{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T20:47:35Z","timestamp":1789073255213,"version":"build-2803163510"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This meta-analysis was conducted to systematically evaluate the dose\u2013response relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and the annualized relapse rate (ARR) in multiple sclerosis (MS), and to investigate the effect of vitamin D supplementation on reducing relapse risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Randomized controlled trials (RCTs) published from inception to April 2025 were retrieved from PubMed, Medline, Web of Science, Cochrane Library, and EMBASE. Study quality was assessed using the Cochrane RoB-2 tool. Meta-analyses were performed using RevMan 5.3. The primary outcome was ARR. Secondary outcomes included the Expanded Disability Status Scale (EDSS) score and serum 25(OH)D levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine studies comprising 1,078 participants were included. No significant difference in EDSS scores was observed between the intervention and control groups (mean difference (MD)\u202f=\u202f\u22120.11, 95%CI [\u22120.40, 0.18],\n                      <jats:italic>Z<\/jats:italic>\n                      =\u202f0.73,\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.47). Serum 25(OH)D levels were significantly higher in the intervention group (pooled MD\u202f=\u202f44.97, 95%CI [29.93, 60.01],\n                      <jats:italic>Z<\/jats:italic>\n                      =\u202f5.86,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001). Subgroup analysis by vitamin D dosage showed that the low\/medium-dose group significantly reduced ARR (pooled MD\u202f=\u202f\u20130.14, 95%CI [\u22120.26, \u22120.03],\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.01), while the high-dose group had no significant effect on ARR (pooled MD\u202f=\u202f0.05, 95%CI [\u22120.08, 0.18],\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.42). No significant overall difference in ARR was found between the two groups (pooled MD\u202f=\u202f-0.07, 95%CI [\u22120.18,0.03],\n                      <jats:italic>Z<\/jats:italic>\n                      =\u202f\u20131.37,\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.17).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results of this meta-analysis showed that vitamin D supplementation, regardless of dosage, could significantly increase the serum 25(OH)D level in patients with multiple sclerosis. Subgroup analysis showed that low\/medium-dose vitamin D supplementation could significantly reduce the ARR, while high-dose supplementation had no significant effect on ARR. There was no significant difference in EDSS scores between the experimental group and the control group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1727615","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T05:24:07Z","timestamp":1767331447000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Vitamin D deficiency and multiple sclerosis relapse: a meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Yujing","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shasha","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhua","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuedan","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/S1474-4422(22)00289-7","article-title":"Multiple 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