Vitamin D status is associated with relapse rate in pediatric-onset multiple sclerosis
Version of Record online: 20 JAN 2010
Copyright © 2010 American Neurological Association
Annals of Neurology
Volume 67, Issue 5, pages 618–624, May 2010
How to Cite
Mowry, E. M., Krupp, L. B., Milazzo, M., Chabas, D., Strober, J. B., Belman, A. L., McDonald, J. C., Oksenberg, J. R., Bacchetti, P. and Waubant, E. (2010), Vitamin D status is associated with relapse rate in pediatric-onset multiple sclerosis. Ann Neurol., 67: 618–624. doi: 10.1002/ana.21972
- Issue online: 26 APR 2010
- Version of Record online: 20 JAN 2010
- Manuscript Accepted: 5 JAN 2010
- Manuscript Revised: 15 DEC 2009
- Manuscript Received: 3 NOV 2009
- National Multiple Sclerosis Society Sylvia Lawry Fellowship Award
- National MS Society. Grant Number: A103210
- Donation from a patient's family
We sought to determine if vitamin D status, a risk factor for multiple sclerosis, is associated with the rate of subsequent clinical relapses in pediatric-onset multiple sclerosis.
This is a retrospective study of patients with pediatric-onset multiple sclerosis or clinically isolated syndrome who were consecutively recruited into a prospective cohort at their clinical visit at the pediatric multiple sclerosis center of University of California, San Francisco or State University of New York at Stony Brook. Of 171 eligible patients, 134 (78%) with multiple sclerosis/clinically isolated syndrome were included in the cohort; a further 24 were excluded from this analysis due to lack of available serum (n = 7) or lack of follow-up (n = 17). Serum 25-hydroxyvitamin D3 levels were measured and were adjusted to reflect a deseasonalized value. The adjusted serum 25-hydroxyvitamin D3 level was the primary predictor in a multivariate negative binomial regression model in which the main outcome measure was the number of subsequent relapses.
Among the 110 subjects, the mean unadjusted 25-hydroxyvitamin D3 level was 22 ± 9ng/ml. After adjustment for age, gender, race, ethnicity, disease duration, disease-modifying therapy, and length of follow-up, every 10ng/ml increase in the adjusted 25-hydroxyvitamin D3 level was associated with a 34% decrease in the rate of subsequent relapses (incidence rate ratio, 0.66; 95% confidence interval, 0.46–0.95; p = 0.024).
Lower serum 25-hydroxyvitamin D3 levels are associated with a substantially increased subsequent relapse rate in pediatric-onset multiple sclerosis or clinically isolated syndrome, providing rationale for a randomized controlled trial of vitamin D supplementation. ANN NEUROL 2010;67:618–624