Low vitamin D serum levels in diffuse systemic sclerosis: a correlation with worst quality of life and severe capillaroscopic findings

Sampaio-Barros, Marília M; Takayama, Liliam; Sampaio-Barros, Percival Degrava; Bonfá, Eloísa; Pereira, Rosa Maria Rodrigues

doi:10.1016/j.rbre.2016.05.006

Cited by 22 publications

(26 citation statements)

References 40 publications

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“…It is worth noticing that Park et al showed in a cross‐sectional study that patients with vitamin D deficiency had more frequent DUs over time, that is active or previous. Recently, Trombetta et al have shown that vitamin D serum levels negatively correlated with Medsger's score for peripheral vascular involvement and some other studies showed that lower levels of vitamin D were found in late‐pattern nerve conduction velocity. Taken together these data suggest that low vitamin D serum levels may actually affect microvascular manifestations of SSc, leading to an increased risk of developing DUs.…”

Section: Discussionmentioning

confidence: 99%

“…Vitamin D is able to influence the immune response; its role has been proven in different settings and it has been studied also in SSc. In particular, low levels have been reported in the literature with a prevalence of insufficiency even higher than 80% and of deficiency higher than 20% and its deficiency has been related to some disease manifestations, such as poor quality of life, low diffusing capacity for carbon monoxide (DLCO), diastolic dysfunction, digital contractures, advanced skin fibrosis, long disease duration, high values of C‐reactive protein and erythrocyte sedimentation rate, high pulmonary arterial pressure at echocardiography, lung involvement, kidney and gastrointestinal Medsger's severity score parameters and high disease activity . In particular, an association with microvascular involvement has been found as shown by the link with avascular areas at nailfold videocapillaroscopy (NVC), peripheral vascular Medsger's severity score parameters and DU development .…”

Section: Introductionmentioning

confidence: 99%

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Vitamin D serum levels and the risk of digital ulcers in systemic sclerosis: A longitudinal study

et al. 2019

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Aim: Low levels of vitamin D (25OHD) have been found to associated with digital ulcers (DUs) in systemic sclerosis (SSc), although only cross-sectional studies have been performed. We aimed to investigate if variations in vitamin D serum levels over time affect DU in SSc. Methods: This is a retrospective study on 65 patients. 25OHD was measured in 2011 and 2016 and its variations correlated with DU. Results: The mean age of our cohort was 58 (SD 12) years with a mean disease duration of 9.5 (5.3) years. Most of our patients had a limited SSc (69.2%). At baseline 50.8% and 41.5% after 5 years had 25OHD <30 ng/mL. Patients receiving supplementation (8750 IU/wk) at baseline numbered 39 (60.0%) and 45 (69.2%) at the end of follow up. Nevertheless, 31 (47.7%) had a decrease of 25OHD in 5 years. In univariate analysis, patients with incident DU had a decrease in 25OHD as compared to patients with no incident DU (−17.4 [37.0] vs 13.0 [89.5], P = 0.018). No differences in 25OHD variations were found for other disease characteristics. In multivariate analysis correcting for previous DU and modified Rodnan Skin Score at baseline, patients with a decrease in 25OHD had an increased risk of developing DU (odds ratio 16.6;95% CI 1.7-164.5, P = 0.017). Conclusions:A decrease in 25OHD is associated with the risk of developing DUs. In addition, vitamin D supplementation with the doses currently recommended may be insufficient in SSc. Further studies in wider cohorts are needed to confirm these results. K E Y W O R D Sdigital ulcers, supplementation, systemic sclerosis, vitamin D

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Vitamin D serum levels and the risk of digital ulcers in systemic sclerosis: A longitudinal study

et al. 2019

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“…A recent study showed that low serum concentrations of 25(OH)D has negative impact in diffuse SSc patients’ quality of life and in addition, a correlation with severe NVC alterations was reported, suggesting a possible role of 25(OH)D in vascular involvement [18]. Furthermore, recently a significant difference in serum IgM anti-vitamin D antibodies in SSc patients was found, compared to healthy controls [19].…”

Section: Discussionmentioning

confidence: 99%

Vitamin D deficiency and clinical correlations in systemic sclerosis patients: A retrospective analysis for possible future developments

Trombetta¹,

Smith

Gotelli³

et al. 2017

PLoS ONE

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ObjectiveAssessment of serum 25-hydroxyvitamin D (25(OH)D) correlations with clinical parameters and evaluation of the efficacy of standard oral supplementation in systemic sclerosis (SSc) patients.Methods154 SSc patients were recruited, in all seasons. Serum 25(OH)D concentrations were evaluated using LIAISON 25-OH (Diasorin, Italy). Medsger disease severity scale (DSS), nailfold videocapillaroscopy (NVC) and all instrumental exam contemplated by international guidelines were performed. Drug assumption, including oral colecalciferol, was evaluated. Non-parametric tests were used for statistical analysis.ResultsAverage 25(OH)D serum concentration was 18.7 ±9 ng/ml (<20 classified as deficiency). A significant correlation was found with presence/absence of lung bi-basal fibrotic changes (16.1 ±8 ng/ml and 20 ±10 ng/ml, respectively; p = 0.04). Peripheral vascular (p = 0.03), kidney (p = 0.02), gastrointestinal (p = 0.05) Medsger’s DSS parameters were found to correlate with 25(OH)D serum concentrations. No significant correlations were observed with digital ulcers incidence, strictly correlated to patterns of microangiopathy, defined at NVC analysis (p<0.0001). Interestingly, no effects of treatment with oral colecalciferol (Dibase 1,000 IU daily for at least 6 months) were found on 25(OH)D serum concentrations in treated (18.8 ±10 ng/ml) or untreated (18.7 ±9 ng/ml) SSc patients (p = 0.81). A significant difference was observed among seasonal 25(OH)D serum concentrations (winter: 14.6 ±7.8 ng/ml, spring: 17.2 ±7.9 ng/ml, summer: 21.43 ±10 ng/ml, autumn: 20.2 ±10 ng/ml; p = 0.032) in all patients.ConclusionSerum 25(OH)D deficiency was found to correlate with lung involvement, peripheral vascular, kidney and gastrointestinal Medsger’s DSS parameters and with seasonality In SSc patients. Supplementation with oral colecalciferol was found not effective in increasing 25(OH)D serum concentrations. Therefore, for successful replacement, supra-physiological vitamin D3 doses or programmed UVB light exposure should be tested.

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“…Ele intensifica-se com situações de estresse e de frio, produzindo agravos como isquemias e ulcerações digitais e necrose tecidual. Ainda, estes indivíduos apresentam deficiência de vitamina D, o que pode interferir em aspectos como a qualidade de vida e a capacidade de produzir uma FPP de boa qualidade (JORGE;SCHNORNBERGER;SANTOS, 2017;KAYSER;CORRÊA;ANDRADE, 2009;MACHADO;SOUTO;FREIRE, 2014;SAMPAIO-BARROS et al, 2016). Neste estudo os sujeitos com esclerose sistêmica não demonstraram melhora estatisticamente significativa nas avaliações pré e pós intervenção, possivelmente em virtude dos períodos de exacerbação do Fenômeno de Raynoud apresentado por estes.…”

Section: Resultsunclassified

Efeitos Da Cinesioterapia Sobre a Força De Preensão Palmar Em Indivíduos Com Doenças Reumáticas

Jorge

Lima

Vieira

et al. 2018

RIES

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Introdução: as doenças reumáticas apresentam manifestações musculoesqueléticas e sistêmicas que podem acometer quaisquer regiões do corpo. No caso das mãos, uma das manifestações é a diminuição da força de preensão palmar destes indivíduos. Objetivo: verificar os efeitos da cinesioterapia sobre a força de preensão palmar em indivíduos com doenças reumáticas. Material e métodos: estudo longitudinal e intervencionista com 24 indivíduos portadores de doenças reumáticas (osteoartrite, artrite reumatoide, fibromialgia, lúpus eritematoso sistêmico, esclerose sistêmica e dermatopolimiosite), com idade média de 50,23 anos. Os indivíduos realizaram 10 sessões de fisioterapia, baseadas em cinesioterapia, com exercícios globais e funcionais, 02 vezes por semana, com duração média de 50 minutos, de março de 2014 a novembro de 2015, na Clínica de Fisioterapia da Universidade de Passo Fundo, Passo Fundo/RS. As avaliações inicial e final envolveram a coleta de dados e a mensuração da força de preensão palmar, por meio da dinamometria manual. Resultados: observou-se que os indivíduos apresentaram melhora da força de preensão palmar, porém os resultados foram estatisticamente significativos apenas para a mão direita dos indivíduos com osteoartrite, para ambas as mãos dos indivíduos com artrite reumatoide e lúpus eritematoso sistêmico e para a força de preensão palmar geral dos indivíduos. Conclusão: o protocolo fisioterapêutico proposto produziu aumento da força de preensão palmar de indivíduos com doenças reumáticas.Palavras-chave: Força da mão. Doenças reumáticas. Fisioterapia. Reabilitação. Exercício. ABSTRACT: Introduction: rheumatic diseases present musculoskeletal and systemic manifestations that can affect any region of the body. In the case of the hands, one of the manifestations is the decrease of the handgrip strength of these individuals. Aim: to verify the effects of kinesiotherapy on handgrip strength in individuals with rheumatic diseases. Material and methods: longitudinal and interventional study with 24 individuals with rheumatic diseases (osteoarthritis, rheumatoid arthritis, fibromyalgia, systemic lupus erythematosus, systemic sclerosis and dermatopolymyositis), mean age 50.23 years. The individuals performed 10 sessions of physiotherapy, based on kinesiotherapy, with global and functional exercises, 02 times a week, with an mean duration of 50 minutes, from March 2014 to November 2015, at the Physiotherapy Clinic of Passo Fundo University, Passo Fundo/RS. The initial and final evaluations involved data collection and measurement of handgrip strength using manual dynamometry. Results: it was observed that the individuals presented improvement of the handgrip strength, but the results were statistically significant only for the right hand of individuals with osteoarthritis, for both hands of individuals with rheumatoid arthritis and systemic lupus erythematosus and for the handgrip strength of individuals. Conclusion: the proposed physiotherapeutic protocol produced an increase in the handgrip strength of individuals with rheumatic diseases.Keywords: Hand strength. Rheumatic diseases. Physical therapy specialty. Rehabilitation. Exercise.

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Low vitamin D serum levels in diffuse systemic sclerosis: a correlation with worst quality of life and severe capillaroscopic findings

Cited by 22 publications

References 40 publications

Vitamin D serum levels and the risk of digital ulcers in systemic sclerosis: A longitudinal study

Vitamin D serum levels and the risk of digital ulcers in systemic sclerosis: A longitudinal study

Vitamin D deficiency and clinical correlations in systemic sclerosis patients: A retrospective analysis for possible future developments

Efeitos Da Cinesioterapia Sobre a Força De Preensão Palmar Em Indivíduos Com Doenças Reumáticas

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