Vitamin D levels Mixed Messages


Hatamian H, Bidabadi E, Saadat SM, Saadat NS, Kazemnezhad E, Ramezani H, Bakhshayesh B.Is serum vitamin D levels associated with disability in patients with newly diagnosed multiple sclerosis?

Iran J Neurol. 2013;12(2):41-6

BACKGROUND:Although the precise etiology of multiple sclerosis (MS) is unknown, it seems that both genetic and environmental factors are important. Recent studies suggest that low serum vitamin D levels are important environmental factor in MS. The aim of this study was to compare the serum levels of vitamin D between MS patients and healthy subjects, and to determine its association with disability in MS patients.

METHODS:In this cross-sectional study, a total of 52 patients with MS were randomly recruited and matched for age and sex with 52 healthy subjects. Demographic characteristics and serum vitamin D levels for both groups, as well as duration of disease Expanded Disability Status Scale (EDSS) for MS patients were evaluated. Statistical analysis was performed by independent samples t-test and multiple linear regression analysis.
RESULTS:The mean serum vitamin D levels were 26.5 ± 16.3 ng/ml in MS patients vs. 37.1 ±19.7 in healthy subjects (P = 0.003). There was no significant association between vitamin D levels and EDSS score of patients with MS (P = 0.345), after adjusting for the covariates.
CONCLUSION: Our findings did not suggest a protective association for serum vitamin D levels against disability in MS patients.
But then we have
Harandi AA, Shahbeigi S, Pakdaman H, Fereshtehnejad SM, Nikravesh E, Jalilzadeh R. Association of serum 25(OH) vitamin D3 concentration with severity of multiple sclerosis. Iran J Neurol. 2012;11(2):54-8
BACKGROUND:There is a known inverse association between solar radiation and the prevalence of multiple sclerosis (MS). Some studies have investigated the link between vitamin D and MS. The aim of this study was to investigate the possible association between serum 25(OH) vitamin D3 concentration and the severity of disease in Iranian patients with MS.
METHODS:Patients with relapsing-remitting MS underwent neurological examination, including measurement of Expanded Disability Status Scale (EDSS) score, and were categorized by disease severity into mild (0 ≤ EDSS ≤3), moderate (3.5 ≤ EDSS ≤5.5) and severe (6 ≤ EDSS). Serum concentrations of 25(OH) vitamin D3, calcium, phosphorus, magnesium and parathyroid hormone were also measured.
RESULTS: A total of 78 (73.1% female) patients with MS were evaluated. The mean (± standard deviation) of age was 33.9 ± 9.2 years. The mean (± standard error) serum concentrations of 25(OH) vitamin D3 were 36.6 ± 5.1 mg/dL, 50.1 ± 12.6 mg/dL and 19.8 ± 6.5 mg/dL in patients with mild, moderate and severe disease, respectively. There was a statistically significant inverse correlation between 25(OH) vitamin D3 concentration and EDSS score (P = 0.016, r= -0.273 by Spearman rank correlation test), which was observed in women only (P = 0.021, r = -0.305). Receiver operating characteristic curve analysis suggested that a serum 25(OH) vitamin D3 concentration cutoff of 16.5 mg/dL could differentiate patients with mild/moderate MS from severe disease with 74.6% accuracy.
CONCLUSION: Our findings further support the association between vitamin D and disease severity in MS.
They both can’t be right can they? So we have one pro and one anti and a deluge of papers on vitamin D.  We have trials on going but will it give a clear cut answer…I doubt it…as I suspect some will fail. We have to make sure we are vitamin D replete to ensure good bone health and let’s hope taking those supplements, most of TeamG are at it too, have some extra health benefit.

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  • They both can be right for the cohort they are looking at, it just does not tell you anything about the world in general. That is because the number of subjects is small and unlike with drugs vitamin d levels cannot be carefully controlled, and they can change rapidly. It also matters when in the year you do the test, summer will be different to winter. It requires repeated vitamin d tests throughout the study and at least a couple of years of follow up. It may also depend on the level of bound or unbound vitamin d not the total.

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