Abstract
Objective. This study was conducted to analyze the effect of certain environmental factors on clinical and laboratorial variables in a cohort of multiple sclerosis patients. Material and methods. Serum vitamin 25(OH) D, smoking habits and oral contraceptive use were evaluated in 36 relapsing-remitting MS female patients between ages 29-45 under Interferon beta-1a therapy. Clinical variables included annualized relapse rate and Expanded Disability Status Scale (EDSS). The effect of sun exposure, dietary and smoking habits and oral contraceptive use on 25(OH) D levels was also examined. Results. Patients with higher 25(OH) D serum levels and consumers of oral contraceptives (OC) had better clinical outcomes, but not in a statistically significant extent. The practice of artificial tanning, consumption of alternative sources of vitamin D (cod liver oil, omega-3 fatty acids) and the use of oral contraceptives were associated with significantly higher vitamin D levels. Conclusions. Smoking seems to have less effect on disease progression and vitamin D levels than anticipated. Oral contraception use could be benefic and maintaining a high plasma D level is also encouraged in MS patients.
Highlights
We examine the direct role of serum vitamin D concentration, smoking habits and oral contraceptive use on relapsingremitting MS evolution in terms of annual relapse rate and Expanded Disability Status Scale (EDSS) score
This result shows the widespread vitamin D defficiency of MS patients but it raises the issue of serum 25(OH) D levels considered „normal”
The lower limit of optimal range has been determined as the serum level above whose beneficial skeletal effects of vitamin D can be observed [18]
Summary
Adequate serum levels of vitamin D is assumed to have a benefic influence on the course of MS, both on the frequency of relapses and the progress of disability. The role of OCs in disease progression is not clear, but it may have a benefic effect on the course of the disease by increasing the serum vitamin D levels [14,15]. The aim of this study is to identify those factors that significantly increase serum vitamin D concentration, indirectly have a benefic effect on MS disease evolution.
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