Exploring the Link: Vitamin D Levels and Its Clinical Implications in Guillain-Barré Syndrome Patients.

Abstract

Introduction: Low levels of Vitamin D are associated with severe manifestations of autoimmune or inflammatory diseases; there is limited information regarding Guillain-Barré Syndrome (GBS).

Objective: To determine the serum levels of vitamin D in patients with GBS compared with healthy controls.

Materials and methods: A prospective observational study of consecutive patients with GBS based on EAN/PNS criteria over a year, from a single center was conducted. Clinical and paraclinical characteristics were obtained from the included patients upon admission; we determined the serum levels of Vitamin D (ng/ml) at admission and categorized them according to Vitamin D levels: sufficient >30 ng/mL, insufficient 20-30 ng/mL, and deficient <20 ng/mL. Poor prognosis was considered as non-independent walking at 3 months follow-up.

Results: The study included 56 patients with GBS (Guillain-Barré Syndrome) and 56 healthy control patients. The control group exhibited higher median levels of vitamin D compared to the GBS patient group [(29.9 ng/dl (IQR 24-34.8) vs 17.1 ng/dl (IQR 13.7-23.8 ng/dl), P < 0.001]. Only 9% (95% CI 1-19%) of the GBS patients had sufficient levels of vitamin D. In correlation analysis, significant differences were found between Vitamin D levels and glucose levels (r2 = -.36, P = 0.007) and the glucose-leukocyte index (GLI) (r2 = -.42, P=<0.001). In comparative analysis (Vitamin D levels ≤15 ngs/ml/ vs ≥ 16 ng/mL), the presence of dysautonomias, facial diparesis, leukocytes, glucose-leukocyte index (GLI), and glucose levels were significant; in the Kaplan-Meier survival analysis, patients with Vitamin D levels ≤15 ngs/ml showed lesser recovery in independent walking at 3 months (log-rank = 0.047).

Conclusion: Patients with GBS and low levels of Vitamin D exhibit a higher frequency of dysautonomias, higher GLI, and lesser recovery of independent walking.