Abstract
The association between vitamin D deficiency and multiple sclerosis (MS) is well described. We set out to use remote sampling to ascertain vitamin D status and vitamin D supplementation in a cross-sectional study of people with MS across the UK. People with MS and matched controls were recruited from across the UK. 1768 people with MS enrolled in the study; remote sampling kits were distributed to a subgroup. Dried blood spots (DBS) were used to assess serum 25(OH)D in people with MS and controls. 1768 MS participants completed the questionnaire; 388 MS participants and 309 controls provided biological samples. Serum 25(OH)D was higher in MS than controls (median 71nmol/L vs 49nmol/L). A higher proportion of MS participants than controls supplemented (72% vs 26%, p<0.001); people with MS supplemented at higher vD doses than controls (median 1600 vs 600 IU/day, p<0.001). People with MS who did not supplement had lower serum 25(OH)D levels than non-supplementing controls (median 38 nmol/L vs 44 nmol/L). Participants engaged well with remote sampling. The UK MS population have higher serum 25(OH)D than controls, mainly as a result of vitamin D supplementation. Remote sampling is a feasible way of carrying out large studies.
Highlights
multiple sclerosis (MS) susceptibility is a complex trait influenced by genetic and environmental factors
A higher proportion of MS participants than controls supplemented (72% vs 26%, p
Remote sampling is a feasible way of carrying out large studies
Summary
MS susceptibility is a complex trait influenced by genetic and environmental factors. Established environmental risk factors include EBV seropositivity, smoking, and childhood obesity [1,2,3]. Serum 25(OH)D is formed by the hepatic 25-hydroxylation of cholecalciferol, which is further hydroxylated in the kidney to generate the biologically active compound (1,25 hydroxyvitamin D). Clinical trials of vitamin D supplementation in MS have failed to provide robust evidence of benefit [8,9,10,11]. Several recent meta-analyses looking at clinical trials of vitamin D for the treatment of MS have demonstrated at best modest reductions in annualised relapse rates (ARR) and/or brain lesion activity but no impact on disability [12,13,14]
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