Vitamin D deficiency and risk of myasthenia gravis
An evidence-based case report
Abstract
Background: An autoimmune condition known as myasthenia gravis (MG) targets the receptors for neurotransmitter acetylcholine at the neuromuscular junction, resulting in inhibition of muscle contraction. This results in muscle weakness resulting in a decrease in quality of life. Immunoregulation and muscle contractility are known to play a role in vitamin D. Literature on how vitamin D affects myasthenia gravis risk has not been widely carried out and the results are still controversial.Objective: To evaluate the association between vitamin D and MG risk.Methods: The search of the literature was conducted from PubMed, Cochrane Library, Embase, and EBSCOhost with the eligibility criteria determined by the authors. The literature search was using MeSH Term, text word, and title/abstract.Results: Two articles were selected and critically appraised. The first article shows an odds ratio of 3.96 (CI95 1.26 to 12.52), which means that myasthenia gravis has vitamin D levels almost 4 times lower than healthy population. A case-control study that followed described a comparison of mean levels of vitamin D (25(OH)D) in myasthenia gravis (mean, 18.8±8.4 ng/mL) compared to healthy controls (26.3±6.1). ng/mL) (p <0.05). Both studies revealed a strong interaction between MG and vitamin D inadequacy. Conclusion: Both studies above support the theory that vitamin D deficiency is associated with the risk of developing MG.Downloads
References
Alekseeva TM, Kryuchkova VV, Stuchevskaya TR, ANK. Epidemiologic studies of myasthenia gravis: literature review. Neuromuscul Dis. 2018;8(3):12–8.
Myasthenia Gravis [Internet]. Available from: https://www.womenshealth.gov/a-z- topics/myasthenia-gravis
Putri TARK, Kariasa IM, Dahlia D. Gambaran karakteristik pasien miastenia gravis di Pulau Jawa characteristics description of miastenia gravis patient in Java Island. J Kesehat Bhakti Husada. 2016;3(1):33–9.
Trouth AJ, Dabi A, Solieman N, Kurukumbi M, Kalyanam J. Myasthenia gravis: a review. Artic ID. 2012;2012.
Murthy JMK. Myasthenia gravis: do the subtypes matter? Ann Indian Acad Neurol. 2020;23(1):2.
SyahrulS,MutiawatiE,AstiniN,FajriN,Suherman S. Clinical characteristic myasthenia gravis among Indonesians. Budapest Int Res Exact Sci J. 2020;2(2):257–63.
Dahlia Y. Profil psikopatologi pasien miastenia gravis di Yayasan Myasthenia Gravis Indonesia [Tesis]. Universitas Indonesia; 2013.
Gani LU, How CH. Vitamin D deficiency. Singapore Med J. 2015;56(8):433–7.
Pusparini. Vitamin D deficiency and diseases. Indones J Clin Pathol Med Lab. 2014;21(1):90–5.
Bischoff-Ferrari HA, Borchers M, Gudat F, Dürmüller U, Stähelin HB, Dick W. Vitamin D receptor expression in human muscle tissue decreases with age. J Bone Miner Res. 2004;19(2):265–9.
Han JL, Li HF, Xie YC, Sun L, Wang ZX, Xu X, et al. Association between vitamin D receptor gene Tru9I polymorphism and myasthenia gravis. Natl Med J China. 2012;92(29):2028–33.
Askmark H, Haggård L, Nygren I, Punga AR. Vitamin D deficiency in patients with myasthenia gravis and improvement of fatigue after supplementation of vitamin D3: a pilot study. Eur J Neurol. 2012;19(12):1554–60.
Guan Y, Lv F, Meng Y, Ma D, Xu X, Song Y, et al. Association between bone mineral density, muscle strength, and vitamin D status in patients with myasthenia gravis: a cross-sectional study. Osteoporos Int. 2017;28(8):2383–90.
Justo ME, Aldecoa M, Cela E, Leoni J, González Maglio DH, Villa AM, et al. Low vitamin D serum levels in a cohort of myasthenia gravis patients in Argentina. Photochem Photobiol. 2021;97(5):1145– 9.
Kang SY, Kang JH, Choi JC, Song SK, Oh JH. Low serum vitamin D levels in patients with myasthenia gravis. J Clin Neurosci. 2018;50:294–7.
Kulie T, Groff A, Redmer J, Hounshell J, Schrager S. Vitamin D: an evidence-based review. J Am Board Fam Med. 2009;22(6):698–706.
Lips P, van Schoor NM, de Jongh RT. Diet, sun, and lifestyle as determinants of vitamin D status. Ann N Y Acad Sci. 2014;1317(1):92–8.
Deluca GC, Kimball SM, Kolasinski J, Ramagopalan SV, Ebers GC. Review: the role of vitamin D in nervous system health and disease. Neuropathol Appl Neurobiol. 2013;39(5):458–84.
Ritterhouse LL, Crowe SR, Niewold TB, Kamen DL, Macwana SR, Roberts VC, et al. Vitamin D deficiency is associated with an increased autoimmune response in healthy individuals and in patients with systemic lupus erythematosus. Ann Rheum Dis. 2011;70(9):1569–74.
Submitted
Copyright (c) 2024 Nadiyah Wijayanthie, Yohannessa Wulandari, Anni Rahmawati
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.
World Nutrition Journal is an open acces journal and under the licence of