RESUMO
BACKGROUND: Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disorder. Vitamin D has important roles both in the autoimmune response and in skeletal muscles. We determined the levels of 25-hydroxy vitamin D [25(OH)D] in patients with MG and in healthy subjects to determine whether vitamin D deficiency is present in MG and whether vitamin D supplementation has beneficial effects on fatigue. METHODS: Plasma levels of 25(OH)D were analyzed in 33 patients with MG (22 males; mean age, 58 years) and in 50 healthy age- and sex-matched blood donors, without vitamin D3 medication. MG composite (MGC) score assessed fatigue. Thirteen patients with MG without previous vitamin D3 supplementation were started on vitamin D3 supplementation (cholecalciferol) 800 IU/day, with a follow-up examination after 2.5-10 months (mean, 6 months). RESULTS: Patients with MG without pre-existing vitamin D3 supplementation (N = 16) had a mean MGC of 4.5 and lower plasma 25(OH)D levels (mean, 51 ± 19 nM) than healthy controls (69 ± 21 nM) (P = 0.017). Seventeen patients had pre-existing vitamin D3 supplementation, because of corticosteroid treatment, and their mean 25(OH)D was 79 ± 22 nM and mean MGC was 5.5. In the 13 patients who received cholecalciferol, 25(OH)D was overall increased at follow-up with 22% (P = 0.033) and MGC score improved by 38% (P = 0.05). CONCLUSIONS: Plasma 25(OH)D levels are significantly lower in patients with MG compared with healthy controls. As vitamin D has beneficial effects on the autoimmune response and on fatigue score in patients with MG, we suggest monitoring this parameter in patients with MG and supplementation with vitamin D3 when 25(OH)D levels are low.
Assuntos
Colecalciferol/uso terapêutico , Miastenia Gravis/complicações , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologia , Adulto , Idoso , Suplementos Nutricionais , Fadiga/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miastenia Gravis/sangue , Projetos Piloto , Vitamina D/sangue , Deficiência de Vitamina D/sangueRESUMO
We aimed at evaluating whether ß-glucans could improve low-density lipoprotein (LDL) cholesterol levels and/or glycemic control in patients with myasthenia gravis (MG), in whom statins usually have muscle-related side effects. Fifty-nine MG patients participated in the study and received a daily dietary supplement of 3 g of ß-glucans during 8 weeks. Body mass index (BMI) and blood sample analysis of lipid and glucose status were performed before and after 8 weeks intake of ß-glucans. In the 52 patients who completed the study, there was a significant reduction in total cholesterol, LDL, ApoA1 and ApoB (all P<0.003). However, glycemic control and BMI were unaltered. The present study indicates that 8 weeks daily intake of 3 g of ß-glucans significantly reduces total cholesterol, LDL, ApoA1 and ApoB in MG patients. ß-glucans may therefore be of value in improving lipid status in MG patients, without the muscle-related side effects accompanied by statins.