Povezanost nivoa 25-hidroksivitamina D [25(OH)D] i mesta stanovanja bolesnika sa multiplom sklerozom u Crnoj Gori – viši nivoi samo kod muškaraca na severu zemlje
Sažetak
Uvod/Cilj. Multipla skleroza (MS) je hronična neurološka bolest, povezana s niskim serumskim nivoom 25-hidroksivitamina D [25 (OH)D]. Cilj rada bio je da se ispitaju povezanost nivoa 25(OH)D u serumu sa geografskom širinom mesta boravka obolelih i onesposobljenošču i progresijom MS, izraženim preko proširenog skora stepena onesposobljenost (EDSS) i stepena spasticiteta obolelih od multiple skleroze (MSSS). Metode. U studiju je bilo uključeno ukupno 196 bolesnika sa severa i juga Crne Gore, starosti između 18 i 65 godina, sa definitivnom dijagnozom MS. Od svakog pojedinačnog bolesnika je na dan prijema uziman serum za analizu nivoa 25(OH)D. Kontrolna grupa se sastojala od 196 zdravih ispitanika, koji su metodom slučajnog uzorka birani među medicinskim osobljem tri bolnice sa severa i Kliničkog centra Crne Gore, sa juga zemlje. Rezultati. Nivoi serumskog 25(OH)D bili su značajno niži kod bolesnika sa MS u odnosu na kontrolnu grupu (p < 0.001). Nivo 25(OH)D značajno se razlikovao u odnosu na pol, pri čemu su kod žena registrovani niži nivoi. Mada kod svih ispitanika nije zabeležena statistički značajna korelacija između nivoa 25(OH)D i prebivališta, nađen je značajno viši nivo 25(OH)D kod muškaraca sa severa u odnosu na žene. Tok bolesti je uticao na nivo 25(OH)D u serumu. Nivo 25(OH)D bio je u značajnoj korelaciji sa kliničkom nesposobnošću (Spearmanov r = -0.23, p = 0.001) i progresijom bolesti (Spearmanov r = -0.25, p = 0.0004). Zaključak. Serumske koncentracije 25(OH)D povezane su sa nesposobnošću i napredovanjem bolesti kod bolesnika sa MS. Niži nivoi 25(OH)D nađeni su kod žena sa severa. Nađene niske koncentracije 25(OH)D ne mogu se objasniti samo geografskom širinom i nedovoljnim izlaganjem suncu, zbog čega su potrebna dalja genetska istraživanja.
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