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Narcolepsy with Cataplexy 5X more probable with lowest vitamin D – Feb 2011

Low Vitamin D in Narcolepsy with Cataplexy

Bertrand Carlander 1, Anne Marie Puech-Cathala2, Isabelle Jaussent3, Sabine Scholz1, Sophie Bayard1,3, Valérie Cochen1, Yves Dauvilliers1,3*
1 National Reference Network for Narcolepsy, Department of Neurology, Hôpital Gui-de-Chauliac, CHU Montpellier, Montpellier, France,
2 Laboratoire d'Hormonologie, Hôpital Lapeyronie, CHU Montpellier, Montpellier, France,
3 Inserm U1061, University of Montpellier 1, Montpellier, France
Received: February 23, 2011; Accepted: April 19, 2011; Published: May 25, 2011

Background
Narcolepsy with cataplexy (NC) is currently thought to be an autoimmune-mediated disorder in which environmental risk factors make a significant contribution to its development. It was proposed that vitamin D deficiency plays a role in autoimmune diseases. Here we investigated whether NC can be associated with 25-hydroxyvitamin D (25(OH)D) level deficiency in patients with NC compared with gender- and age-matched normal controls.

Methodology
Serum level of 25 (OH)D was determined in 51 European patients with typical NC compared to 55 age-, gender-, and ethnicity-matched healthy controls. Demographic and clinical data (age at onset, duration and severity of disease at baseline, and treatment intake at time of study) and season of blood sampling were collected to control for confounding variables.

Principal Findings
Serum 25(OH)D concentration was lower in NC compared to controls (median, 59.45 nmol/l [extreme values 24.05–124.03] vs. 74.73 nmol/l [26.88–167.48] p = 0.0039). Patients with NC had significantly greater vitamin D deficiency (<75 nmol/l) than controls (72.5% vs 50.9%, p = 0.0238). Division into quartiles of the whole sample revealed that the risk of being affected with NC increased with lower 25(OH)D level, with a 5.34 OR [1.65–17.27] for the lowest quartile (p = 0.0051). Further adjustment for BMI did not modify the strength of the association (OR: 3.63, 95% CI = 1.06–12.46, p = 0.0191). No between BMI and 25(OH)D interaction, and no correlation between 25(OH)D level and disease duration or severity or treatment intake were found in NC.

Conclusion
We found a higher frequency of vitamin D deficiency in NC. Further studies are needed to assess the contribution of hypovitaminosis D to the risk of developing narcolepsy, and to focus on the utility of assessing vitamin D status to correct potential deficiency.

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