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International neurological journal 7 (77) 2015

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Quality of Life in Patients with Multiple Sclerosis: Therapeutic Effect of Cholecalciferol (Vitamin D3)

Authors: Malyk S.L., Moskovko S.P., Moskovko H.S., Tytarenko N.V. - Vinnytsia National Medical University named after M.I. Pyrohov, Vinnytsia, Ukraine

Categories: Neurology

Sections: Clinical researches

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Summary

Метою даного дослідження було вивчення вірогідного впливу річного курсу компенсації дефіциту обміну 25(OH)D за допомогою офіцинального препарату вітаміну D на якість життя хворих із множинним склерозом. Проаналізовано дані спостереження за 57 пацієнтами з множинним склерозом. Через 1 рік у групі вітаміну D3 установлено значуще покращення оцінки загального сприйняття здоров’я (р = 0,002), життєздатності (р = 0,003), ролі емоційних проблем в обмеженні життєдіяльності (р = 0,01), показника психічного здоров’я (р = 0,008). Застосування вітаміну D3 позитивно позначилося на психічному компоненті якості життя.

Целью данного исследования было изучение вероятного влияния годового курса компенсации дефицита обмена 25(OH)D с помощью официнального препарата витамина D на качество жизни больных с множественным склерозом. Проанализированы данные наблюдений за 57 пациентами с множественным склерозом. Через 1 год в группе витамина D3 установлено значимое улучшение оценки общего восприятия здоровья (р = 0,002), жизнеспособности (р = 0,003), роли эмоциональных проблем в ограничении жизнедеятельности (р = 0,01), показателя психического здоровья (р = 0,008). Применение витамина D3 положительно сказалось на психическом компоненте качества жизни.

The objective of this study was to investigate the likely impact of the annual course of compensation for 25(OH)D metabolism deficiency using officinal preparation of vitamin D on the quality of life of patients with multiple sclerosis. We have analyzed the observation data of 57 patients with multiple sclerosis. After 1 year, in vitamin D3 group a significant increase has been determined in terms of the assessment of the general perception of health (p = 0.002), vitality (p = 0.003), role of the emotional problems in disability (p = 0.01), indicator of mental health (p = 0.008). The use of vitamin D3 had a positive impact on the mental component of quality of life.


Keywords

множинний склероз, якість життя, холекальциферол (вітамін D3), SF-36.

множественный склероз, качество жизни, холекальциферол (витамин D3), SF-36.

multiple sclerosis, quality of life, cholecalciferol (vitamin D3), SF-36.

Background. Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system. Patients with MS rate their health related quality of life lower than general populations. Quality of life is a subjective and multidimensional concept. Quality of life of patients with MS is influenced by disability, depressive and anxiety symptoms, fatigue, comorbidity, sleep disorders, sexual dysfunction. Measurement of quality of life of patients with MS is of interest for their medical care, rehabilitation, and nursing. The impact of Cholecalciferol (Vitamin D3) supplementation on a patient's quality of life has not been completely clarified.

Purpose. The aim of this study was to assess the impact of oral Colecalciferol (Vitamin D3) – Aquadetrim®Vitaminum D3 on quality of life in patients with MS.

Materials and methods. Data were analyzed from 57 MS patients (20 men, 37 women). The mean age of all subjects was 35.93±8.07 years (21–55), with mean EDSS 3.74±0.58 (3.0–5.5) and disease duration of 9.03±5.76 years (1–27). Twenty-five patients were untreated (І group) and 32 were treated with Aquadetrim® Vitaminum D 34,000 IU/day in late fall and winter and 500-1500 IU/day in spring and summer (ІI group). Аt baseline and in 12 months after initiation of Vitamin D3 therapy MS patients were assessed using the Expanded Disability Status Scale (EDSS), Hamilton Rating Scale for Аnxiety (HARS), Hamilton Rating Scale for Depression (HDRS), Modified Fatigue Impact Scale (MFIS), Mini Mental State Examination  (MMSE). Venous blood sample was obtained from all participants and serum 25-hydroxy Vitamin D was measured by enzyme immunoassay (EIA) method. Quality of life, assessed by MOS 36-item Short Form Health Survey (SF-36), was related to Vitamin D3 supplementation and to clinical and demographic parameters at baseline and after one year. The data was analysed by the SPSS 20 (© SPSS Inc.) programme.

Results. At baseline MS groups did not differ in EDSS, HАRS, HDRS, MFIS, MMSE, physical and mental quality of life scales. After one year of follow-up general health score (p = 0.002), vitality score (p = 0.003), role emotional score (p = 0.01) and mental health score  (p = 0.008) significantly increased in Vitamin D3 supplementation group. Vitamin D3 has no influence on quality of life at inclusion time, but when quality of life was evaluated after one year, Vitamin D3 supplementation positively affected mental quality of life. Аnxiety, depression and fatigue negatively influenced on mental quality of life at baseline (р < 0.01). Mainly depression and fatigue negatively influenced on physical and mental quality of life after one year (р < 0.05). EDSS correlated with a poor physical quality of life only at baseline (р < 0.01).

Conclusion. Vitamin D3 supplementation had a positively impact on quality of life in MS patients, influencing mainly mental quality of life. The impairment of quality of life in patients with MS was strongly associated with increasing depression, anxiety, fatigue, whereas clinical disability had a lower unfavourable role.


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