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. 2012 Aug;72(2):234-40.
doi: 10.1002/ana.23591.

Vitamin D status predicts new brain magnetic resonance imaging activity in multiple sclerosis

Ellen M Mowry  1 , Emmanuelle Waubant, Charles E McCulloch, Darin T Okuda, Alan A Evangelista, Robin R Lincoln, Pierre-Antoine Gourraud, Don Brenneman, Mary C Owen, Pamela Qualley, Monica Bucci, Stephen L Hauser, Daniel Pelletier
Affiliations

Vitamin D status predicts new brain magnetic resonance imaging activity in multiple sclerosis

Ellen M Mowry et al. Ann Neurol. 2012 Aug.

Abstract

Objective: We sought to determine whether vitamin D status is associated with developing new T2 lesions or contrast-enhancing lesions on brain magnetic resonance imaging (MRI) in relapsing multiple sclerosis (MS).

Methods: EPIC is a 5-year longitudinal MS cohort study at the University of California at San Francisco. Participants had clinical evaluations, brain MRI, and blood draws annually. From the overall cohort, we evaluated patients with clinically isolated syndrome or relapsing-remitting MS at baseline. In univariate and multivariate (adjusted for age, sex, ethnicity, smoking, and MS treatments) repeated measures analyses, annual 25-hydroxyvitamin D levels were evaluated for their association with subsequent new T2-weighted and gadolinium-enhancing T1-weighted lesions on brain MRI, clinical relapses, and disability (Expanded Disability Status Scale [EDSS]).

Results: A total of 2,362 3T brain MRI scans were acquired from 469 subjects. In multivariate analyses, each 10ng/ml higher 25-hydroxyvitamin D level was associated with a 15% lower risk of a new T2 lesion (incidence rate ratio [IRR], 0.85; 95% confidence interval [CI], 0.76-0.95; p = 0.004) and a 32% lower risk of a gadolinium-enhancing lesion (IRR, 0.68; 95% CI, 0.53-0.87; p = 0.002). Each 10ng/ml higher vitamin D level was associated with lower subsequent disability (-0.047; 95% CI, -0.091 to -0.003; p = 0.037). Higher vitamin D levels were associated with lower, but not statistically significant, relapse risk. Except for the EDSS model, all associations were stronger when the within-person change in vitamin D level was the predictor.

Interpretation: Vitamin D levels are inversely associated with MS activity on brain MRI. These results provide further support for a randomized trial of vitamin D supplementation.

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Conflict of interest statement

Several authors (CEM, AE, PAG, DB, RL, MCO, PQ, MB) report no conflicts of interest. Dr. Mowry is funded by NIH K23NS067055. Dr. Waubant has received has received honorarium for 2 educational presentations from TEVA. She is ad hoc consultant for Roche, Sanofi Aventis, and Actelion. She has received free study medication from Bioden Idec and Sanofi Aventis. She has received funding from the Marcled Foundation, the Nancy Davis Foundation, the National MS Society, and the NIH. She has received an educational grant from TEVA and Biogen Idec. Dr. Okuda has received funding for travel or speaker honoraria from the National MS Society, Multiple Sclerosis Association of America, TEVA Neuroscience, Biogen IDEC, and Acorda Therapeutics; and received research support from Pfizer, Inc. and EMD Serono, Inc. Dr. Hauser served as both a board member and consultant to BioMarin and Receptos, has served as a consultant to Novartis, has received travel accommodations from Roche, and his institution (UCSF) has received payment for lectures given to Wyeth-Pfizer. He has received personal compensation from Wiley Publishing for serving as Editor-In-Chief of the journal Annals of Neurology and from McGraw-Hill Publishers for serving as editor of Harrison’s Internal Medical textbook. He has received stock/stock options from Receptos, all of which were then transferred to his institution (UCSF). Dr. Pelletier has received research funding from Biogen-Idec and has received consulting fees from Synarc. Inc and CNS Imaging Consultant LLC.

Figures

Figure 1
Figure 1
MRI Outcomes Associated with Quintiles of Vitamin D
See this image and copyright information in PMC

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