Title:Myasthenia Gravis and Vitamin D Serum Levels: A Systematic Review
and Meta-analysis
Volume: 22
Issue: 5
Author(s): Giovanni Bonaccorso*
Affiliation:
- Sandviken Närsjukhus, Uppsala University, Region Gävleborg, Sweden
- Universitat autònoma de Barcelona, Barcelona,
Spain
- Universidad de Murcia, Murcia, Spain
Keywords:
Myasthenia gravis, autoimmunity, tolerance, vitamin D, cholecalciferol, 25-hydroxy-cholecalciferol.
Abstract:
Background: Vitamin D has been extensively studied for its role in immune modulation,
especially in the process of tolerance induction. The loss of tolerance towards self-antigens is the basis
of several autoimmune disorders; this seems to be related to lower levels of Vitamin D. A neurological
autoimmune disorder due to the loss of tolerance to compounds at the neuromuscular junction is
known as Myasthenia Gravis (MG).
Objective: To assess the possible correlation between altered Vitamin D levels and MG.
Methods: In this systematic review, all recruited studies compared Vitamin D levels in MG patients
and healthy controls. Five studies fulfilled the selection criteria and were included in the quantitative
synthesis. The meta-analysis involved data of a total population size of 450 individuals, equally divided
into 219 cases and 231 controls.
Results: The results showed a statistically significant mean difference between cases and controls. The
overall mean Vitamin D levels in MG patients were 4.69 ng/ml lower than control levels (95% CI
-6.17; -3.22); by applying a random-effects model, this mean difference was estimated at -3.79 (95%
CI -7.24; -0.33), after exclusion of data source of heterogeneity and through applying a fixed-effect
model, resulted in a mean difference -5.39 (95% CI -6.91; -3.88). The p-value was lower than 0.05.
Conclusion: There are statistically significant lower levels of Vitamin D in MG patients, so routine
checking and possible correction should be advised in MG patients based on the current data.
