Severe vitamin D deficiency and smoking increases the risk of multiple sclerosis and disability accumulation in clinically isolated syndromes
Author(s): ,
M.I Zuluaga
Affiliations:
Multiple Sclerosis Centre of Catalonia/Neuroimmunology Department, Vall d'Hebron University Hospital
,
S Otero-Romero
Affiliations:
Department of Neurology & Immunology, Vall Hebron University Hospitla - MS Centre of Catalonia (Cemcat)
,
N Fissolo
Affiliations:
Multiple Sclerosis Centre of Catalonia/Neuroimmunology Department, Vall d'Hebron University Hospital
,
M Comabella
Affiliations:
Multiple Sclerosis Centre of Catalonia/Neuroimmunology Department, Vall d'Hebron University Hospital
,
L Negrotto
Affiliations:
Multiple Sclerosis Centre of Catalonia/Neuroimmunology Department, Vall d'Hebron University Hospital
,
I Galán
Affiliations:
Multiple Sclerosis Centre of Catalonia/Neuroimmunology Department, Vall d'Hebron University Hospital
,
G Arrambide
Affiliations:
Multiple Sclerosis Centre of Catalonia/Neuroimmunology Department, Vall d'Hebron University Hospital
,
J Rio
Affiliations:
Department of Neurology & Immunology, Vall Hebron University Hospitla - MS Centre of Catalonia (Cemcat)
,
C Nos
Affiliations:
Multiple Sclerosis Centre of Catalonia/Neuroimmunology Department, Vall d'Hebron University Hospital
,
M.J Arévalo
Affiliations:
Multiple Sclerosis Centre of Catalonia/Neuroimmunology Department, Vall d'Hebron University Hospital
,
À Vidal-Jordana
Affiliations:
Multiple Sclerosis Centre of Catalonia/Neuroimmunology Department, Vall d'Hebron University Hospital
,
J Castilló
Affiliations:
Multiple Sclerosis Centre of Catalonia/Neuroimmunology Department, Vall d'Hebron University Hospital
,
B Rodriguez-Acevedo
Affiliations:
Multiple Sclerosis Centre of Catalonia/Neuroimmunology Department, Vall d'Hebron University Hospital
,
L Midaglia
Affiliations:
Multiple Sclerosis Centre of Catalonia/Neuroimmunology Department, Vall d'Hebron University Hospital
,
P Mulero
Affiliations:
Department of Neurology & Immunology, Vall Hebron University Hospitla - MS Centre of Catalonia (Cemcat)
,
R Mitjana
Affiliations:
Radiology-MRI Unit, Vall Hebron University Hospital, Barcelona, Spain
,
C Auger
Affiliations:
Radiology-MRI Unit, Vall Hebron University Hospital, Barcelona, Spain
,
J Sastre-Garriga
Affiliations:
Multiple Sclerosis Centre of Catalonia/Neuroimmunology Department, Vall d'Hebron University Hospital
,
À Rovira
Affiliations:
Radiology-MRI Unit, Vall Hebron University Hospital, Barcelona, Spain
,
X Montalban
Affiliations:
Multiple Sclerosis Centre of Catalonia/Neuroimmunology Department, Vall d'Hebron University Hospital
M Tintoré
Affiliations:
Multiple Sclerosis Centre of Catalonia/Neuroimmunology Department, Vall d'Hebron University Hospital
ECTRIMS Online Library. Zuluaga M. Sep 16, 2016; 147079; 252
Maria Isabel Zuluaga
Maria Isabel Zuluaga
Contributions
Abstract

Abstract: 252

Type: LB Oral

Abstract Category: Late Breaking News

Background: Environmental factors may play a role in the prognosis of multiple sclerosis in CIS patients, specially smoking and vitamin D levels.

Objective: The aim of this study was to investigate the effect of serum 25OH Vitamin D (25OHVitD) and cotinine levels on the risk of definite MS and disability progression.

Methods: Clinical and imaging data were prospectively acquired from an ongoing CIS cohort started in 1995. 25OHVitD and cotinine levels were analysed in serum samples collected during the first year after CIS and stored in standard conditions. We studied the effect of 25OHVitD and cotinine levels on confirmed MS and accrual disability (confirmed EDSS 3.0). Uni- and multivariate Cox regression analyses adjusted by sex, age, CIS topography, oligoclonal bands, baseline number of lesions and disease modifying treatment initiation were conducted.

Results: 25OHVitD levels were analysed in 503 patients (mean value of 17.6 ng/mg; SD 9.7); of which 72% had low levels (≤20 ng/ml). Severe deficiency of 25OHVitD (< 8.0 ng/ml) showed an increased risk for disability (HR 2.3 95%CI 1.1-5.0; p=0.032); that persisted in the multivariate analysis (aHR 2.35 95%CI 1.0-5.5; p=0.05). In total, 464 determinations of cotinine were performed (median value 0.54 ng/ml; 0-105). Cotinine levels in the active smoker range (>14 ng/ml) were present in 43% of the patients. Active smokers had a higher risk for disability progression (HR 2.5 95%CI 1.5-4.1; p=0.001) that persisted when adjusting for possible confounders (aHR 2.4 95%CI 1.4-4.1; p=0.002). The impact of both factors on conversion to MS was less consistent.

Conclusion: Severe vitamin D deficiency 25OHVitD and active smoking at the time of the CIS have a robust independent effect on disability accumulation in CIS patients.

Disclosure: Authors have nothing ot disclose in relation to this work

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