APS patients show higher frequency of vitD deficiency than the healthy individuals. The meta-analysis study, including three cohorts and ours, suggests that APS patients have significantly lower serum vitD levels and higher frequency of vitD deficiency than controls.
BackgroundVitamin D, due to its immunoregulatory properties, has been implicated in the pathogenesis of autoimmune diseases, such as antiphospholipid syndrome (APS).ObjectivesA) To determine vitamin D levels in patients with primary APS and to compare them with patients with positive antiphospholipid antibodies (aPL), not meeting clinical criteria for APS, and with healthy controls. B) To analyze the association of the vitamin D levels with both the clinical manifestations and the immunological profile of patients with primary APS.MethodsWe conducted a retrospective study including patients attended at the rheumatology clinic from a tertiary facility in Northern Spain. We included 74 patients with primary APS, 54 patients with positive aPL serology not meeting clinical criteria for APS and 326 healthy controls adjusted by the month of vitamin D analysis. We considered 30 ng/ml and 10 ng/ml as the thresholds for vitamin D insufficiency and deficiency, respectively.ResultsMedian levels of vitamin D were similar in the three groups: 21 (range 5–69) in primary APS, 25 (4–50) in the aPL-positive group, and 21 (4–105) in controls. Overall, 53.9% of measurements were performed during the sunny season (April to September). Ten percent of patients with primary APS were males, versus 16% in the aPL serology group and 26% among healthy controls (p=0.007). Mean age was 46±15 in primary APS, 49±17 in the aPL-positive group and 53±10 in the control group (p<0.001). Regarding vitamin D insufficiency, 82% of APS patients had levels of vitamin D (<30 ng/ml) versus 70% and 72% of patients with aPL serology and controls, respectively (p=0.168). When analyzing the prevalence of vitamin D deficiency (<10 ng/ml), we found significant differences across the groups: 16.2% in patients with primary APS, 11.1% in patients with positive serology and only 4.9% in healthy controls (p=0.002). There was no significant association between insufficient levels of vitamin D and the presence of thrombotic or obstetric events. Nevertheless, we found a trend for the presence of more thrombotic events in patients with vitamin D deficiency (p=0.097). Regarding the immunological profile, we found no association between vitamin D and either the number of positive antibodies or their serological evolution. However, we found an association between insufficient levels of vitamin D and the presence of lupus anticoagulant (54.7% vs 18.2%, p=0.047)ConclusionsMore than 80% of patients with primary APS have insufficient levels of vitamin D and 16% of them have very low levels of vitamin D.Primary APS patients show a higher frequency of vitamin D deficiency than healthy controls.Patients with vitamin D insufficiency have more commonly positivity for lupus anticoagulant.Disclosure of InterestNone declared
patients with primary APS, 54 patients with positive aPL serology not meeting clinical criteria for APS and 326 healthy controls adjusted by the month of vitamin D analysis. We considered 30 ng/ml and 10 ng/ml as the thresholds for vitamin D insufficiency and deficiency, respectively. Results: Median levels of vitamin D were similar in the three groups: 21 (range 5-69) in primary APS, 25 (4-50) in the aPL-positive group, and 21 (4-105) in controls. Overall, 53.9% of measurements were performed during the sunny season (April to September). Ten percent of patients with primary APS were males, versus 16% in the aPL serology group and 26% among healthy controls (p=0.007). Mean age was 46±15 in primary APS, 49±17 in the aPL-positive group and 53±10 in the control group (p<0.001). Regarding vitamin D insufficiency, 82% of APS patients had levels of vitamin D (<30 ng/ml) versus 70% and 72% of patients with aPL serology and controls, respectively (p=0.168). When analyzing the prevalence of vitamin D deficiency (<10 ng/ml), we found significant differences across the groups: 16.2% in patients with primary APS, 11.1% in patients with positive serology and only 4.9% in healthy controls (p=0.002). There was no significant association between insufficient levels of vitamin D and the presence of thrombotic or obstetric events. Nevertheless, we found a trend for the presence of more thrombotic events in patients with vitamin D deficiency (p=0.097). Regarding the immunological profile, we found no association between vitamin D and either the number of positive antibodies or their serological evolution. However, we found an association between insufficient levels of vitamin D and the presence of lupus anticoagulant (54.7% vs 18.2%, p=0.047) Conclusions: More than 80% of patients with primary APS have insufficient levels of vitamin D and 16% of them have very low levels of vitamin D. Primary APS patients show a higher frequency of vitamin D deficiency than healthy controls. Patients with vitamin D insufficiency have more commonly positivity for lupus anticoagulant.
BackgroundAntiphospholipid syndrome (APS) is an autoinmune disease characterized by the presence of antiphospholipid antibodies (aPL) and at least one clinical event (thrombosis and /or pregnancy morbidities). The titers of aPL can fluctuate and eventually become negative. This negativization, particularly if persistent, may be associated with a lower frequency of clinical events.ObjectivesTo describe the clinical and serological course of patients with thrombotic APS as well as the factors related with the aPL negativizationMethodsWe performed a retrospective study including patients attended at the Rheumatology clinic from a tertiary hospital in Northern Spain. We included 94 patients with thrombotic APS according to Sidney criteria of 2006. They were classified according to the serological evolution as persistently negative aPL, transiently positive, and persistently positive aPL according to previously established criteria.ResultsAfter a mean follow-up of 145±56 months, 48.9% of patients presented a persistently negative serology, whereas in 12.8% it was transiently positive, and persistently positive in 38.3%. When analyzing potential factors related to the negativization (table 1), we found that patients with positive lupus anticoagulant tended to have a persistently negative serology during follow-up, but it did not reach statistical significance (OR 2.7; 95% CI 0.8–9.4; p=0.145). We found no association between traditional cardiovascular risk factors or previous treatments and the serological evolution.VariableTotalPersistently negativePersistently positive and transiently positiveP (n=46)(n=48) Age45±1644±1447±170.33Male sex, n (%)19 (21)8 (18)11 (24)0.61SLE, n (%)25 (27)12 (26)13 (27)1Load of antibodies, n (%)0.94 129 (31)15 (33)14 (29) 240 (43)19 (41)21 (44) 325 (27)12 (26)13 (27)Anticardiolipin antibodies, n (%)76 (81)36 (78)40 (83)0.60Antiβ2-GlycoproteinI antibodies, n (%)59 (63)27 (59)32 (67)0.52Lupus anticoagulant, n (%)35 (66)18 (78)17 (57)0.14Family history of thrombosis, n (%)17 (31)10 (40)7 (24)0.25Tobacco use, n (%)41 (44)21 (46)20 (42)0.83Hypertension, n (%)45 (48)21 (46)24 (50)0.69Dyslipidemia, n (%)43 (46)21 (46)22 (46)1Diabetes, n (%)4 (4)2 (4)2 (4)1Antimalarials, n (%)34 (36)16 (35)18 (37)0.83Heparin, n (%)34 (36)16 (35)18 (37)0.83Oral anticoagulants, n (%)68 (72)33 (72)35 (73)1Antiplatelets, n (%)71 (76)33 (73)38 (79)0.63Corticosteroids, n (%)5 (5)2 (4)3 (6)1Immunosuppressants, n (%)4 (4)1 (2)3 (6)0.36ConclusionsAfter a mean follow-up of 12 years, 49% of thrombotic APS patients presented a persistently negative serology. We found no significant association between immunological, traditional cardiovascular risk factors or previous treatments and the persistently negative serology.Disclosure of InterestNone declared
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.