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Assessment of serum vitamin D level in patients with systemic lupus erythematosus
Egyptian Rheumatology and Rehabilitation volume 41, pages 71–78 (2014)
Abstract
Objective
To evaluate the serum level of vitamin D in patients with systemic lupus erythematosus (SLE) and its relationship with disease activity.
Patients and methods
Forty patients suffering from SLE were enrolled in this study (group I). They were further divided into two subgroups according to the SLE disease activity index (SLEDAI) score: group Ia with respect to disease activity and group Ib with respect to disease remission. Another 20 age-matched and sex-matched healthy individuals were chosen as control group II. All patients underwent complete medical history taking and thorough clinical examination; the disease activity was assessed by the use of SLEDAI score. Serum vitamin D level in all patients and controls was measured.
Results
Vitamin D level was significantly higher in controls than in patients. The vitamin D deficiency was highly prevalent among patients with disease activity than in the remission group. There was highly significant inverse correlation between vitamin D level and SLEDAI score in the patient group. Vitamin D level correlated inversely with C reactive protein (CRP) and anti-dsDNA in the disease activity group, whereas it correlated positively with C3.
Conclusion
Vitamin D deficiency is prevalent in SLE patients more than in healthy controls; vitamin D deficiency is highly prevalent among patients with disease activity than in the remission group, and vitamin D level correlated inversely with disease activity, which suggest that inadequate vitamin D level, among other factors, probably contributed to the development of active disease in patients with SLE.
References
Rahman A, Isenberg DA. Review article: systemic lupus erythematosus. N Engl J Med 2008; 358:929–939.
Hanly JG, Urowitz MB, Su L, et al. Autoantibodies as biomarkers for the prediction of neuropsychiatric events in systemic lupus erythematosus. Ann Rheum Dis 2011; 70:1726–1732.
Bosch X. Systemic lupus erythematosus and the neutrophil. N Engl J Med 2011; 365:758–760.
Zhao G, Ford ES, Li C, Croft JB, et al. Serum 25-hydroxyvitamin D levels and all-cause and cardiovascular disease mortality among US adults with hypertension: the NHANES linked mortality study. J Hypertens 2012; 30:284–289.
Alvarez-Rodriguez L, Lopez-Hoyos M, Garcia-Unzueta M, Amado JA, Cachon PM, Martinez-Taboata VM, et al. Age and low levels of circulating vitamin D are associated with impaired innate immune function. J Leukoc Biol 2012; 91:829–838.
Ruiz-Irastorza G, Egurbide MV, Olivares N, Martinez-Berriotxoa A, Aguirre C, et al. Vitamin D deficiency in systemic lupus erythematosus: prevalence, predictors and clinical consequences. Rheumatology (Oxford) 2008; 47:920–923.
Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, Shaller JG, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982; 25:1271–1277.
Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH. Derivation of the SLEDAI. A disease activity index for lupus patients. The committee on prognosis studies in SLE. Arthritis Rheum 1992; 35:630–640.
Wielders JP, Wijnberg FA. Preanalytical stability of 25(OH)-vitamin D3 in human blood or serum at room temperature: solid as a rock. Clin Chem 2009;55:1584–1585.
Fragoso TS, Dantas AT, Marques CD, Rocha Junior LF, Melo JH, Costa AJ, Duarte AL, et al. 25-Hydroxyivitamin D3 levels in patients with systemic lupus erythematosus and its association with clinical parameters and laboratory tests. Rev Bras Reumatol 2012; 52:60–65.
Toloza SMA, Cole DE, Gladman DD, Ibanez D, Urowitz MB, et al. Vitamin D insufficiency in a large female SLE cohort. Lupus 2010; 19:13–19.
Nagpal S, Na S, Rathnachalam R. Noncalcemic actions of vitamin D receptor ligands. Endocr Rev 2005; 26:662–687.
Kamen DL, Aranow C. The link between vitamin D deficiency and systemic lupus erythematosus. Curr Rheumatol Rep 2008; 10:273–280.
Damanhouri LH. Vitamin D deficiency in Saudi patients with systemic lupus erythematosus. Saudi Med J 2009; 30:1291–1295.
Handono K, Daramatasia W, Pratiwi D, Sunarti S, Wahono S, Handono K, et al. Low level of vitamin D increased dendritic cell maturation and expression of interferon-γ and interleukin-4 in systemic lupus erythematosus. J Pharm Biol Sci 2012; 2:37–43.
Kamen DL, Cooper GS, Bouali H, Shaftman SR, Hollis BW, Gilkeson GS, et al. Vitamin D deficiency in systemic lupus erythematosus. Autoimmun Rev 2006; 5:114–117.
Thudi A, Yin S, Wandstrat AE, Li QZ, Olsen NJ, et al. Vitamin D levels and disease status in Texas patients with systemic lupus erythematosus. Am J Med Sci 2008; 335:99–104.
Stockton KA, Kandiah DA, Paratz JD, Stockton KA, Kandiah DA, Paratz JD, Bennell KL, et al. Fatigue, muscle strength and vitamin D status in women with systemic lupus erythematosus compared with healthy controls. Lupus 2012; 21:271–278.
Borba VZC, Vieira JGH, Kasamatsu T, Radominski SC, Sato EI, Lazarette-Castro M, et al. Vitamin D deficiency in patients with active systemic lupus erythematosus. Osteoporos Int 2009; 20:427–433.
Amital H, Szekanecz Z, Szücs G, Danko K, Nagy E, Csepany T, et al. Serum concentrations of 25-OH vitamin D in patients with systemic lupus erythematosus (SLE) are inversely related to disease activity: is it time to routinely supplement patients with SLE with vitamin D? Ann Rheum Dis 2010; 69:1155–1157.
Mok CC, Birmingham DJ, Ho LY, Hebert LA, Song H, Rovin BH, et al. Vitamin D deficiency as marker for disease activity and damage in systemic lupus erythematosus: a comparison with anti-dsDNA and anti-C1q. Lupus 2012; 21:36–42.
Ben-Zvi I, Aranow C, Mackay M, Stanevsky A, Kamen DL, Martinescu LM, et al. The impact of vitamin D on dendritic cell function in patients with systemic lupus erythematosus. PLoS One 2010; 5:9193.
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Emam, F.E., El-Wahab, T.M.A., Mohammed, M.S. et al. Assessment of serum vitamin D level in patients with systemic lupus erythematosus. Egypt Rheumatol Rehabil 41, 71–78 (2014). https://doi.org/10.4103/1110-161X.132460
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DOI: https://doi.org/10.4103/1110-161X.132460