title: The association of serum 25-hydroxyvitamin D levels with multiple sclerosis severity and progression in a case-control study from China.
abstract: Low vitamin D levels had been shown to play a role in the pathogenesis of multiple sclerosis (MS). Currently, there is little information regarding the correlation between levels of vitamin D and MS in Chinese. This study aimed at detection of association between serum 25-hydroxyvitamin D [25(OH) D] concentrations and MS and its relation to the disease severity in Chinese.
  
  
  
  The present study was a case-control type, it included 141 patients with definitive MS on the basis of 'McDonald' criteria and 282 age-sex matched controls. All patients were clinically evaluated including disease severity using expanded disability status scale (EDSS) score and progression index (PI). Serum 25(OH) D measurements were performed at baseline.
  
  
  
  The median serum level of 25(OH) D in patients with MS was 15.9 (IQR, 11.4-24.4) ng/mL, which was significantly lower (P<0.0001) than those in healthy controls (20.6 [IQR, 15.3-27.7] ng/mL). There was a negative correlation between levels of 25(OH) D and the EDSS score (r=-0.549, P<0.0001). In multivariate conditional logistic analyses using dichotomous 25(OH) D levels, values less than or equal to 20ng/mL indicted higher risk of MS (OR 1.691, 95 CI: 1.058-2.394; P=0.024). Similarly, in binary logistic multivariate analyses using dichotomous 25(OH) D levels, values less than or equal to 20ng/mL indicted the MS high progression (OR 6.278, 95 CI: 2.662-15.659; P<0.001).
  
  
  
  Low serum 25(OH) D levels were associated with increased activity and progression in Chinese patients with MS. Further analytical work is required to establish a causal association between vitamin D status and MS risk and progression.
authors.affiliation: Department of Neurosurgical, Shouguang City People's Hospital, Shouguang, Shandong Province, PR China.
authors.forename: Yongbo
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Kunming General Hospital of the People's Liberation Army, Kunming, Yunnan Province, PR China.
authors.forename: Guoyi
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Neurosurgical, Shouguang City People's Hospital, Shouguang, Shandong Province, PR China.
authors.forename: Xinwen
authors.initials: X
authors.lastname: Han
authors.affiliation: Department of Neurosurgical, Shouguang City People's Hospital, Shouguang, Shandong Province, PR China.
authors.forename: Huihua
authors.initials: H
authors.lastname: Dong
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, PR China. Electronic address: basler777@163.com.
authors.forename: Jia
authors.initials: J
authors.lastname: Geng
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D013223:Statistics as Topic; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Multiple sclerosis; Progression; Severity; Vitamin D