Prevalence and predictors of vitamin D deficiency in non-supplemented women with systemic lupus erythematosus in the Mediterranean region: a cohort study

Muñoz-Ortego, Juan; Torrente-Segarra, Vicenç; Prieto-Alhambra, Daniel; Salman-Monte, Tarek Carlos; Carbonell-Abelló, Jordi

doi:10.3109/03009742.2012.697189

Cited by 35 publications

(34 citation statements)

References 14 publications

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“…However, no significant correlation was found between vitamin D insufficiency and deficiency with bone loss. In our previous study, daily sunscreen use and high BMI were the main predictors of vitamin D deficiency [19]. as we mentioned before, we found a statistically significant correlation between low BMI and low BMD.…”

Section: Discussionsupporting

confidence: 81%

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Prevalence and predictors of low bone density and fragility fractures in women with systemic lupus erythematosus in a Mediterranean region

et al. 2014

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Studies have found an increase in bone loss and fracture in individuals with systemic lupus erythematosus (SLE) compared with general population. The aim of this study was to describe the prevalence of osteopenia, osteoporosis, and fragility fractures and to find potential predictors of bone loss in our cohort of SLE patients. We performed a cross-sectional study and collected 67 bone density measurements (BMD) of our SLE patients. We also collected sociodemographic data, 25-OH-vitamin D levels, serological markers, activity index, SLE cumulative damage index, and pharmacologic treatment. Sixty-seven consecutive BMD from SLE patients were assessed. Osteopenia was found in 28-46% of SLE patients. Osteoporosis ranged from 3 to 6%[corrected]. The only statistically significant correlation we found was between weight and height with total hip and femoral neck BMD (p < 0.05). The most frequent BMD-affected site was at the femoral neck, showing osteopenia in 40.3% [corrected] of SLE patients. Osteoporosis was found in up to 6% [corrected] of SLE patients. We found no predictors of bone loss in relation to the disease activity or its treatment. Fragility fractures were seen in 4.4% of SLE patients. All patients with fragility fractures showed osteopenia at BMD. There is a high prevalence of bone loss in SLE patients, since up to 40% [corrected] of SLE patients showed low BMD. Total hip and femoral neck osteopenia were the most frequent findings correlated with low BMI. We found a lower prevalence of fragility fractures compared with other series.

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Section: Discussionsupporting

confidence: 81%

“…It is well known that Sle patients show reduced 25-OH-vitamin D levels compared with general population [16,19]. Many factors are related to this (HcQ use, sunscreen, and renal involvement).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of low bone density and fragility fractures in women with systemic lupus erythematosus in a Mediterranean region

et al. 2014

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“…1 2 Studies within patients with SLE indicate that lower 25[OH]D levels may correlate with increased disease activity, [3][4][5][6][7][8][9][10][11][12][13][14][15][16] although inconsistently. [17][18][19][20][21][22][23][24] Variation within the vitamin D receptor gene (VDR), the vitamin D receptor protein that binds the active form of vitamin D, 1,25-dihydroxyvitamin D (1,25[OH] 2 D), has been associated with higher SLE disease activity in females 25 and higher damage score. 26 Whether vitamin D is related to risk of developing SLE has not been clearly established.…”

Section: Introductionmentioning

confidence: 99%

Combined role of vitamin D status and CYP24A1 in the transition to systemic lupus erythematosus

et al. 2016

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Objective We examined whether measures of vitamin D were associated with transitioning to systemic lupus erythematosus (SLE) in individuals at risk for SLE. Methods 436 individuals who reported having a relative with SLE but who did not have SLE themselves were evaluated at baseline and again an average of 6.3 (± 3.9) years later. Fifty-six individuals transitioned to SLE (≥4 cumulative ACR criteria). 25-hydroxyvitamin D (25[OH]D) levels were measured by ELISA. Six single nucleotide polymorphisms (SNPs) in four vitamin D genes were genotyped. Generalized estimating equations, adjusting for correlation within families, were used to test associations between the vitamin D variables and the outcome of transitioning to SLE. Results Mean baseline 25[OH]D levels (p=0.42) and vitamin D supplementation (p=0.65) were not different between those who did and did not transition to SLE. Vitamin D deficiency (25[OH]D <20 ng/ml) was greater in those who transitioned compared to those who did not transition to SLE (46% versus 33%, p=0.05). The association between 25[OH]D and SLE was modified by CYP24A1 rs4809959, where for each additional minor allele, increased 25[OH]D was associated with decreased SLE risk: 0 minor alleles (adjusted OR:1.03, CI:0.98,1.09), 1 minor allele (adjusted OR:1.01, CI:0.97,1.05), 2 minor alleles (adjusted OR:0.91, CI:0.84,0.98). Similarly, vitamin D deficiency significantly increased the risk of transitioning to SLE in those with two minor alleles at rs4809959 (adjusted OR:4.90, CI: 1.33,18.04). Conclusions Vitamin D status and CYP24A1 may have a combined role in the transition to SLE in individuals at increased genetic risk for SLE.

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“…While the specific questions used were not individually validated against adolescent plasma 25(OH)D, previous studies have suggested a positive association between plasma vitamin D and lighter skin, [13] less frequent sunscreen use, [14] [15] and tanning bed use [16] and we hypothesize that girls with more frequent sunburns are likely to have greater vitamin D exposure. We asked participants about the color of their untanned skin (very fair, fair, olive, or dark).…”

Section: Methodsmentioning

confidence: 99%

Adolescent dietary vitamin D and sun exposure in relation to benign breast disease

Boeke

Tamimi

Berkey

et al. 2015

Cancer Causes Control

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Purpose Vitamin D may reduce cell proliferation and tumor growth in breast tissue, and exposure may be most important during adolescence when breast tissue is developing. In the Nurses’ Health Study II, higher recalled adolescent vitamin D intake was associated with a lower risk of benign breast disease (BBD). Our study aim was to assess adolescent vitamin D exposure in relation to BBD in young women. Methods Vitamin D was assessed in 6,593 adolescent girls (9 to 15 years of age at baseline) in the prospective Growing Up Today Study cohort using the mean energy-adjusted intakes from food frequency questionnaires in 1996, 1997, and 1998. In 1999, 5286 girls reported skin color, sunscreen use, tanning bed use, and number of sunburns in the past year, and we used state of residence to assess low vs. high ultraviolet (UV) index. Biopsy-confirmed BBD was reported on questionnaires in 2005, 2007, and 2010 (n=122). Results Dietary vitamin D, tanning behaviors, and other sun exposure variables were not significantly associated with BBD in logistic regression models adjusted for age, family history of breast cancer or BBD, age at menarche, nulliparity, alcohol intake, body mass index, and physical activity. The relative risk for the top (>467 IU/day) vs. bottom (<243 IU/day) quartile of vitamin D intake was 0.76 (95% CI: 0.47, 1.23). Conclusions Sun exposure was not significantly associated with BBD in this prospective cohort study. However, a suggestive inverse association between dietary vitamin D and BBD was observed that merits further study.

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Prevalence and predictors of vitamin D deficiency in non-supplemented women with systemic lupus erythematosus in the Mediterranean region: a cohort study

Abstract: Vitamin D insufficiency is highly prevalent among SLE patients, even in southern regions. Sunscreen use and obesity increase the risk. Clinicians should be aware of these factors and supplement SLE patients at risk of vitamin D deficiency accordingly.

Cited by 35 publications

References 14 publications

Prevalence and predictors of low bone density and fragility fractures in women with systemic lupus erythematosus in a Mediterranean region

Prevalence and predictors of low bone density and fragility fractures in women with systemic lupus erythematosus in a Mediterranean region

Combined role of vitamin D status and CYP24A1 in the transition to systemic lupus erythematosus

Adolescent dietary vitamin D and sun exposure in relation to benign breast disease

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