Volume 4, Issue 14 (Summer 2018)                   Caspian.J.Neurol.Sci 2018, 4(14): 114-120 | Back to browse issues page

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Fayyazi E, Shaygannejad V, Maljaie M B, Mirmosayyeb O, Badihian S, Moosavian S P. Association Between Sunlight Exposure and Vitamin D Intake and Multiple Sclerosis Disability and Progression. Caspian.J.Neurol.Sci. 2018; 4 (14) :114-120
URL: http://cjns.gums.ac.ir/article-1-219-en.html
1- Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Medical Students Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
2- Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran;
3- Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Food Safety Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
4- Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Medical Students Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract:   (157 Views)
Background: Some studies on Multiple Sclerosis (MS) have suggested that adequate vitamin D intake can modulate the course of MS and decreases its incidence. However, there are limited studies with conflicting findings on the relation between MS severity, its course, and vitamin D intake. 
Objectives: The current study aimed to compare vitamin D intake and sunlight exposure between MS phenotypes and evaluate their association with disability and fatigue in each phenotype.
Materials & Methods: A total of 197 patients with MS were recruited from patients referring to MS clinic in Kashani Hospital in Isfahan, Iran. Subjects were assessed for sunlight exposure, vitamin D intake, physical activity, and fatigue. SPSS was used for statistical analysis. P<0.05 were set as significant.
Results: According to the obtained results, expanded disability status scale and fatigue scale scores in Primary-Progressive MS (PPMS) and Secondary-Progressive MS (SPMS) groups were higher than RRMS group. In addition, patients in RRMS group had higher scores of sun exposure and physical activity, compared to SPMS and PPMS groups. We found a negative correlation between the scores of fatigue scale and sunlight exposure scale in RRMS patients.
Conclusion: We found higher sunlight exposure in RRMS group and lower sunlight exposure in the PPMS group, while dietary vitamin D intake was not different between the groups. Further studies with larger sample sizes and stronger methodologies are required to evaluate our findings.
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Type of Study: Research | Subject: Special
Received: 2017/10/10 | Accepted: 2018/03/5 | Published: 2018/07/1

References
1. Chen S, Sims GP, Chen XX, Gu YY, Chen S, Lipsky PE. Modulatory effects of 1, 25-dihydroxyvitamin D3 on human B cell differentiation. J Immunol. 2007; 179(3):1634-47. [DOI:10.4049/jimmunol.179.3.1634] [PMID] [DOI:10.4049/jimmunol.179.3.1634]
2. Ciccarelli O, Thompson A. Multiple Sclerosis in 2015: Managing the complexity of Multiple Sclerosis. Nat Rev Neurol. 2016; 12(2):70-2. [DOI:10.1038/nrneurol.2016.2] [PMID] [DOI:10.1038/nrneurol.2016.2]
3. Dutta R, Trapp BD. Relapsing and progressive forms of Multiple Sclerosis–insights from pathology. Curr Opin Neurol. 2014; 27(3):271-8. [DOI:10.1097/WCO.0000000000000094] [PMID] [PMCID] [DOI:10.1097/WCO.0000000000000094]
4. Lublin FD, Reingold SC, Cohen JA, Cutter GR, Sørensen PS, Thompson AJ, et al. Defining the clinical course of Multiple Sclerosis The 2013 revisions. Neurol. 2014; 83(3):278-86. [DOI:10.1212/WNL.0000000000000560] [PMID] [PMCID] [DOI:10.1212/WNL.0000000000000560]
5. Leray E, Moreau T, Fromont A, Edan G. Epidemiology of Multiple Sclerosis. Rev Neurol. 2016; 172(1):3-13. [DOI:10.1016/j.neurol.2015.10.006] [PMID] [DOI:10.1016/j.neurol.2015.10.006]
6. Riccio P, Rossano R. Nutrition facts in Multiple Sclerosis. ASN Neuro. 2015; 7(1):1759091414568185. [DOI:10.1177/1759091414568185] [PMID] [PMCID] [DOI:10.1177/1759091414568185]
7. Riccio P. The molecular basis of nutritional intervention in Multiple Sclerosis: a narrative review. Complement Ther Med. 2011; 19(4):228-37. [DOI:10.1016/j.ctim.2011.06.006] [PMID] [DOI:10.1016/j.ctim.2011.06.006]
8. Ascherio A, Munger KL. Environmental risk factors for Multiple Sclerosis. Part II: Noninfectious factors. Ann Neurol. 2007; 61(6):504-13. [DOI:10.1002/ana.21141] [PMID] [DOI:10.1002/ana.21141]
9. Ascherio A, Munger KL, Simon KC. Vitamin D and Multiple Sclerosis. Lancet Neurol. 2010; 9(6):599-612. [DOI:10.1016/S1474-4422(10)70086-7] [DOI:10.1016/S1474-4422(10)70086-7]
10. Munger KL, Zhang S, O'reilly E, Hernan M, Olek M, Willett W, et al. Vitamin D intake and incidence of Multiple Sclerosis. Neurol. 2004; 62(1):60-5. [DOI:10.1212/01.WNL.0000101723.79681.38] [PMID] [DOI:10.1212/01.WNL.0000101723.79681.38]
11. Muris AH, Smolders J, Rolf L, Klinkenberg LJ, van der Linden N, Meex S, et al. Vitamin D status does not affect disability progression of patients with Multiple Sclerosis over three year follow-up. PloS One. 2016; 11(6):e0156122. [DOI:10.1371/journal.pone.0156122] [PMID] [PMCID] [DOI:10.1371/journal.pone.0156122]
12. Esmael A, El-Sherif M, Elazzouny AA. Effects of vitamin D deficiency on the relapse, severity, and disability of Multiple Sclerosis. Egypt J Neurol Psychiatr Neurosurg. 2016; 53(3):174-8. [DOI:10.4103/1110-1083.193086] [DOI:10.4103/1110-1083.193086]
13. van der Mei IA, Ponsonby AL, Dwyer T, Blizzard L, Simmons R, Taylor B, et al. Past exposure to sun, skin phenotype, and risk of Multiple Sclerosis: Case-control study. Bmj. 2003; 327(7410):316. [DOI:10.1136/bmj.327.7410.316] [PMID] [PMCID] [DOI:10.1136/bmj.327.7410.316]
14. Langer-Gould A, Chen L, Gonzales E, Schroeder C, Xiang A, Barcellos L, et al. Lifetime Sun Exposure and the Risk of Multiple Sclerosis in Blacks and Hispanics (P3. 002). Neurol. 2016; 86(16 Supplement).
15. Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, et al. Diagnostic criteria for Multiple Sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011; 69(2):292-302. [DOI:10.1002/ana.22366] [PMID] [PMCID] [DOI:10.1002/ana.22366]
16. Azar M, Sarkisian E. Food composition table of Iran: National Nutrition and Food Research Institute. Tehran: Shahid Beheshti University; 1980.
17. Weihrauch J, Neira P. Provisional table on the vitamin D content of foods. Washington DC: US Department of Agriculture; 1991.
18. Glanz K, Yaroch AL, Dancel M, Saraiya M, Crane LA, Buller DB, et al. Measures of sun exposure and sun protection practices for behavioral and epidemiologic research. Arch Dermatol. 2008; 144(2):217-22. [DOI:10.1001/archdermatol.2007.46] [PMID] [DOI:10.1001/archdermatol.2007.46]
19. Aadahl M, JØrgensen T. Validation of a new self-report instrument for measuring physical activity. Med Sci Sports Exerc. 2003; 35(7):1196-202. [DOI:10.1249/01.MSS.0000074446.02192.14] [PMID] [DOI:10.1249/01.MSS.0000074446.02192.14]
20. Rezazadeh A, Rashidkhani B, Omidvar N. Association of major dietary patterns with socioeconomic and lifestyle factors of adult women living in Tehran, Iran. Nutr. 2010; 26(3):337-41. [DOI:10.1016/j.nut.2009.06.019] [PMID] [DOI:10.1016/j.nut.2009.06.019]
21. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale: Application to patients with Multiple Sclerosis and systemic lupus erythematosus. Arch Neurol. 1989; 46(10):1121-3. [DOI:10.1001/archneur.1989.00520460115022] [PMID] [DOI:10.1001/archneur.1989.00520460115022]
22. Goldenberg MM. Multiple Sclerosis review. Phys Ther. 2012; 37(3):175-84. [PMID] [PMCID]
23. Braley TJ, Chervin RD. Fatigue in Multiple Sclerosis: Mechanisms, evaluation, and treatment. Sleep. 2010; 33(8):1061. [DOI:10.1093/sleep/33.8.1061] [DOI:10.1093/sleep/33.8.1061]
24. Rottoli M, La Gioia S, Frigeni B, Barcella V. Pathophysiology, assessment and management of Multiple Sclerosis fatigue: An update. Expert Rev Neurother. 2017; 17(4):373-9. [DOI:10.1080/14737175.2017.1247695.] [PMID] [DOI:10.1080/14737175.2017.1247695]
25. Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyvitamin D levels and risk of Multiple Sclerosis. JAMA. 2006; 296(23):2832-8. [DOI:10.1001/jama.296.23.2832] [PMID] [DOI:10.1001/jama.296.23.2832]
26. Salzer J, Hallmans G, Nyström M, Stenlund H, Wadell G, Sundström P. Vitamin D as a protective factor in Multiple Sclerosis. Neurol. 2012; 79(21):2140-5. [DOI:10.1212/WNL.0b013e3182752ea8] [PMID] [DOI:10.1212/WNL.0b013e3182752ea8]
27. Kampman M, Wilsgaard T, Mellgren S. Outdoor activities and diet in childhood and adolescence relate to MS risk above the Arctic Circle. J Neurol. 2007; 254(4):471-7. [DOI:10.1007/s00415-006-0395-5] [PMID] [DOI:10.1007/s00415-006-0395-5]
28. Mowry EM, Krupp LB, Milazzo M, Chabas D, Strober JB, Belman AL, et al. Vitamin D status is associated with relapse rate in pediatric‐onset Multiple Sclerosis. Ann Neurol. 2010; 67(5):618-24. [PMID] [PMID]
29. Correale J, Ysrraelit MC, Gaitán MI. Immunomodulatory effects of Vitamin D in Multiple Sclerosis. Brain. 2009; 132(5):1146-60. [DOI:10.1093/brain/awp033] [PMID] [DOI:10.1093/brain/awp033]
30. Simpson S, Taylor B, Blizzard L, Ponsonby AL, Pittas F, Tremlett H, et al. Higher 25‐hydroxyvitamin D is associated with lower relapse risk in Multiple Sclerosis. Ann Neurol. 2010; 68(2):193-203. [PMID] [PMID]
31. Soilu-Hänninen M, Airas L, Mononen I, Heikkilä A, Viljanen M, Hänninen A. 25-Hydroxyvitamin D levels in serum at the onset of Multiple Sclerosis. Mult Scler. 2005; 11(3):266-71. [DOI:10.1191/1352458505ms1157oa] [PMID] [DOI:10.1191/1352458505ms1157oa]
32. Smolders J, Menheere P, Kessels A, Damoiseaux J, Hupperts R. Association of vitamin D metabolite levels with relapse rate and disability in Multiple Sclerosis. Mult Scler. 2008; 14(9):1220-4. [DOI:10.1177/1352458508094399] [PMID] [DOI:10.1177/1352458508094399]
33. van der Mei IA, Ponsonby A-L, Dwyer T, Blizzard L, Taylor BV, Kilpatrick T, et al. Vitamin D levels in people with Multiple Sclerosis and community controls in Tasmania, Australia. J Neurol. 2007; 254(5):581. [DOI:10.1007/s00415-006-0315-8] [PMID] [DOI:10.1007/s00415-006-0315-8]
34. Weinstock-Guttman B, Zivadinov R, Qu J, Cookfair D, Duan X, Bang E, et al. Vitamin D metabolites are associated with clinical and MRI outcomes in Multiple Sclerosis patients. J Neurol, Neurosurg & Psychiatry. 2011; 82(2):189-95. [DOI:10.1136/jnnp.2010.227942] [PMID] [DOI:10.1136/jnnp.2010.227942]
35. Ascherio A, Munger KL, White R, Köchert K, Simon KC, Polman CH, et al. Vitamin D as an early predictor of Multiple Sclerosis activity and progression. JAMA Neurol. 2014; 71(3):306-14. [DOI:10.1001/jamaneurol.2013.5993] [PMID] [PMCID] [DOI:10.1001/jamaneurol.2013.5993]
36. Lucas RM, Ponsonby AL. Considering the potential benefits as well as adverse effects of sun exposure: can all the potential benefits be provided by oral vitamin D supplementation? Prog Biophys Mol Biol. 2006; 92(1):140-9. [DOI:10.1016/j.pbiomolbio.2006.02.019] [PMID] [DOI:10.1016/j.pbiomolbio.2006.02.019]
37. Antonovsky A, Leibowitz U, Smith HA, Medalie JM, Balogh M, Kats R, et al. Epidemiologic study of Multiple Sclerosis in Israel: I. An overall review of methods and findings. Arch Neurol. 1965; 13(2):183-93. [DOI:10.1001/archneur.1965.00470020073010] [PMID] [DOI:10.1001/archneur.1965.00470020073010]
38. Cendrowski W, Wender M, Dominik W, Flejsierowicz Z, Owsianowski M, Popiel M. Epidemiological study of Multiple Sclerosis in western Poland. Eur Neurol. 1969; 2(2):90-108. [DOI:10.1159/000113777] [PMID] [DOI:10.1159/000113777]
39. Bjørnevik K, Riise T, Casetta I, Drulovic J, Granieri E, Holmøy T, et al. Sun exposure and Multiple Sclerosis risk in Norway and Italy: The EnvIMS study. Mult Scler J. 2014; 20(8):1042-9. [DOI:10.1177/1352458513513968] [PMID] [DOI:10.1177/1352458513513968]
40. Islam T, Gauderman WJ, Cozen W, Mack TM. Childhood sun exposure influences risk of Multiple Sclerosis in monozygotic twins. Neurol. 2007; 69(4):381-8. [DOI:10.1212/01.wnl.0000268266.50850.48] [PMID] [DOI:10.1212/01.wnl.0000268266.50850.48]
41. Tremlett H, Van Der Mei IA, Pittas F, Blizzard L, Paley G, Mesaros D, et al. Monthly ambient sunlight, infections and relapse rates in Multiple Sclerosis. Neuroepidemiology. 2008; 31(4):271-9. [DOI:10.1159/000166602] [PMID] [DOI:10.1159/000166602]
42. Freedman DM, Dosemeci M, Alavanja MC. Mortality from Multiple Sclerosis and exposure to residential and occupational solar radiation: a case-control study based on death certificates. Occup Environ Med. 2000; 57(6):418-21. [DOI:10.1136/oem.57.6.418] [PMID] [PMCID] [DOI:10.1136/oem.57.6.418]

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