title: Vitamin D is Not a Protective Factor in ALS.
abstract: OBJECTIVE
  Vitamin D deficiency has been associated with poorer prognosis in ALS. Better understanding of the role of vitamin D in ALS is needed to determine whether trials of systematic supplementation are justified. Our aim was to report vitamin D levels during the course of ALS and to evaluate its relationship with clinical parameters at diagnosis and with disease progression.
  
  
  METHODS
  We prospectively collected vitamin D serum concentrations from 125 consecutive ALS patients. Cox proportional hazard models analyzed the relationship between vitamin D concentrations, clinical parameters, and survival.
  
  
  RESULTS
  The mean vitamin D concentration was below our laboratory's lower limit of normal (P < 0.0001) and did not change during the course of the disease. The concentrations were higher in patients with bulbar onset (P = 0.003) and were negatively associated with body mass index (BMI) (P = 0.0095). Models with ALSFRS-R (ALS Functional Rating Scale-Revised) and BMI as a covariates showed that vitamin D concentrations predicted worse prognosis.
  
  
  CONCLUSIONS
  The distribution of vitamin D concentrations in our cohort was consistent with previous reports. Surprisingly, we noted a negative effect of higher vitamin D levels on prognosis in ALS. More detailed research is warranted to determine whether manipulation of vitamin D could be beneficial to patients.
authors.affiliation: Unité mixte de recherche U930, Institut National de la Santé et de la Recherche Médicale, Université François-Rabelais, Tours, France.|Laboratoire de Biochimie et de Biologie Moléculaire, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours, Tours, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Blasco
authors.affiliation: Unité mixte de recherche U930, Institut National de la Santé et de la Recherche Médicale, Université François-Rabelais, Tours, France.
authors.forename: Blandine
authors.initials: B
authors.lastname: Madji Hounoum
authors.affiliation: Unité mixte de recherche U930, Institut National de la Santé et de la Recherche Médicale, Université François-Rabelais, Tours, France.|Laboratoire de Médecine Nucléaire in vitro, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours, Tours, France.
authors.forename: Diane
authors.initials: D
authors.lastname: Dufour-Rainfray
authors.affiliation: Unité mixte de recherche U930, Institut National de la Santé et de la Recherche Médicale, Université François-Rabelais, Tours, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Patin
authors.affiliation: Service de Médecine Interne, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours, Tours, France.|INSERM U1069, Tours, France.
authors.forename: François
authors.initials: F
authors.lastname: Maillot
authors.affiliation: Centre SLA, Service de Neurologie, Centre Hospitalier Régional Universitaire de Tours, Tours, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Beltran
authors.affiliation: Northern Navajo Medical Center, Shiprock, NM, USA.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Gordon
authors.affiliation: Unité mixte de recherche U930, Institut National de la Santé et de la Recherche Médicale, Université François-Rabelais, Tours, France.|Laboratoire de Biochimie et de Biologie Moléculaire, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours, Tours, France.
authors.forename: Christian R
authors.initials: CR
authors.lastname: Andres
authors.affiliation: Unité mixte de recherche U930, Institut National de la Santé et de la Recherche Médicale, Université François-Rabelais, Tours, France.|Centre SLA, Service de Neurologie, Centre Hospitalier Régional Universitaire de Tours, Tours, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Corcia
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D015992:Body Mass Index; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D065840:Protective Factors; D014807:Vitamin D / Q000097:blood*
chemical_list: D014807:Vitamin D
keywords: Amyotrophic lateral sclerosis; Neuroprotection; Prognosis; Survival; Vitamin D