Elena H Martínez-Lapiscina1, Rattanaporn Mahatanan2, Chih-Hong Lee3, Prangthip Charoenpong4, Jia-Pei Hong5. 1. Center of Neuroimmunology and Department of Neurology, Hospital Clinic of Barcelona, Institute d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. 2. Department of Internal Medicine, Redington Fairview General Hospital, Skowhegan, ME, USA; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. 3. Departments of Neurology, Chang Gung Memorial Hospital Linkao Medical Center and Chang Gung University, College of Medicine, Taoyuan, Taiwan. 4. Department of Internal Medicine, Division of Pulmonary and Critical Care, Louisiana State University, Shreveport, Louisiana, USA; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. 5. Departments of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital Linkao Medical Center and Chang Gung University, College of Medicine, Taoyuan, Taiwan; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. Electronic address: jhong@hsph.harvard.edu.
Abstract
BACKGROUND: Vitamin D supplementation is recommended for patients with multiple sclerosis (MS). However, a recent meta-analysis based on low-quality trials suggested no evidence of supplementation benefit. A systematic review and meta-analysis of high-quality observational cohort studies should provide us further evidences. METHODS: MEDLINE, EMBASE, and WEB-of-SCIENCE databases were systematically searched to identify eligible studies published before October 2018. Prospective cohort studies assessing the associations of serum 25(OH)D levels with MS relapses, radiological inflammatory lesions, or changes in expanded disability status scale in adults (≥18 years) with MS were included. Pooled RRs were calculated using fixed-effect or random-effects model depending on heterogeneity. RESULTS: Thirteen studies and 3498 patients were included. Each 25 nmol/L increase in serum 25(OH)D levels was associated with a reduction in (1) clinical relapse rate [RR = 0.90; 95% confidence interval (CI) = 0.83-0.99], (2) gadolinium-enhancing lesions (RR = 0.69; 95% CI = 0.60-0.79), (3) new/enlarging T2 lesions (RR = 0.86; 95% CI = 0.77-0.95), and (4) new active lesions (RR = 0.81; 95% CI = 0.74-0.89) in the magnetic resonance imaging(MRI). CONCLUSIONS: Serum 25(OH)D levels are associated with a modest decrease in relapse rate and radiological inflammatory activities in patients with MS. The association with disability worsening remains inconclusive.
BACKGROUND:Vitamin D supplementation is recommended for patients with multiple sclerosis (MS). However, a recent meta-analysis based on low-quality trials suggested no evidence of supplementation benefit. A systematic review and meta-analysis of high-quality observational cohort studies should provide us further evidences. METHODS: MEDLINE, EMBASE, and WEB-of-SCIENCE databases were systematically searched to identify eligible studies published before October 2018. Prospective cohort studies assessing the associations of serum 25(OH)D levels with MS relapses, radiological inflammatory lesions, or changes in expanded disability status scale in adults (≥18 years) with MS were included. Pooled RRs were calculated using fixed-effect or random-effects model depending on heterogeneity. RESULTS: Thirteen studies and 3498 patients were included. Each 25 nmol/L increase in serum 25(OH)D levels was associated with a reduction in (1) clinical relapse rate [RR = 0.90; 95% confidence interval (CI) = 0.83-0.99], (2) gadolinium-enhancing lesions (RR = 0.69; 95% CI = 0.60-0.79), (3) new/enlarging T2 lesions (RR = 0.86; 95% CI = 0.77-0.95), and (4) new active lesions (RR = 0.81; 95% CI = 0.74-0.89) in the magnetic resonance imaging(MRI). CONCLUSIONS: Serum 25(OH)D levels are associated with a modest decrease in relapse rate and radiological inflammatory activities in patients with MS. The association with disability worsening remains inconclusive.
Authors: Nicola Vickaryous; Mark Jitlal; Benjamin Meir Jacobs; Rod Middleton; Siddharthan Chandran; Niall John James MacDougall; Gavin Giovannoni; Ruth Dobson Journal: PLoS One Date: 2020-12-30 Impact factor: 3.240
Authors: John P Bilezikian; Anna Maria Formenti; Robert A Adler; Neil Binkley; Roger Bouillon; Marise Lazaretti-Castro; Claudio Marcocci; Nicola Napoli; Rene Rizzoli; Andrea Giustina Journal: Rev Endocr Metab Disord Date: 2021-12-23 Impact factor: 6.514