Self-reported use of vitamin D supplements is associated with higher physical quality of life scores in multiple sclerosis
Section snippets
Background
Multiple sclerosis (MS) is a progressive demyelinating condition of the central nervous system. Symptoms include motor, sensory and cognitive dysfunction, all of which have a significant impact on quality of life (QoL). QoL is difficult to measure compared to more objective parameters like disability. A commonly used and validated tool for assessing QoL in people with MS is the MSQOL-54, a 54-question instrument which combines the SF-36 (Ware et al., 1993) with 18 MS-specific questions (
Participants and data collection
Participants were enrolled in the HOLISM study for which methodology has been described previously (Hadgkiss et al., 2013; Weiland et al., 2018a). Participants were recruited via online platforms, and SurveyMonkey® was used to provide respondents with a participant information sheet and questionnaire. Inclusion criteria required participants be at least 18yo and self-reporting a physician diagnosis of MS. The University of Melbourne Health Sciences Human Ethics Sub-Committee provided ethical
Sample characteristics
The analysis sample comprised 1,401 participants who participated at both timepoints (Table 1). 1,155 (82.4%) provided data for P-QoL and 1,316 (93.9%) for M-QoL composite scores. The average P-QoL at baseline was 63.36 (IQR: 45.53-80.13), essentially unchanged at follow-up (median=64.36; IQR: 45.27-81.80). The median M-QoL at baseline was 76.10; IQR: 57.95-85.43, essentially unchanged at follow-up (median=76.13; IQR: 55.36-86.96). Subdomains were largely unchanged between baseline and 2.5-year
Discussion
Through analysing data from a large international sample of people with MS followed over 2.5 years, we found that self-reported vitamin D supplement use, sun exposure, and sun-related attire were cross-sectionally associated with higher P-QoL and M-QoL, in keeping with our baseline results (Jelinek et al., 2015), though the cross-sectional nature of these analyses and the potential for reverse causality precludes causal interpretation. Prospectively, self-reported vitamin D supplement use,
Conclusion
QoL in this international population of people with MS was relatively stable over a 2.5-year period. Self-reported vitamin D supplement use was a predictor of improved QoL, adding weight to current hypotheses about MS pathogenesis and progression. Were these results substantiated in other longitudinal studies, particularly those using objective measures of serum vitamin D, and thence by randomised clinical trials, vitamin D supplementation would be an inexpensive and safe intervention that
Ethics approval and consent to participate
The Health Sciences Human Ethics Sub-Committee at The University of Melbourne provided ethical approval for the study (Ethics ID: 1545102). Participants were asked to read the participant information and to consent before entering the survey.
Availability of data and material
Data may not be shared due to the conditions approved by our institutional ethics committee, in that all data are stored as re-identifiable information at The University of Melbourne in the form of password-protected computer databases, and only the listed investigators have access to the data. All data have been reported on a group basis, summarising the group findings rather than individual findings so personal information cannot be identified. Therefore, we can supply aggregate group data on
Author statement
Conceptualisation: GAJ, TW, SSY; Methodology: SSY; Software: N/A; Validation: SSY; Formal analysis: SSY; Investigation: SSY; Resources: GAJ, TW, SN, SSY; Data Curation: SSY; Writing - original draft: SSY; Writing - review & editing: SSY, PJ, TW, NN, SN, GAJ; Visualisation: SSY; Supervision: SN; Project Administration: GAJ, TW, SN, NN, SSY; Funding acquisition: GAJ, TW, SN.
Funding
The study was funded by Wal Pisciotta and anonymous philanthropic funders, for which we are thankful.
Declaration of Competing Interest
GJ receives royalties for his books, Overcoming Multiple Sclerosis and Recovering from Multiple Sclerosis. GJ and SN received remuneration for conducting lifestyle educational workshops for people with MS.
Acknowledgements
We thank all the participants in the HOLISM study for participating in the study and Wal Pisciotta and other anonymous philanthropic funders for supporting this study.
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