Vitamin D status and disability among patients with multiple sclerosis: a systematic review and meta-analysis

Abstract

Association between the serum vitamin D level and disability of patients with multiple sclerosis (MS) has been investigated during several researches. However, these studies reported different results. The current study aims to estimate the correlation between the concentrations of 25 (OH) vitamin D and the level of disability among MS patients. Using Mesh and non-Mesh terms related to MS, disability level and vitamin D, different data banks were searched. Required information was extracted from the selected eligible primary articles. Stata version 11 software was applied for combining the primary correlation coefficients using random effect model. The effect of MS type and patients' age was assessed using meta-regression models. Sensitivity analysis was performed to investigate the role of each primary study in the pooled estimate. Egger test was applied to find any publication bias. Of 14 eligible studies, the total correlation coefficient (95% confidence interval) between 25 (OH) vitamin D level and disability in both sexes as well as among female was estimated as of −0.29 (−0.40, −0.17) and −0.35 (−0.46, −0.24) respectively. Two articles carried out among male did not report significant results. Our meta-analysis showed a significant negative correlation between 25 (OH) vitamin D level and disability of MS patients so that the disability reduces with increasing the 25 (OH) vitamin D level.

Multiple Sclerosis in Mongolia; the First Study Exploring Predictors of Disability and Depression in Mongolian MS Patients

“…Furthermore, in Mongolia, there is a lack of foods rich in vitamin D (e.g., foods, including fatty fish, are rich in natural vitamin D) [ 62 ]. Although sun exposure and vitamin D may have independent risk factors for CNS demyelination [ 63 ], a recent meta-analysis reported [ 64 ] a significant association between low vitamin D and increased risk of developing MS. Although a high prevalence of vitamin D deficiency has been reported in Mongolia [ 65 ], serum vitamin D levels in MS patients were not performed in our current study.…”

Using personalized prognosis in the treatment of relapsing multiple sclerosis: A practical guide

“…Low Vitamin D levels (and of its metabolite 25(OH)D) early in the RRMS disease course have been associated higher relapse rates ( 17 ), higher MRI lesion activity, and an increase in the annualised change in EDSS ( 18 ). A meta-analysis of 14 studies showed primary progressive MS (PPMS) a significant negative correlation between 25(OH)D levels and disability across all forms of MS (RRMS, SPMS, PPMS) ( 19 ). As noted by Smolders et al.…”

Author response to comment on: Alopecia in multiple sclerosis patients treated with disease modifying therapies

“…Several studies have failed to show favorable effects of vitamin D supplementation on MS progression or relapse reduction while others suggested a possible inverse association with MS disability. 4 , 5 However, many of these studies are classified as “low evidence” studies due to limitations in study design, including short study durations, small sample sizes, insensitive assessment tools, and poor control for confounding factors. However, an association between lower seasonally adjusted, serum vitamin D and higher disability was detected when a study with a longer follow-up duration (10 years) was pursued.…”