OBJECTIVE: We sought to determine if vitamin D status, a risk factor for multiple sclerosis, is associated with the rate of subsequent clinical relapses in pediatric-onset multiple sclerosis. METHODS: This is a retrospective study of patients with pediatric-onset multiple sclerosis or clinically isolated syndrome who were consecutively recruited into a prospective cohort at their clinical visit at the pediatric multiple sclerosis center of University of California, San Francisco or State University of New York at Stony Brook. Of 171 eligible patients, 134 (78%) with multiple sclerosis/clinically isolated syndrome were included in the cohort; a further 24 were excluded from this analysis due to lack of available serum (n = 7) or lack of follow-up (n = 17). Serum 25-hydroxyvitamin D(3) levels were measured and were adjusted to reflect a deseasonalized value. The adjusted serum 25-hydroxyvitamin D(3) level was the primary predictor in a multivariate negative binomial regression model in which the main outcome measure was the number of subsequent relapses. RESULTS: Among the 110 subjects, the mean unadjusted 25-hydroxyvitamin D(3) level was 22 +/- 9 ng/ml. After adjustment for age, gender, race, ethnicity, disease duration, disease-modifying therapy, and length of follow-up, every 10 ng/ml increase in the adjusted 25-hydroxyvitamin D(3) level was associated with a 34% decrease in the rate of subsequent relapses (incidence rate ratio, 0.66; 95% confidence interval, 0.46-0.95; p = 0.024). INTERPRETATION: Lower serum 25-hydroxyvitamin D(3) levels are associated with a substantially increased subsequent relapse rate in pediatric-onset multiple sclerosis or clinically isolated syndrome, providing rationale for a randomized controlled trial of vitamin D supplementation.
OBJECTIVE: We sought to determine if vitamin D status, a risk factor for multiple sclerosis, is associated with the rate of subsequent clinical relapses in pediatric-onset multiple sclerosis. METHODS: This is a retrospective study of patients with pediatric-onset multiple sclerosis or clinically isolated syndrome who were consecutively recruited into a prospective cohort at their clinical visit at the pediatric multiple sclerosis center of University of California, San Francisco or State University of New York at Stony Brook. Of 171 eligible patients, 134 (78%) with multiple sclerosis/clinically isolated syndrome were included in the cohort; a further 24 were excluded from this analysis due to lack of available serum (n = 7) or lack of follow-up (n = 17). Serum 25-hydroxyvitamin D(3) levels were measured and were adjusted to reflect a deseasonalized value. The adjusted serum 25-hydroxyvitamin D(3) level was the primary predictor in a multivariate negative binomial regression model in which the main outcome measure was the number of subsequent relapses. RESULTS: Among the 110 subjects, the mean unadjusted 25-hydroxyvitamin D(3) level was 22 +/- 9 ng/ml. After adjustment for age, gender, race, ethnicity, disease duration, disease-modifying therapy, and length of follow-up, every 10 ng/ml increase in the adjusted 25-hydroxyvitamin D(3) level was associated with a 34% decrease in the rate of subsequent relapses (incidence rate ratio, 0.66; 95% confidence interval, 0.46-0.95; p = 0.024). INTERPRETATION: Lower serum 25-hydroxyvitamin D(3) levels are associated with a substantially increased subsequent relapse rate in pediatric-onset multiple sclerosis or clinically isolated syndrome, providing rationale for a randomized controlled trial of vitamin D supplementation.
Authors: Muhammad Taimur Malik; Brian C Healy; Leslie A Benson; Pia Kivisakk; Alexander Musallam; Howard L Weiner; Tanuja Chitnis Journal: Neurology Date: 2014-05-21 Impact factor: 9.910
Authors: Manuel Zeitelhofer; Milena Z Adzemovic; David Gomez-Cabrero; Petra Bergman; Sonja Hochmeister; Marie N'diaye; Atul Paulson; Sabrina Ruhrmann; Malin Almgren; Jesper N Tegnér; Tomas J Ekström; André Ortlieb Guerreiro-Cacais; Maja Jagodic Journal: Proc Natl Acad Sci U S A Date: 2017-02-14 Impact factor: 11.205
Authors: Jennifer S Graves; Lisa F Barcellos; Steve Simpson; Anita Belman; Rui Lin; Bruce V Taylor; Anne-Louise Ponsonby; Terence Dwyer; Lauren Krupp; Emmanuelle Waubant; Ingrid A F van der Mei Journal: Mult Scler Relat Disord Date: 2017-10-14 Impact factor: 4.339
Authors: G Disanto; A E Handel; J M Morahan; G C Deluca; S M Kimball; E Hypponen; G Giovannoni; G C Ebers; S V Ramagopalan Journal: QJM Date: 2011-06-29
Authors: Pavan Bhargava; Sonya U Steele; Emmanuelle Waubant; Nisha R Revirajan; Jacqueline Marcus; Marieme Dembele; Sandra D Cassard; Bruce W Hollis; Ciprian Crainiceanu; Ellen M Mowry Journal: Mult Scler Date: 2015-08-18 Impact factor: 6.312