Interdependence and contributions of sun exposure and vitamin D to MRI measures in multiple sclerosis.
J Neurol Neurosurg Psychiatry. 2013 Feb 5.
Zivadinov R, Treu CN, Weinstock-Guttman B, Turner C, Bergsland N, O'Connor K, Dwyer MG, Carl E, Ramasamy DP, Qu J, Ramanathan M.
Department of Neurology, Buffalo Neuroimaging Analysis Center, State University of New York, , Buffalo, New York, USA.
PURPOSE: To assess the relationships of sun exposure history, supplementation and environmental factors to vitamin D levels in multiple sclerosis (MS) patients and to evaluate the associations between sun exposure and MRI measures.
METHODS: This study included 264 MS patients (mean age 46.9±10 years, disease duration 14.6±10 years; 67.8% relapsing-remitting, 28% secondary progressive and 4.2% primary progressive MS) and 69 healthy controls. Subjects underwent neurological and 3 T MRI examinations, provided blood samples and answered questions to a structured questionnaire. Information on race, skin and eye colour, supplement use, body mass index (BMI) and sun exposure was obtained by questionnaire. The vitamin D metabolites (25-hydroxy vitamin D3, 1, 25-dihydroxy vitamin D3 and 24, 25-dihydroxy vitamin D3) were measured using mass spectrometry.
- Multivitamin supplementation (partial correlation r(p)=0.29, p<0.001),
- BMI (r(p)=-0.24, p=0.001),
- summer sun exposure (r(p)=0.22, p=0.002) and
- darker eye colour (r(p)=-0.18, p=0.015)
had the strongest associations with vitamin D metabolite levels in the MS group.
Increased summer sun exposure was associated with
- increased grey matter volume (GMV, r(p)=0.16, p=0.019) and
- whole brain volume (WBV, r(p)=0.20, p=0.004)
after correcting for Extended Disability Status Scale in the MS group.
Inclusion of 25-hydroxy vitamin D3 levels did not substantially affect the positive associations of sun exposure with
- WBV (r(p)=0.18, p=0.003) and
- GMV (r(p)=0.14, p=0.026) in the MS group.
CONCLUSIONS: Sun exposure may have direct effects on MRI measures of neurodegeneration in MS, independently of vitamin D.
This agrees with many previous studies which indicate that net UV may be more important than vitamin D.
However, notice that this study compares measured vitamin D levels with recalled amount of time out in the sun (for how many years)
- Vitamin D prevents multiple sclerosis through multiple mechanisms – Jan 2013
- Risk of going from pre-MS to MS reduced 68 percent with 7100 IU vitamin D – RCT Dec 2012
- Vitamin D can both prevent and treat Multiple Sclerosis – review Nov 2012
- MS helped by average daily 2800 IU vitamin D – RCT Aug 2012
- Clinical trials for MS and Vitamin D INTERVENTION 21 as of March 2013
- Overview MS and vitamin D - which had the following
Controversy: Which is better: UV or Vitamin D
- Sources of UV, in addition to the sun, include your own UV bulb
- MS 20X more correlated to UV than other variables – Jan 2011
- Lack of UV increased offspring MS – April 2010
- Increased sun and vitamin D both reduced MS risk – March 2011
- 30% less likely to get MS for UV increase of 1000 kJ/m2
- Latitude is significantly associated with the prevalence of multiple sclerosis: a meta-analysis Oct 2011
Meta-analysis of >300 studies of MS and latitude
- UV suppresses MS but vitamin D might not – March 2010
- 7% less likely to get MS for each 4 ng increase in vitamin D level in blood
- MS prevention by UV is 2X better than prevention by vitamin D levels – Jan 2012
- Did sunshine help Ann Romney’s multiple sclerosis? Vitamin D Council Aug 2012
1999 MS Diagnosis ==> Conventional Therapy, Yoga, reflexology, and taking up riding horses out-doors ==> 2001 MS in remission
MS flareup in Spring 2012 Reminder - lowest vitamin D levels occur in the Spring
- Less MS (MRI) decline after raising Vitamin D levels – clinical trial Oct 2012
- Exceptionally important findings on Sunlight Exposure, Multiple Sclerosis (MS) and Brain Volume, Independent of Vitamin D SunlightInstutute Report on this study