Richard W Browne1, Bianca Weinstock-Guttman2, Robert Zivadinov3, Dana Horakova4, Mary Lou Bodziak1, Miriam Tamaño-Blanco5, Darlene Badgett5, Michaela Tyblova4, Manuela Vaneckova6, Zdenek Seidl6, Jan Krasensky6, Niels Bergsland7, Deepa P Ramasamy8, Jesper Hagemeier8, Jun Qu5, Eva Havrdova4, Murali Ramanathan9. 1. Department of Biotechnical and Clinical Laboratory Sciences, State University of New York, Buffalo, NY, USA. 2. Department of Neurology, State University of New York, Buffalo, NY, USA. 3. Department of Neurology, State University of New York, Buffalo, NY, USA; Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA. 4. Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic. 5. Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA. 6. Department of Radiology, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic. 7. Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA; IRCCS, S. Maria Nascente, Don Gnocchi Foundation, Milan, Italy. 8. Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA. 9. Department of Neurology, State University of New York, Buffalo, NY, USA; Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA. Electronic address: Murali@Buffalo.Edu.
Abstract
CONTEXT: High serum cholesterol is adversely associated with clinical and imaging disease progression outcomes in multiple sclerosis (MS) and in clinically isolated syndrome (CIS), the earliest stage of MS. Low vitamin D levels are associated with an increased risk of disease progression. OBJECTIVES: To investigate the mechanisms mediating the adverse effects of cholesterol in CIS and to determine the role of the nexus between the vitamin D3 (D3) and cholesterol pathways. DESIGN: Multi-center, prospective, longitudinal prospective study. SETTING: University hospital multiple sclerosis centers. INTERVENTION: Serum samples were obtained prior to any treatment from study subjects. METHODS: Serum obtained prior to any treatment from 172 CIS patients enrolled in a multi-center, prospective, longitudinal study (119 females: 53 males, age: 28.1 ± SD 8.1 years) were analyzed for high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein AI (ApoAI), ApoAII, ApoB, ApoE, and lipoprotein-a. Levels of 25-hydroxy vitamin D3 (25(OH)D3), 1,25-dihydroxy D3, and 24,25-dihydroxy D3 were measured using liquid chromatography-mass spectrometry. RESULTS: Greater levels of HDL-C biomarkers (e.g., HDL-C itself, ApoAI, ApoAII and paroxonase arylesterase activity) and LDL-C biomarkers (e.g., LDL-C itself, Apo B) were associated with greater 25(OH)D3. The effects of HDL-C biomarkers were stronger than those of LDL-C. Free cholesterol and cholesteryl ester levels were positively associated with higher 25(OH)D3 levels. Cholesterol palmitate was particularly potent. The nexus between the D3 and cholesterol pathways was proximal to, or in linkage disequilibrium with, 7-dehydrocholesterol reductase DHCR7 rs1790349, endothelial lipase LIPG rs4939883 and proprotein convertase subtilisin/kexin type 9 PCSK9 rs11206510. CONCLUSIONS: The associations between cholesterol biomarkers and vitamin D metabolite levels in CIS are consistent with the biochemical inter-dependence between the two pathways. Cholesterol biomarkers should be considered for inclusion as covariates when assessing vitamin D levels in CIS.
CONTEXT: High serum cholesterol is adversely associated with clinical and imaging disease progression outcomes in multiple sclerosis (MS) and in clinically isolated syndrome (CIS), the earliest stage of MS. Low vitamin D levels are associated with an increased risk of disease progression. OBJECTIVES: To investigate the mechanisms mediating the adverse effects of cholesterol in CIS and to determine the role of the nexus between the vitamin D3 (D3) and cholesterol pathways. DESIGN: Multi-center, prospective, longitudinal prospective study. SETTING: University hospital multiple sclerosis centers. INTERVENTION: Serum samples were obtained prior to any treatment from study subjects. METHODS: Serum obtained prior to any treatment from 172 CIS patients enrolled in a multi-center, prospective, longitudinal study (119 females: 53 males, age: 28.1 ± SD 8.1 years) were analyzed for high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein AI (ApoAI), ApoAII, ApoB, ApoE, and lipoprotein-a. Levels of 25-hydroxy vitamin D3 (25(OH)D3), 1,25-dihydroxy D3, and 24,25-dihydroxy D3 were measured using liquid chromatography-mass spectrometry. RESULTS: Greater levels of HDL-C biomarkers (e.g., HDL-C itself, ApoAI, ApoAII and paroxonase arylesterase activity) and LDL-C biomarkers (e.g., LDL-C itself, Apo B) were associated with greater 25(OH)D3. The effects of HDL-C biomarkers were stronger than those of LDL-C. Free cholesterol and cholesteryl ester levels were positively associated with higher 25(OH)D3 levels. Cholesterol palmitate was particularly potent. The nexus between the D3 and cholesterol pathways was proximal to, or in linkage disequilibrium with, 7-dehydrocholesterol reductase DHCR7rs1790349, endothelial lipase LIPGrs4939883 and proprotein convertase subtilisin/kexin type 9 PCSK9 rs11206510. CONCLUSIONS: The associations between cholesterol biomarkers and vitamin D metabolite levels in CIS are consistent with the biochemical inter-dependence between the two pathways. Cholesterol biomarkers should be considered for inclusion as covariates when assessing vitamin D levels in CIS.
Authors: Lauren E Mokry; Stephanie Ross; Omar S Ahmad; Vincenzo Forgetta; George Davey Smith; David Goltzman; Aaron Leong; Celia M T Greenwood; George Thanassoulis; J Brent Richards Journal: PLoS Med Date: 2015-08-25 Impact factor: 11.069