Low vitamin D-25(OH) level in Indonesian multiple sclerosis and neuromyelitis optic patients

Mult Scler Relat Disord. 2018 Oct:25:329-333. doi: 10.1016/j.msard.2018.08.030. Epub 2018 Aug 31.

Abstract

Background: Vitamin D deficiency is commonly found in multiple sclerosis (MS) and Neuromyelitis Optic (NMO) patients and can impair the immunological status. As a tropical country, Indonesia has a lot of sunshine throughout the year as a source of vitamin D. The aim of this study was to evaluate and compare the serum vitamin D-25(OH) level in Indonesian MS and NMO patients to healthy individuals.

Methods: A cross-sectional study was conducted in Dr. Cipto Mangunkusumo General Hospital Jakarta from November 2016 to May 2017. Forty-eight patients (29 MS and 19 NMO) and 33 healthy controls were enrolled. We assessed the dietary recall, vitamin D supplementation, sunshine exposure, medication, annual relapse rate, and Expanded Disability Status Scale (EDSS). Vitamin D level was measured using direct competitive chemiluminescence immunoassay.

Results: Vitamin D deficiency was found in 48.4% of MS and 56.2% of NMO patients. The serum vitamin D level in MS and NMO groups was not significantly different from the healthy controls. Vitamin D level was not associated with EDSS and the annual relapse rate. Positive significant correlation was observed between sunshine exposure and vitamin D level in healthy control, but not evident in MS and NMO groups. MS and NMO subjects who still treated with corticosteroid had lower vitamin D level.

Conclusion: Vitamin D deficiency is commonly found in Indonesian MS and NMO patients, but not associated with EDSS and annual relapse rate. Despite living in a country with adequate sunshine exposure, the physician should anticipate low serum vitamin D level, especially in MS or NMO patients who received corticosteroid.

Keywords: Demyelinating diseases; Expanded Disability Status Scale (EDSS); Indonesia; Multiple sclerosis (MS); Neuromyelitis optic (NMO); Vitamin D.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Inflammatory Agents / therapeutic use
  • Cross-Sectional Studies
  • Disability Evaluation
  • Female
  • Humans
  • Indonesia / epidemiology
  • Male
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Multiple Sclerosis / blood*
  • Multiple Sclerosis / drug therapy
  • Multiple Sclerosis / epidemiology*
  • Neuromyelitis Optica / blood*
  • Neuromyelitis Optica / drug therapy
  • Neuromyelitis Optica / epidemiology*
  • Statistics, Nonparametric
  • Vitamin D / blood*
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / epidemiology
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Vitamin D
  • Methylprednisolone