Assessment of Biochemical and Densitometric Markers of Calcium-Phosphate Metabolism in the Groups of Patients with Multiple Sclerosis Selected due to the Serum Level of Vitamin D₃

Abstract

Background In addition to the widely known effect of vitamin D3 (vitD3) on the skeleton, its role in the regulation of the immune response was also confirmed. Aim The assessment of biochemical and densitometric markers of calcium-phosphate metabolism in the groups of patients with relapsing-remitting multiple sclerosis (RRMS) selected due to the serum level of vitamin D3. Methods The concentrations of biochemical markers and indices of lumbar spine bone densitometry (DXA) were determined in 82 patients divided into vitamin D3 deficiency (VitDd), insufficiency (VitDi), and normal vitamin D3 level (VitDn) subgroups. Results The highest level of the parathyroid hormone (PTH) and the highest prevalence of hypophosphatemia and osteopenia were demonstrated in VitDd group compared to VitDi and VitDn. However, in VitDd, VitDi, and VitDn subgroups no significant differences were observed in the levels of alkaline phosphatase (ALP) and ionized calcium (Ca2+) and in DXA indices. A negative correlation was observed between the level of vitamin D3 and the Expanded Disability Status Scale (EDSS) in the whole MS group. The subgroups were significantly different with respect to the EDSS scores and the frequency of complaints related to walking according to the EQ-5D. Conclusions It is necessary to assess calcium-phosphate metabolism and supplementation of vitamin D3 in RRMS patients. The higher the clinical stage of the disease assessed with the EDSS, the lower the level of vitamin D3 in blood serum. Subjectively reported complaints related to difficulties with walking were reflected in the EDSS in VitDd patients.

Multiple Sclerosis Patients Show Lower Bioavailable 25(OH)D and 1,25(OH)2D, but No Difference in Ratio of 25(OH)D/24,25(OH)2D and FGF23 Concentrations

“…Lastly, EDSS scores were comparable between male and female MS patients, which is consistent with previous research [86,87]. In female MS patients, however, EDSS showed negative correlations with free and bioavailable 1.25(OH) 2 D; free, bioavailable, and total 25(OH)D; and 24.25(OH) 2 D, which is in line with earlier studies, which reported a negative correlation between EDSS and 1.25(OH) 2 D or 25(OH)D, respectively [46,88]. In contrast, in male MS patients, negative correlations between EDSS and CTX, P1NP, and osteocalcin were observed, which differs from previous studies, which found no correlations between EDSS and BTMs or only a positive correlation between EDSS and CTX [67,89].…”

Study of ABO System and Multiple Sclerosis disease in Iraq

“…The relation between 25-OHD3 and inflammation risk was studied by most researchers [14], while others assessed the role of 25-OHD3 in myelination and re-myelination [15]. Thus, 25-OHvitD3 has vital roles in CNS functions, maturement of the immune cells, homeostasis of epithelial barrier and inhibiting proliferation and induces differentiation for different type of cells [16]. Also, the blood homeostasis for both calcium and phosphate is maintained via vitamin D with the PTH [17] Typically, neurologists have assessed MS patient disability by "Expanded Disability Status Scale" (EDSS).…”