Severe vitamin D deficiency increases the risk for moderate to severe disease activity in Chinese patients with SLE

Cc, Gao; Sy, Liu; Zz, Wu; Tf, Li; Gm, Gao; Liu, ZS; Zheng, Zhaohui

doi:10.1177/0961203316635289

Cited by 28 publications

(37 citation statements)

References 21 publications

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“…A total of 138 women with SLE, mean age 40.3 ± 11 years, mean disease duration 8.8 ± 6.4 years, were included: 48.6% had mild-to-moderate disease activity, mean 2.3 ± 2.9 years, and 43.5% had damage, mean 0.72 ± 1, within the range shown by other studies [42, 43], while 19.6% met the criteria for the diagnosis of fibromyalgia: tender points were 4.9 ± 5.9 high sensitivity points/zones. Mean depression score was 16.1 ± 1, (Table 1).…”

Section: Resultssupporting

confidence: 53%

Factors Associated with Health-Related Quality of Life in Mexican Lupus Patients Using the LupusQol

et al. 2017

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IntroductionHealth-related quality of life (HRQOL) is affected by numerous clinical variables, including disease activity, damage, fibromyalgia, depression and anxiety. However, these associations have not yet been described in Mexican patients with systemic lupus erythematosus (SLE).ObjectiveTo evaluate the relationship between disease activity, damage, depression and fibromyalgia and HRQOL measured by the LupusQoL-instrument in Mexican patients with SLE.MethodsA cross-sectional study was conducted in women fulfilling the 1997 ACR classification criteria for SLE. HRQOL was evaluated using a disease-specific instrument for SLE, the LupusQoL (validated for the Spanish-speaking population). Patients were evaluated clinically to determine the degree of disease activity and damage using the Mexican Systemic Lupus Erythematosus Disease Activity Index (Mex-SLEDAI) and Systemic Lupus International Collaborating Clinics-Damage Index (SLICC), respectively. Fibromyalgia and depression were assessed using the ACR criteria and the CES-D scale, respectively. The relationship between HRQOL and these variables was measured using Spearman’s rank correlation coefficient and linear regression analysis.ResultsA total of 138 women with SLE, age 40.3±11 years, disease duration 8.8±6.4 years, with disease activity in 51.4%, depression in 50%, damage in 43% and fibromyalgia in 19.6% were included. Poorer HRQOL correlated with depression (r = -0.61; p< 0.005), fibromyalgia (r = -0.42; p< 0.005), disease activity (r = -0.37; p < 0.005) and damage (r = -0.31; p < 0.005). In the multivariate linear regression analysis, damage (β = -3.756, p<0.005), fibromyalgia (β = -0.920, p<0.005), depression (β = -0.911, p<0.005) and disease activity (β = -0.911, p<0.005) were associated with poor HRQOL.ConclusionSLE disease activity, damage, fibromyalgia and depression were associated with poor HRQOL in our sample of Mexican SLE patients.

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Section: Resultssupporting

confidence: 53%

Factors Associated with Health-Related Quality of Life in Mexican Lupus Patients Using the LupusQol

et al. 2017

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“…SLEDAI, SELENA-SLEDAI, BILAG, ECLAM) making somehow tricky the direct comparison between trials. Independently of the score used, a significant proportion of these observational studies showed the existence of an association between lower 25(OH)D3 serum concentration and higher disease activity [11,42,43,45,89,103,105,108,109,121,126,128] [129,131,132,135,136]. However, this correlation was not confirmed in all the studies [10,12,44,48,90,101,106,114,118,124,130,133].…”

Section: Vitamin D and Sle Disease Activitymentioning

confidence: 93%

“…On the other hand, however, 25(OH)D3 concentration might be lowered secondary to the presence of systemic inflammation. Interestingly, even if a continuous high disease activity correlates with organ damage, most of the studies failed to show a correlation between low serum 25(OH)D3 and lupus-related organ damage [105]; in some circumstances, lower vitamin D levels have been associated with disease flares [42,112,122]. A more consistent consensus has been raised with regards to the negative correlation between vitamin D and ANA titres [11,46,88,90,100,128,129], in keeping with the in vitro ability of vitamin D of inhibiting B cells activation and autoantibodies production.…”

Section: Vitamin D and Sle Disease Activitymentioning

confidence: 99%

To Supplement or not to Supplement? The Rationale of Vitamin D Supplementation in Systemic Lupus Erythematosus

Nerviani¹,

Mauro²,

Gilio³

et al. 2018

TORJ

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Background: Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease characterised by abnormal activation of the immune system, chronic inflammation and organ damage. Lupus patients are more prone to be vitamin D deficient. However, current evidence is not conclusive with regards to the role played by vitamin D in SLE development, progression, and clinical manifestations. Objective: Here, we will summarise the current knowledge about vitamin D deficiency prevalence, risk factors, molecular effects, and potential pathogenic role in SLE. We will focus on the link between vitamin D deficiency and lupus clinical manifestations, and on the clinical trials assessing the effects of vitamin D supplementation in SLE. Method: A detailed literature search was performed exploiting the available databases, using “vitamin D and lupus/SLE” as keywords. The relevant interventional trials published over the last decade have been considered and the results are reported here. Conclusion: Several immune cells express vitamin D receptors. Thus, an immunomodulatory role for vitamin D in lupus is plausible. Numerous observational studies have investigated the relationship between vitamin D levels and clinical/serological manifestations of SLE with contrasting results. Negative correlations between vitamin D levels and disease activity, fatigue, renal and cardiovascular disease, and anti-dsDNA titres have been described but not conclusively accepted. In experimental models of lupus, vitamin D supplementation can improve the disease. Interventional trials have assessed the potential therapeutic value of vitamin D in SLE, but further larger studies are needed.

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“…Despite some contradictory findings, several studies have reported significantly lower serum VitD levels in SLE patients [43][44][45]. Recent data indicated that these lower levels were also associated with an increased risk for moderate to severe SLE manifestations in patients [46]. The association of VitD status with SLE activity, serological markers and disease risk related to VDR genes polymorphisms was recently reviewed by Watad et al [47].…”

Section: Vitamin D Status In Inflammatory Rheumatic Disordersmentioning

confidence: 99%

Vitamin D Deficiency and Rheumatoid Arthritis

Ishikawa

Colavite

Fraga-Silva

et al. 2016

Clinic Rev Allerg Immunol

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Vitamin D (VitD) is a hormone primarily synthesized in human skin under the stimulation of ultraviolet radiation. Beyond its endocrine role in bone metabolism, VitD is endowed with remarkable immunomodulatory properties. The effects of VitD on the immune system include the enhancement of microbicidal ability of monocytes/macrophages and the down-modulation of inflammatory cytokines produced by T lymphocytes. VitD deficiency is involved in many health problems, including immune-mediated diseases such as autoimmune disorders. Rheumatoid arthritis (RA) is a chronic inflammatory systemic autoimmune disease that compromises the joints, causing cartilage destruction and bone erosion. RA treatment usually consists of combined therapies that generally suppress the entire immune response leading to increased susceptibility to infections. This review describes the main effects of VitD on innate and adaptive immune system and also VitD status in inflammatory rheumatic diseases such as RA. Despite some controversies, the majority of reports reinforce the idea that lower VitD levels correlate with more severe clinical manifestations in RA and other rheumatic diseases. Therefore, supplementation with VitD to achieve normal serum levels is worthwhile as an aforethought. Original data concerning the potential applicability of 1,25-dihydroxyvitamin D (VitD3), the active form of vitamin D, as a tolerogenic adjuvant are also included. In this sense, the effect of VitD3 associated with proteoglycan (PG), which is a specific cartilage antigen, was tested in the course of experimental arthritis. This association significantly lowered clinical scores and local histopathological alterations. Even though local analysis of T cell subsets and cytokine production did not reveal any difference between the experimental groups, VitD3+PG association significantly reduced cytokine production by spleen cells. These results suggest that VitD3 played a role as a tolerogenic adjuvant by down-modulating the course of experimental RA. Considering this tolerogenic effect of VitD3+PG association, further investigations will reveal its plausible use in human RA.

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Severe vitamin D deficiency increases the risk for moderate to severe disease activity in Chinese patients with SLE

Abstract: Vitamin D deficiency is highly prevalent in patients with SLE. Severe deficiency increases the risk for moderate to severe disease activity, but not for organ damage.

Cited by 28 publications

References 21 publications

Factors Associated with Health-Related Quality of Life in Mexican Lupus Patients Using the LupusQol

Factors Associated with Health-Related Quality of Life in Mexican Lupus Patients Using the LupusQol

To Supplement or not to Supplement? The Rationale of Vitamin D Supplementation in Systemic Lupus Erythematosus

Vitamin D Deficiency and Rheumatoid Arthritis

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