文摘
摘要目的:解开影响维生素D和吸烟患者临床孤立综合征(CIS)随后在11年。
背景:信息长期影响维生素D和吸烟的多发性硬化症(MS)是稀缺。
设计/方法:我们包括277年11年随访CIS参与者受益(倍泰龙/ Betaseron新兴首次治疗多发性硬化症)为谁25-hydroxy-vitaminD水平和可替宁(吸烟)在基线评估,6个月,12日,24日,54岁,60岁和11年(可替宁只在6、12和24个月)。我们利用线性混合效应模型来预测变化的速度在eds和所有6个月至11年。进一步,利用线性和逻辑回归模型,我们评估血清25-hydroxyvitaminD和是否可替宁含量测量6到24个月后CIS导致预测MRI结果在11年。
结果:在调整了潜在的混杂因素,50 nmol / l 25-hydroxy-vitaminD增量预测少残疾恶化[βEDSS_increase=−0.12,95%置信区间ci: 0.22−−0.02, p = 0.02,βZ_MSFC= + 0.092,95%置信区间ci: 0.005 - -0.178, p = 0.04)。血清25-hydroxy-vitaminD整体水平没有显著相关核磁共振结果,虽然有些结果建议有利影响。T2和T1损伤卷的几率高于中位数下降随着25-hydroxy-vitaminD水平(T2:或者增加50 nmol / L = 0.32, T1:或= 0.39;都假定值= 0.1),而脑容量的概率(或= 3.3,p = 0.02)和丘脑的体积(或= 2.4,p = 0.07)高于中位数25-hydroxy-vitaminD水平的增加而增加。烟草使用与残疾相关不显著恶化,但与更高的T2 (B = + 1454毫米3,p = 0.04)和T1病灶体积(B = + 620毫米3,p = 0.03)。吸烟者显示与降低大脑和丘脑的卷。
结论:维生素D高度和发病后戒烟可能有利于长期临床和中枢神经系统的完整性。
披露:Martinez-Lapiscina博士已经收到个人赔偿咨询、担任科学顾问委员会说,与CIHR或其他活动,研究马尼托巴省,多发性硬化症协会加拿大、多发性硬化症科学基础、克罗恩氏和结肠炎加拿大,国家多发性硬化症协会、CMSC。芒格博士没有披露。Cortese博士已经收到个人赔偿咨询、担任科学顾问委员会说,与诺华或其他活动。Barkhof博士已经收到个人赔偿咨询、担任科学顾问委员会说,与拜耳或其他活动,Biogen-IDEC,默克公司诺华赛诺菲,罗氏,Teva, IXICO。博士Barkhof女士已经收到了来自荷兰的基础研究支持研究和欧盟(FP7和IMI)之下。Edan博士已经收到个人赔偿咨询、担任科学顾问委员会说,与生原体或其他活动,默克公司诺华赛诺菲,罗氏公司,拜耳公司局部反馈。Edan博士已经收到了来自诺华制药研究支持,赛诺菲,默克,生原体,罗氏和梯瓦。弗里德曼博士已经收到个人赔偿咨询、担任科学顾问委员会说,与拜耳医疗或其他活动,Idec, EMD加拿大,Genzyme,默克公司Serono,诺华,佐安内特,加拿大和梯瓦。哈博士已经收到个人赔偿咨询、担任科学顾问委员会说,与拜耳医疗或其他活动,生原体,Geneuro, Genzyme,落实的默克公司Receptos Celgene公司,诺华,罗氏,CSL贝林。好吃博士已经收到个人赔偿咨询、担任科学顾问委员会说,好吃的博士或其他活动收到演讲酬金和科学会议的旅费,一直是临床试验指导委员会成员或参与临床试验的顾问委员会在过去3年生原体,默克公司Serono,基因泰克,Genzyme,诺华公司,赛诺菲-安万特(sanofi - aventis)梯瓦制药、罗氏,Celgene公司Actelion股价,nms, MSIF。 Dr. Kappos’ institution has received compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Actelion, Alkermes, Almirall, Bayer, Biogen, Celgene/Receptos, df-mp, Excemed, GeNeuro SA, Genzyme, Japan Tobacco, Merck, Minoryx, Mitsubishi Pharma, Novartis, Roche, Sanofi-Aventis, Santhera, Teva and Vianex, and license fees for Neurostatus-UHB products. Dr. Kappos’ institution has received research support from Bayer, Biogen, Novartis, the Swiss MS Society, the Swiss National Research Foundation, the European Union, and Roche Research Foundations. Dr. Foley has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen Idec and Bayer . Dr. Penner has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Adamas Pharmaceuticals, Almirall, Bayer, Biogen, Celgene, Desitin, Genzyme, Merck, Novartis, Roche, and Teva. Dr. Hemmer has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Novartis, AllergyCare and TG Therapeutics, Desitin. Dr. Fox has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Acorda Therapeutics, Bayer, Biogen, Chugai, Eli Lilly, EMD Serono, Genzyme, Novartis, Ono, Opexa Therapeutics, Roche, Sanofi, and Teva Neuroscience. Dr. Fox has received research support from Acorda Therapeutics, Bayer, Biogen, Chugai, Eli Lilly, EMD Serono, Genzyme, Novartis, Ono, Opexa Therapeutics, Roche, Sanofi, and Teva Neuroscience. Dr. Schippling has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Bayer Healthcare, Biogen, Merck Serono, Novartis Pharmaceuticals, Teva, and Sanofi-Genzyme. Dr. Schippling has received research support from Biogen, Bayer Healthcare, Novartis Pharmaceuticals, and Sanofi Genzyme. Dr. Wicklein has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Bayer AG. Dr. Ascherio has nothing to disclose.
