VITAMIN D LEVELS, VITAMIN D INTAKE AND SUNLIGHT EXPOSURE IN PEDIATRIC MULTIPLE SCLEROSIS

Objectives: Studies have shown that adult multiple sclerosis (MS) patients tend to have insufficient vitamin D levels and vitamin D may have a positive immunoregulatory effect in MS. There are no studies of vitamin D in children with MS.

Methods: We recruited 23 pediatric MS patients and 40 healthy controls between January and March 2005. Serum levels of 25(OH)-vitamin D, calcium and parathyroid hormone levels were measured and a diet and lifestyle questionnaire was administered. Patients with serum 25(OH)-vitamin D levels below 70 nmol/L were considered to be vitamin D insufficient and patients with levels below 30 nmol/L were considered vitamin D deficient.

Results: The mean age of MS patients was 14.69yrs (SD=2.74) compared to 12.38yrs (SD=3.19) for healthy patients. In MS patients, the mean 25(OH)-vitamin D was 53.04 nmol/L (SD=22.27), which did not significantly differ from the mean 25(OH)-vitamin D of healthy patients (45.83 nmol/L (SD=18.71)). Over 80% of MS patients and 90% of healthy patients were vitamin D insufficient, while 25% of MS and 8% of healthy patients were vitamin D deficient. Vitamin D supplementation (400–1000 IU/day) was reported by 48% of MS patients, of whom 64% were vitamin D insufficient. In the healthy cohort, 28% were taking vitamin D supplementation (400 IU/day), of whom 10% were vitamin D insufficient. Analysis of the demographic data and sunlight exposure questionnaires is pending.

Conclusion: We report an alarmingly high prevalence of vitamin D insufficiency in both pediatric MS and healthy patients in a northern climate. Vitamin D insufficiency occurred despite standard vitamin D supplementation. These results require further validation but they suggest that vitamin D insufficiency may be a major public health concern in Canada. Further studies on the impact of vitamin D insufficiency in MS are also required.