Seasonal variations of 25-OH vitamin D serum levels are associated with clinical disease activity in multiple sclerosis patients.
Low 25-hydroxy vitamin D (25-[OH]-D) serum concentrations have been associated with higher disease activity in multiple sclerosis (MS) patients. In a large cross-sectional study we assessed the vitamin D status in MS patients in relation to seasonality and relapse rate. 415 MS-patients (355 relapsing-remitting MS and 60 secondary-progressive, 282 female, mean age 39.1years) of whom 25-(OH)-D serum concentrations were determined at visits between 2010 and 2013 were included in the study. All clinical data including relapse at visit and expanded disability status scale were recorded in a standardized manner by an experienced neurologist. Seasonal variations of 25-(OH)-D serum concentrations were modelled by sinusoidal regression and seasonal variability in the prevalence of relapse by cubic regression. The mean 25-(OH)-D serum concentration was 24.8ng/ml (range 8.3-140ng/ml) with peak levels of 32.2ng/ml in July/August and nadir in January/February (17.2ng/ml). The lowest modelled prevalence of relapse was in September/October (28%) and the highest modelled prevalence in March/April (47%). The nadir of 25-(OH)-D serum concentrations preceded the peak in prevalence of relapses by two months. In summary, seasonal variation of 25-(OH)-D serum levels were inversely associated with clinical disease activity in MS patients. Future studies should investigate whether vitamin D supplementation in MS patients may decrease the seasonal risk for MS relapses.
Institute of Clinical Neuroimmunology, Ludwig-Maximilians University, Munich, Germany.
Christina
C
Hartl
Institute of Social Pediatrics, Ludwig-Maximilians University, Munich, Germany.
Viola
V
Obermeier
Institute of Clinical Neuroimmunology, Ludwig-Maximilians University, Munich, Germany.
Lisa Ann
LA
Gerdes
Institute of Laboratory Medicine, Ludwig-Maximilians University, Munich, Germany.
Mathias
M
Brügel
Institute of Social Pediatrics, Ludwig-Maximilians University, Munich, Germany.
Rüdiger
R
von Kries
Institute of Clinical Neuroimmunology, Ludwig-Maximilians University, Munich, Germany. Electronic address: tania.kuempfel@med.uni-muenchen.de.
Tania
T
Kümpfel
D000293:Adolescent; D000328:Adult; D000368:Aged; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood* / Q000503:physiopathology*; D012008:Recurrence; D012621:Seasons; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D055815:Young Adult
D014807:Vitamin D; C104450:25-hydroxyvitamin D
25-Hydroxyvitamin-D; Disease activity; Multiple sclerosis; Relapse; Seasonal variations; Vitamin D