Vitamin B6 status is related to disease severity and modulated by endurance exercise in individuals with multiple sclerosis: a secondary analysis of a randomized controlled trial

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition Pub Date : 2025-06-01 DOI:10.1016/j.ajcnut.2025.04.014

Sergen Belen , Nadine Patt , Marie Kupjetz , Per M Ueland , Adrian McCann , Roman Gonzenbach , Jens Bansi , Philipp Zimmer

{"title":"Vitamin B6 status is related to disease severity and modulated by endurance exercise in individuals with multiple sclerosis: a secondary analysis of a randomized controlled trial","authors":"Sergen Belen , Nadine Patt , Marie Kupjetz , Per M Ueland , Adrian McCann , Roman Gonzenbach , Jens Bansi , Philipp Zimmer","doi":"10.1016/j.ajcnut.2025.04.014","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Low circulating concentrations of B vitamins are linked to various chronic and neurodegenerative diseases. Notably, pyridoxal 5'-phosphate (vitamin B<sub>6</sub>) deficiency is linked to altered inflammatory responses and cellular immune function, both critical in multiple sclerosis (MS). Nevertheless, most MS research has focused on folate (vitamin B<sub>9</sub>) and vitamin B<sub>12</sub>, leaving other B vitamins understudied.</div></div><div><h3>Objectives</h3><div>This secondary analysis investigated B-vitamin serum concentrations and related metabolites across MS phenotypes (primary progressive MS, relapsing-remitting MS, and secondary progressive MS) and disease severity levels. Additionally, the impact of endurance exercise on B-vitamin concentrations was investigated.</div></div><div><h3>Methods</h3><div>In total, 106 individuals with MS participated in a randomized controlled trial, including different endurance exercise conditions. Serum B-vitamin concentrations were analyzed in 99 participants before and after 3 wk of intervention. Before analysis, participants were dichotomized to 1 of the 2 disability groups based on their expanded disability status scale (EDSS) score: EDSS<sub>≥4.5</sub> (<em>n</em> = 47, EDSS: 5.86 ± 0.56) and EDSS<sub><4</sub> (<em>n</em> = 52, EDSS: 3.59 ± 0.83).</div></div><div><h3>Results</h3><div>Higher EDSS scores were associated with lower pyridoxal 5'-phosphate (vitamin B-6) concentrations (<em>r</em><sub>s</sub>: −0.32; 95% CI: −0.49, −0.12; <em>P</em> = 0.011), with the EDSS<sub>≥4.5</sub> group also showing lower baseline pyridoxal 5'-phosphate (vitamin B<sub>6</sub>) concentrations (β: −0.18; 95% CI: −0.30, −0.07; <em>P</em> = 0.007) than the EDSS<sub><4</sub> group. Significant time × EDSS group interactions were evident for pyridoxal 5'-phosphate (vitamin B<sub>6</sub>; β: 0.05; 95% CI: 0.02, 0.08; <em>P</em> = 0.011), pyridoxal (vitamin B<sub>6</sub>; β: 0.05; 95% CI: 0.02, 0.09; <em>P</em> = 0.005), and riboflavin (vitamin B<sub>2</sub>; β: 0.06; 95% CI: 0.02, 0.09; <em>P</em> = 0.008), showing increases in these vitamers in the EDSS<sub>≥4.5</sub> group postexercise. N1-Methylnicotinamide (vitamin B<sub>3</sub>; β: −0.11; 95% CI: −0.15, −0.06; <em>P</em> < 0.001) decreased in both groups over time.</div></div><div><h3>Conclusions</h3><div>Disease severity is associated with distinct B-vitamin profiles in individuals with MS, although endurance exercise appears to modify specific B-vitamin concentrations.</div><div>This trial was registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> as NCT04356248.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"121 6","pages":"Pages 1403-1414"},"PeriodicalIF":6.5000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Clinical Nutrition","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S000291652500200X","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Low circulating concentrations of B vitamins are linked to various chronic and neurodegenerative diseases. Notably, pyridoxal 5'-phosphate (vitamin B₆) deficiency is linked to altered inflammatory responses and cellular immune function, both critical in multiple sclerosis (MS). Nevertheless, most MS research has focused on folate (vitamin B₉) and vitamin B₁₂, leaving other B vitamins understudied.

Objectives

This secondary analysis investigated B-vitamin serum concentrations and related metabolites across MS phenotypes (primary progressive MS, relapsing-remitting MS, and secondary progressive MS) and disease severity levels. Additionally, the impact of endurance exercise on B-vitamin concentrations was investigated.

Methods

In total, 106 individuals with MS participated in a randomized controlled trial, including different endurance exercise conditions. Serum B-vitamin concentrations were analyzed in 99 participants before and after 3 wk of intervention. Before analysis, participants were dichotomized to 1 of the 2 disability groups based on their expanded disability status scale (EDSS) score: EDSS_≥4.5 (n = 47, EDSS: 5.86 ± 0.56) and EDSS_<4 (n = 52, EDSS: 3.59 ± 0.83).

Results

Higher EDSS scores were associated with lower pyridoxal 5'-phosphate (vitamin B-6) concentrations (r_s: −0.32; 95% CI: −0.49, −0.12; P = 0.011), with the EDSS_≥4.5 group also showing lower baseline pyridoxal 5'-phosphate (vitamin B₆) concentrations (β: −0.18; 95% CI: −0.30, −0.07; P = 0.007) than the EDSS_<4 group. Significant time × EDSS group interactions were evident for pyridoxal 5'-phosphate (vitamin B₆; β: 0.05; 95% CI: 0.02, 0.08; P = 0.011), pyridoxal (vitamin B₆; β: 0.05; 95% CI: 0.02, 0.09; P = 0.005), and riboflavin (vitamin B₂; β: 0.06; 95% CI: 0.02, 0.09; P = 0.008), showing increases in these vitamers in the EDSS_≥4.5 group postexercise. N1-Methylnicotinamide (vitamin B₃; β: −0.11; 95% CI: −0.15, −0.06; P < 0.001) decreased in both groups over time.

Conclusions

Disease severity is associated with distinct B-vitamin profiles in individuals with MS, although endurance exercise appears to modify specific B-vitamin concentrations.

This trial was registered at clinicaltrials.gov as NCT04356248.

查看原文本刊更多论文

维生素B6状态与多发性硬化症患者的疾病严重程度有关，并受耐力运动的调节：一项随机对照试验的二次分析

背景：低循环B族维生素浓度与多种慢性和神经退行性疾病有关。值得注意的是，吡哆醛5'-磷酸（维生素B6）缺乏与炎症反应和细胞免疫功能的改变有关，这两者在多发性硬化症（MS）中都是至关重要的。然而，大多数多发性硬化症研究都集中在叶酸（维生素B9）和维生素B12上，而对其他B族维生素研究不足。目的：这项二级分析调查了不同MS表型（原发性进展型MS、复发缓解型MS和继发性进展型MS）和疾病严重程度的b族维生素血清浓度和相关代谢物。此外，还研究了耐力运动对b族维生素浓度的影响。方法：106例多发性硬化症患者参加了随机对照试验，包括不同的耐力运动条件。在干预前和干预后3周分析了99名参与者的血清b族维生素浓度。分析前，根据扩展残疾状态量表（EDSS）得分将参与者分为2个残疾组：EDSS≥4.5 （n = 47, EDSS: 5.86±0.56）和EDSS （n = 52, EDSS: 3.59±0.83）。结果：较高的EDSS评分与较低的吡哆醛5'-磷酸（维生素B-6）浓度相关(rs: -0.32；95% ci: -0.49, -0.12；P = 0.011), EDSS≥4.5组也显示较低的基线吡哆醛5'-磷酸（维生素B6）浓度(β: -0.18；95% ci: -0.30, -0.07；P = 0.007)高于EDSS组。吡哆醛5′-磷酸(维生素B6；β:0.05;95% ci: 0.02, 0.08；P = 0.011)，吡哆醛(维生素B6；β:0.05;95% ci: 0.02, 0.09；P = 0.005)，核黄素(维生素B2；β:0.06;95% ci: 0.02, 0.09；P = 0.008)，显示EDSS≥4.5组运动后这些维生素含量增加。n1 -甲基烟酰胺(维生素B3；β:-0.11;95% ci: -0.15, -0.06；P < 0.001)随着时间的推移而降低。结论：疾病严重程度与MS个体不同的b族维生素谱相关，尽管耐力运动似乎可以改变特定的b族维生素浓度。该试验在clinicaltrials.gov注册为NCT04356248。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

American Journal of Clinical Nutrition 医学-营养学

CiteScore

12.40

自引率

4.20%

发文量

332

审稿时长

38 days

期刊介绍： American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism. Purpose: The purpose of AJCN is to: Publish original research studies relevant to human and clinical nutrition. Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits. Encourage public health and epidemiologic studies relevant to human nutrition. Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches. Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles. Peer Review Process: All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.