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Higher 25-hydroxyvitamin D is associated with lower relapse risk in Multiple Sclerosis

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journal contribution
posted on 2023-05-17, 03:06 authored by Steve Simpson JRSteve Simpson JR, Bruce TaylorBruce Taylor, Christopher BlizzardChristopher Blizzard, Ponsonby, AL, Pittas, F, Tremlett, H, Dwyer, T, Gies, P, Ingrid van der MeiIngrid van der Mei
Objective: A protective association between higher vitamin D levels and the onset of multiple sclerosis (MS) has been demonstrated; however, its role in modulating MS clinical course has been little studied. We investigated whether higher levels of serum 25-hydroxyvitamin D (25-OH-D) were associated with a lower risk of relapses in people with MS. Methods: We conducted a prospective cohort study of 145 participants with relapsing-remitting MS from 2002 to 2005. Serum 25-OH-D levels were measured biannually, and the hazard of relapse was assessed using survival analysis. Results: There was an inverse linear relationship between 25-OH-D levels and the hazard of relapse over the subsequent 6 months, with hazard ratio (HR) 0.91 (95% confidence interval [CI]: 0.85-0.97) per 10nmol/l increase in 25-OH-D level (p 0.006). When variation due to timing of blood collection was removed by estimating 25-OH-D at the start of each season, this association persisted, with HR 0.90 (95% CI, 0.83-0.98) per 10nmol/l increase (p 0.016). Taking into account the biological half-life of 25-OH-D, we estimated 25-OH-D at monthly intervals, resulting in a slightly enhanced association, with HR 0.88 (95% CI, 0.82-0.95) per 10nmol/l increase (p 0.001). Adjusting for potential confounders did not alter these findings. Interpretation: In this prospective population-based cohort study, in a cohort largely on immunomodulatory therapy, higher 25-OH-D levels were associated with a reduced hazard of relapse. This occurred in a dosedependent linear fashion, with each 10nmol/l increase in 25-OH-D resulting in up to a 12% reduction in risk of relapse. Clinically, raising 25-OH-D levels by 50nmol/l could halve the hazard of a relapse.


Publication title

Annals of Neurology








Menzies Institute for Medical Research



Place of publication

Div John Wiley & Sons Inc, 605 Third Ave, New York, USA, Ny, 10158-0012

Rights statement

Copyright 2010 American Neurological Association

Repository Status

  • Open

Socio-economic Objectives

Clinical health not elsewhere classified

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