Hélène Blasco1,2, Blandine Madji Hounoum1, Diane Dufour-Rainfray1,3, Franck Patin1, François Maillot4,5, Stéphane Beltran6, Paul H Gordon7, Christian R Andres1,2, Philippe Corcia1,6. 1. Unité mixte de recherche U930, Institut National de la Santé et de la Recherche Médicale, Université François-Rabelais, Tours, France. 2. Laboratoire de Biochimie et de Biologie Moléculaire, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours, Tours, France. 3. Laboratoire de Médecine Nucléaire in vitro, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours, Tours, France. 4. Service de Médecine Interne, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours, Tours, France. 5. INSERM U1069, Tours, France. 6. Centre SLA, Service de Neurologie, Centre Hospitalier Régional Universitaire de Tours, Tours, France. 7. Northern Navajo Medical Center, Shiprock, NM, USA.
Abstract
AIMS: Vitamin D deficiency has been associated with poorer prognosis in ALS. Better understanding of the role of vitamin D in ALS is needed to determine whether trials of systematic supplementation are justified. Our aim was to report vitamin D levels during the course of ALS and to evaluate its relationship with clinical parameters at diagnosis and with disease progression. METHODS: We prospectively collected vitamin D serum concentrations from 125 consecutive ALS patients. Cox proportional hazard models analyzed the relationship between vitamin D concentrations, clinical parameters, and survival. RESULTS: The mean vitamin D concentration was below our laboratory's lower limit of normal (P < 0.0001) and did not change during the course of the disease. The concentrations were higher in patients with bulbar onset (P = 0.003) and were negatively associated with body mass index (BMI) (P = 0.0095). Models with ALSFRS-R (ALS Functional Rating Scale-Revised) and BMI as a covariates showed that vitamin D concentrations predicted worse prognosis. CONCLUSION: The distribution of vitamin D concentrations in our cohort was consistent with previous reports. Surprisingly, we noted a negative effect of higher vitamin D levels on prognosis in ALS. More detailed research is warranted to determine whether manipulation of vitamin D could be beneficial to patients.
AIMS: Vitamin Ddeficiency has been associated with poorer prognosis in ALS. Better understanding of the role of vitamin D in ALS is needed to determine whether trials of systematic supplementation are justified. Our aim was to report vitamin D levels during the course of ALS and to evaluate its relationship with clinical parameters at diagnosis and with disease progression. METHODS: We prospectively collected vitamin D serum concentrations from 125 consecutive ALSpatients. Cox proportional hazard models analyzed the relationship between vitamin D concentrations, clinical parameters, and survival. RESULTS: The mean vitamin D concentration was below our laboratory's lower limit of normal (P < 0.0001) and did not change during the course of the disease. The concentrations were higher in patients with bulbar onset (P = 0.003) and were negatively associated with body mass index (BMI) (P = 0.0095). Models with ALSFRS-R (ALS Functional Rating Scale-Revised) and BMI as a covariates showed that vitamin D concentrations predicted worse prognosis. CONCLUSION: The distribution of vitamin D concentrations in our cohort was consistent with previous reports. Surprisingly, we noted a negative effect of higher vitamin D levels on prognosis in ALS. More detailed research is warranted to determine whether manipulation of vitamin D could be beneficial to patients.
Authors: Polina S Goncharova; Tatiana K Davydova; Tatiana E Popova; Maxim A Novitsky; Marina M Petrova; Oksana A Gavrilyuk; Mustafa Al-Zamil; Natalia G Zhukova; Regina F Nasyrova; Natalia A Shnayder Journal: Nutrients Date: 2021-10-26 Impact factor: 5.717