Objective: The investigators sought to determine if vitamin D status is associated with developing new T2 lesions or contrast-enhancing lesions on brain MRI in relapsing MS.
Methods: EPIC is a 5-year longitudinal MS cohort study at the University of California, San Francisco. Participants had clinical evaluations, brain MRI, and blood draws annually. From the overall cohort, they evaluated MSers with clinically isolated syndrome or relapsing-remitting MS at baseline.
Results: 2,362 MRI scans were acquired from 469 subjects. Each 10ng/mL higher 25-hydroxyvitamin D was associated with a 15% lower risk of a new T2 lesion (incidence rate ratio [IRR]= 0.85, 95% 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, -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 (lower the levels the worse MS) associated with MS activity on brain MRI. These results provide further support for a randomized trial of vitamin D supplementation.
“The other option is for MSers to make sure they vD replete; there are health benefits outside of MS to justify this approach, for example bone health, reduce your risks of infection to reduce your risks of certain tumours.”
“The case for making sure the whole population is vD replete is very compelling; but then I would say that as I have a conflict of interest.”