Author Of 2 Presentations
P0464 - High prevalence of hypovitaminosis D and its impact on disability in Ecuadorian patients with multiple sclerosis (ID 1835)
Abstract
Background
Vitamin D has been considered an environmental factor in multiple sclerosis (MS) development. The prevalence of MS is high in North American and European countries in which the ultraviolet (UV) exposure in low. The UV is responsible for the synthesis of vitamin D in the skin. Some studies have shown that the serum vitamin D levels can fluctuate being these levels lower in winter than in summer. Moreover, low serum levels of vitamin D have been associated with worst disability in MS patients. However, the role of vitamin D is still unknown in MS patients from Ecuador, an Andean country with 12 months of solar exposure.
Objectives
Our study seeks to establish the serum levels of vitamin D in Ecuadorian patients with MS and its influence on disability.
Methods
This is a retrospective study in which we measured the serum levels of vitamin D in MS patients who were attended at Carlos Andrade Marin Hospital in Quito, Ecuador. The severity of the disease was measured using the expanded disability status scale (EDSS). The Shapiro-Wilk test was used to determine if the distribution of the paired data was normal. The Wilcoxon signed-rank test was used to compare the paired data of the non-normal distribution. All the data were analyzed through SPSS version 25 and a value of p <0.05 was considered significant.
Results
We included 66 patients with MS. The majority were female (69%). The mean age at the onset of the disease was 29.6 years (SD+/-11.7).The mean EDSS in the last follow up was 2.9 (range 0 – 8). The mean serum concentrations of vitamin D was 26.2 ng/ml (SD+/- 1.6). In this study, the prevalence of vitamin D hypovitaminosis was 81.8%. The prevalence of vitamin D deficiency (10-20 ng/mL), vitamin D insufficiency (20-30 ng/mL), and vitamin D sufficiency (>30 ng/mL) was 34.5%, 47.3%, and 18.2%, respectively. We found an inverse correlation between disability and serum levels of vitamin D (-0.24) but, the correlation was not statistically significant (p>0.5). The mean EDSS in those patients with serum vitamin D levels more than 30 ng/ml and less than 30 ng/ml was 2.6 SD+/-1.5 vs 3.1 SD+/-1.9 respectively, p=0.054.
Conclusions
We found a high prevalence of vitamin D hypovitaminosis in Ecuadorian patients with MS. The serum levels of vitamin D were not associated with disability. The main limitation of this study is its retrospective nature and the absence of control group. It is necessary more studies on the influence of vitamin D in Ecuadorian patients with MS.
P0757 - The neutrophil-to-lymphocyte ratio in aquaporin-4-positive NMOSD patients: A Latin American multicenter study (ID 1034)
Abstract
Background
Neutrophil-to-lymphocyte ratio (NLR) has been investigated in many autoimmune diseases as a marker of both inflammation and disease activity. So far, the role of NLR in aquaporin-4(AQP4)-ab-positive neuromyelitis optica spectrum disorders (NMOSD) is uncertain due to a lack of data.
Objectives
The aim of this study was to evaluate NLR in AQP4-ab-positive NMOSD patients at disease onset and determine their clinical significance during follow-up.
Methods
We retrospectively included and reviewed the medical records of all recent/newly diagnosed treatment-naïve AQP4-ab-positive NMOSD patients (n=90) according to the 2015 international diagnostic criteria. Additionally, demographic, clinical, paraclinical (e.g. new/enlarging or contrast-enhancing lesions) and prognostic (via EDSS) data at 12 and 24 months were also evaluated. NRL was calculated as the absolute count of neutrophils divided by the absolute count of lymphocytes from peripheral blood samples. Three-hundred and sixty-five healthy subjects who underwent routine physical exam were included as controls. Multivariate regression analysis was used to describe and identified independent association between log-transformed NLR and clinical (relapses and EDSS change) as well as MRI activity (new/enlarging and/or contrast-enhancing MRI lesions). P<0.05 was considered as significant.
Results
NLR was higher in NMOSD patients during the first relapse compared with controls (2.9 ±1.6vs. 1.8 ±0.6;p<0.0001). Regardless of immunosuppressants’ initiation at disease onset, NLR continued to be higher in NMOSD patients at 12 (2.8 ±1.3;p<0.0001) and 24 (3.1 ±1.6;p<0.0001) months compared with controls. No association was observed at 12 and 24 months between log-transformed NLR and the presence of relapses ([OR=0.66, CI95%0.28-1.58, p=0.36] and [OR=0.76, CI95%0.30-1.93, p=0.57], respectively), new/enlarging and/or contrast-enhancing MRI lesions ([OR=1.72, CI95%0.58-5.04, p=0.32] and [OR=0.42, CI95%0.47-2.52, p=0.82], respectively) and physical disability ([OR=-0.21, CI95%-1.04-0.61, p=0.60] and [OR=-0.15, CI95%-1.01-0.69, p=0.71], respectively).
Conclusions
This study suggested that NLR may be a marker of inflammation in AQP4-ab-positive NMOSD patients. However, a higher NLR was not an independent predictor of clinical or radiological disease activity in our model.
Presenter Of 1 Presentation
P0464 - High prevalence of hypovitaminosis D and its impact on disability in Ecuadorian patients with multiple sclerosis (ID 1835)
Abstract
Background
Vitamin D has been considered an environmental factor in multiple sclerosis (MS) development. The prevalence of MS is high in North American and European countries in which the ultraviolet (UV) exposure in low. The UV is responsible for the synthesis of vitamin D in the skin. Some studies have shown that the serum vitamin D levels can fluctuate being these levels lower in winter than in summer. Moreover, low serum levels of vitamin D have been associated with worst disability in MS patients. However, the role of vitamin D is still unknown in MS patients from Ecuador, an Andean country with 12 months of solar exposure.
Objectives
Our study seeks to establish the serum levels of vitamin D in Ecuadorian patients with MS and its influence on disability.
Methods
This is a retrospective study in which we measured the serum levels of vitamin D in MS patients who were attended at Carlos Andrade Marin Hospital in Quito, Ecuador. The severity of the disease was measured using the expanded disability status scale (EDSS). The Shapiro-Wilk test was used to determine if the distribution of the paired data was normal. The Wilcoxon signed-rank test was used to compare the paired data of the non-normal distribution. All the data were analyzed through SPSS version 25 and a value of p <0.05 was considered significant.
Results
We included 66 patients with MS. The majority were female (69%). The mean age at the onset of the disease was 29.6 years (SD+/-11.7).The mean EDSS in the last follow up was 2.9 (range 0 – 8). The mean serum concentrations of vitamin D was 26.2 ng/ml (SD+/- 1.6). In this study, the prevalence of vitamin D hypovitaminosis was 81.8%. The prevalence of vitamin D deficiency (10-20 ng/mL), vitamin D insufficiency (20-30 ng/mL), and vitamin D sufficiency (>30 ng/mL) was 34.5%, 47.3%, and 18.2%, respectively. We found an inverse correlation between disability and serum levels of vitamin D (-0.24) but, the correlation was not statistically significant (p>0.5). The mean EDSS in those patients with serum vitamin D levels more than 30 ng/ml and less than 30 ng/ml was 2.6 SD+/-1.5 vs 3.1 SD+/-1.9 respectively, p=0.054.
Conclusions
We found a high prevalence of vitamin D hypovitaminosis in Ecuadorian patients with MS. The serum levels of vitamin D were not associated with disability. The main limitation of this study is its retrospective nature and the absence of control group. It is necessary more studies on the influence of vitamin D in Ecuadorian patients with MS.