –0.33). In relapsing–remitting MS, vitamin D levels were only correlated with disability scores for EDSS < 4 (P = 0.0012). Patients with >20 ng/ml of vitamin D were 2.78 times more likely to have an EDSS < 4 (P = 0.0011, 95% confidence interval 1.49–5.00). Conclusion Data support previous work suggesting that vitamin D deficiency is associated with higher risk of disability in MS. Vitamin D levels also correlated with the degree of disability in fully ambulatory patients with relapsing–remitting MS. These additional results support the pertinence of randomized controlled trials analysing the interest of an early vitamin D supplementation in MS patients to influence evolution of disability.