Low vitamin D, but not tobacco use or high BMI, is associated with long-term disability progression in multiple sclerosis

BackgroundLow vitamin D levels, tobacco use and high body mass index (BMI) have been linked to adverse disease outcomes in multiple sclerosis (MS), but their influence on long-term disability progression remains unclear. Therefore, we explored whether these modifiable lifestyle factors were associated with 10-year clinical patients MS.MethodsIn this prospective study, a cohort of 88 relapsing-remitting MS completed randomized controlled study ?-3 fatty acids between 2004 2008. During 24 months, serum 25-hydroxyvitamin (25(OH)D), cotinine (nicotine metabolite), BMI repeatedly measured. In 2017, follow-up was conducted among 80 the participants, including assessment by Expanded Disability Status Scale (EDSS). Linear regression used explore associations EDSS change over 10 years.ResultsHigher seasonally adjusted 25(OH)D levels lower (change per 1 SD increase model for sex, age baseline EDSS: -0.45 point, 95% CI: -0.75 -0.16, p=0.003). Further adjustments potential confounders related status gave similar results. The association mainly driven low during spring, as well below nmol/L. No clear found cotinine.ConclusionLower apparently not or higher BMI, significantly worse MS.