Vitamin D Status Does Not Affect Disability Progression of Patients with Multiple Sclerosis over Three Year Follow-Up.
OBJECTIVE
The risk of developing multiple sclerosis (MS) as well as MS disease activity is associated with vitamin D (25(OH)D) status. The relationship between the main functional disability hallmark of MS, disability progression, and 25(OH)D status is less well established though, especially not in MS patients with progressive disease.


METHODS
This retrospective follow-up study included 554 MS patients with a serum baseline 25(OH)D level and Expanded Disability Status Scale (EDSS) with a minimum follow-up of three years. Logistic regressions were performed to assess the effect of baseline 25(OH)D status on relapse rate. Repeated measures linear regression analyses were performed to assess the effect on disability and disability progression.


RESULTS
Baseline deseasonalized 25(OH)D status was associated with subsequent relapse risk (yes/no), but only in the younger MS patients (≤ 37.5 years; OR = 0.872, per 10 nmol/L 25(OH)D, p = 0.041). Baseline 25(OH)D status was not significantly associated with either disability or disability progression, irrespective of MS phenotype.


CONCLUSIONS
Within the physiological range, 25(OH)D status is just significantly associated with the occurrence of relapses in younger MS patients, but is not associated with disability or disability progression over three years follow-up. Whether high dose supplementation to supra physiological 25(OH)D levels prevents disability progression in MS should become clear from long term follow-up of supplementation studies.
School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands.|Academic MS Center Limburg, Zuyderland Medical Center, Sittard, the Netherlands.
Anne-Hilde
http://orcid.org/0000-0002-3749-5241
AH
Muris
Academic MS Center Limburg, Zuyderland Medical Center, Sittard, the Netherlands.
Joost
J
Smolders
School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands.|Academic MS Center Limburg, Zuyderland Medical Center, Sittard, the Netherlands.
Linda
L
Rolf
Central Diagnostic Laboratory, Maastricht University Medical Center, Maastricht, the Netherlands.
Lieke J J
LJ
Klinkenberg
Central Diagnostic Laboratory, Maastricht University Medical Center, Maastricht, the Netherlands.
Noreen
N
van der Linden
Central Diagnostic Laboratory, Maastricht University Medical Center, Maastricht, the Netherlands.
Steven
S
Meex
Central Diagnostic Laboratory, Maastricht University Medical Center, Maastricht, the Netherlands.
Jan
J
Damoiseaux
School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands.|Academic MS Center Limburg, Zuyderland Medical Center, Sittard, the Netherlands.
Raymond
R
Hupperts
D000328:Adult; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood* / Q000503:physiopathology; D012189:Retrospective Studies; D014807:Vitamin D / Q000097:blood*
D014807:Vitamin D