Vitamin D as an early predictor of multiple sclerosis activity and progression.
Vitamin D as an early predictor of multiple sclerosis activity and progression.
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DOI：
10.1001/jamaneurol.2013.5993
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发表时间：
2014-03
期刊：
影响因子：
29
通讯作者：
Pohl C
中科院分区：
文献类型：
--
作者：
Ascherio A;Munger KL;White R;Köchert K;Simon KC;Polman CH;Freedman MS;Hartung HP;Miller DH;Montalbán X;Edan G;Barkhof F;Pleimes D;Radü EW;Sandbrink R;Kappos L;Pohl C
目前尚不清楚维生素 D 不足是否会对多发性硬化症 (MS) 患者的预后产生不利影响，这种情况在多发性硬化症 (MS) 患者中很常见。确定 25-羟基维生素 D (25(OH))D（维生素 D 状态标志物）的血清浓度是否可以预测首次事件提示多发性硬化症 (MS)（临床孤立综合征 [CIS]）的患者的疾病活动度和预后。 BENEFIT 是一项随机试验，最初旨在评估早期与延迟干扰素 β-1b (IFNB-1b) 治疗对 CIS 患者的影响。在基线、6、12 和 24 个月时测量血清 25(OH)D 浓度。 468 名随机患者中，有 465 名患者至少进行了一次 25(OH)D 测量，334 名患者同时进行了 6 个月和 12 个月（季节性异步）测量。对患者进行了 5 年的临床随访和 MRI 随访。 MRI：新的活动性病灶，T2 病灶体积和脑体积增加。临床：MS 复发和残疾 (EDSS)。较高的 25(OH)D 水平预示着 MS 活动的减少和进展速度的减慢。前 12 个月内平均血清 25(OH)D 水平增加 50 nmol/L (20 ng/mL)，可预测新活动性病变发生率降低 57% (p=0·0009)、复发率降低 57% (p=0·03)、T2 病变体积每年增加 25% 降低 (p=0·00004) 以及每年脑容量损失降低 0·41% (p=0·07) 从第 12 个月到第 60 个月。在长达 12 个月测量的 25(OH)D 与从第 24 个月到第 60 个月的 MS 活动或进展之间发现了类似的关联。在使用二分 25(OH)D 水平的分析中，长达 12 个月的值 >= 50 nmol/L (20 ng/mL) 预测随后的残疾程度较低 (EDSS = -0·17; p=0·004) 4年。在主要接受 IFNB-1b 治疗的 MS 患者中，病程早期的 25(OH)D 水平较低是 MS 长期活动和进展的一个重要危险因素。
It remains unclear whether vitamin D insufficiency, which is common in individuals with multiple sclerosis (MS), has an adverse effect on MS outcomes. To determine whether serum concentrations of 25-hydroxyvitamin D (25(OH))D, a marker of vitamin D status, predict disease activity and prognosis in patients with a first event suggestive of multiple sclerosis (MS) (clinically isolated syndrome [CIS]). BENEFIT was a randomized trial originally designed to evaluate the impact of early- versus delayed-interferon beta-1b (IFNB-1b) treatment in patients with CIS. Serum 25(OH)D concentrations were measured at baseline, 6, 12, and 24 months. 465 of the 468 patients randomized had at least one 25(OH)D measurement, and 334 patients had both 6 and 12 months (seasonally asynchronous) measurements. Patients were followed for 5 years clinically and by MRI. MRI: New active lesions, increased T2 lesion volume, and brain volume. Clinical: MS relapses and disability (EDSS). Higher 25(OH)D levels predicted reduced MS activity and slower rate of progression. A 50 nmol/L (20 ng/mL) increment in average serum 25(OH)D levels within the first 12 months predicted a 57% lower rate of new active lesions (p=0·0009), 57% lower relapse rate (p=0·03), 25% lower yearly increase in T2 lesion volume (p=0·00004), and 0·41% lower yearly loss in brain volume (p=0·07) from month 12 to 60. Similar associations were found between 25(OH)D measured up to 12 months and MS activity or progression from month 24 to 60. In analyses using dichotomous 25(OH)D levels, values >= 50 nmol/L (20 ng/mL) up to 12 months predicted lower disability (EDSS = −0·17; p=0·004) during the subsequent 4 years. Among MS patients mainly treated with IFNB-1b, low 25(OH)D levels early in the disease course are a strong risk factor for long term MS activity and progression.
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影响因子：
11.2
作者：
POSER, CM;PATY, DW;TOURTELLOTTE, WW
通讯作者：
TOURTELLOTTE, WW
影响因子：
3.5
作者：
Ahn J;Yu K;Stolzenberg-Solomon R;Simon KC;McCullough ML;Gallicchio L;Jacobs EJ;Ascherio A;Helzlsouer K;Jacobs KB;Li Q;Weinstein SJ;Purdue M;Virtamo J;Horst R;Wheeler W;Chanock S;Hunter DJ;Hayes RB;Kraft P;Albanes D
通讯作者：
Albanes D
影响因子：
11.2
作者：
Mowry, Ellen M.;Krupp, Lauren B.;Waubant, Emmanuelle
通讯作者：
Waubant, Emmanuelle
影响因子：
11.2
作者：
Mowry, Ellen M.;Waubant, Emmanuelle;Pelletier, Daniel
通讯作者：
Pelletier, Daniel
影响因子：
11.2
作者：
McDonald, WI;Compston, A;Wolinsky, JS
通讯作者：
Wolinsky, JS