Serum Concentration of 25 Hydroxy Vitamin D In Patients With Multiple Sclerosis

Abstract

Multiple sclerosis (MS) is a chronic disease with autoimmune basis and uncertain etiology characterized by demyelinative and inflammatory physiopathology causing axonal damages (Kampman and Brustad, 2008).The prevalence of MS is increasing in many developing countries, and this has drawn research attention towards various factors that might affect the incidence or severity of this disease (Cohen et al., 2012). There are multiple risk factors for MS in a complex relationship with each other from genetic ones to environmental factors (Goodin, 2009). One of the environmental risk factors for MS is low serum level of vitamin D. Vitamin D has immunomodulatory and immunoregulatory functions which renders vitamin D a promising candidate in both pathogenesis and treatment of autoimmune diseases such as MS. This explain the lower serum vitamin D level in MS patients than that in normal population (Holmoy, 2008). To achieve this aim the present work was carried on 62 patients suggested to have M.S. They were attending the outpatient clinics and Neurology Department Clinics, AinShamsUniversityHospital . This work was conducted at the Clinical Pathology Department, AinShamsUniversityHospital, in the period between June 2013 to July 2014 . Subjects included in this study were classified in to two groups. The first group (G1) included 62 patients diagnosed as having M.S, on the basis of their MRI finding and clinical presentation and according to revised Mc Donald criteria 2010. And the second group (G2) included 20 age- matched healthy volunteers without any neurological or medical diseases serving as controls. All subjects in the study were subjected to:- General and neurological examination, magnetic resonance imaging (MRI) of the brain and spinal cord in MRI unit in Ain Shams University Hospital and measurement of serum 25 hydroxyvitamin D. In our study we found that distribution of M.S was common in female patients 36 (58.1) % than males 26 ( 41.9)% . Motor manifestations were the most common manifestations among study cases (80.6%) followed by cerebellar, cranial, sensory, autonomic, ocular and finally spinal manifestations. There was a highly significant difference between cases and controls as regard vitamin D level. Cases had lower mean vitamin D levels compared to controls (15.2 ± 6.4 ng/ml VS 41.1± 19.1 ng/ml) with p< .0001 and t= 84.984 There was no significant difference between male and female cases or remission and relapse cases as regard vitamin D level however, a significant difference was found between RRMS and SPMS cases as regard vitamin D level with lower levels among SPMS cases (12.7 ± 4.8 ng/ml VS 16.5± 6.9 ng/ml) with p= .032 and t= 4.836 . There was a significant negative correlation between vitamin D level and disease score with p= .039 and R= .263. Also there was significant negative correlation between vitamin D level and number of relapse with p= .038 and R= .265 There was no significant correlation between vitamin D level and annual rate of relapse, disease duration, age or age of onset.