Serum Levels of 25(OH) Vitamin D3 and Clinical Manifestation of First Demyelinating Attack

Multiple sclerosis (MS) is a common demyelinating disease of the central nervous system. The role of vitamin D against onset and progression of multiple sclerosis is well-recognized. In this study, we evaluated the serum levels of 25(OH) vitamin D3 in patients with clinically isolated syndrome with the manifestation of optic neuritis, brain stem, and spinal cord syndrome.
In this cross sectional study, a total of 104 cases were enrolled (35 patients with optic neuritis, 35 patients with spinal cord syndrome, and 34 patients with brain stem syndrome). The serum levels of 25(OH) vitamin D3 were measured in all patients.
Findings: Mean serum level of 25(OH) vitamin D3 was 11.30 ± 6.82, 14.00 ± 10.27, and 18.65 ± 13.15 ng/ml in patients with spinal cord syndrome, optic neuritis, and brain stem syndrome, respectively. Serum level of 25(OH) vitamin D3 was significantly lower in patients with spinal cord syndrome in comparison to patients with optic neuritis or brain stem syndrome (P = 0.010).
According to previous studies, the association between poor serum levels of 25-OH vitamin D3 and increased relapse rate and magnetic resonance imaging (MRI) lesions in patients with multiple sclerosis has been reported. Furthermore, lower 25-OH vitamin D3 levels are associated with increased risk of the disease later in life. In our study, different serum levels of 25-OH vitamin D3 was associated with variable clinical manifestations of the disease. The status of 25-OH vitamin D3 appears to play an important role since the very early stages of disease.