THE role of vitamin D in multisystem sarcoidosis

Abstract

Recently published data indicate that vitamin D abnormalities are common in sar coidosis patients. The purpose of this study was to compar e serum vitamin 25(OH)D levels among sarcoidosis patients with differ ent clinical courses of the disease. The study also included the first obser vations on cognitive functions (i.e. depr ession and fatigue syndrome) in r elation to vitamin D deficiency in sar coidosis patients. At the Biochemical Laboratory of the Clinical Center of Serbia, Belgrade, vitamin D25(OH)D was measur ed using the Elecsys ® Vitamin D total test. A total of 226 patients with biopsy-positive sarcoidosis were analyzed. The average median value of ser um vitamin D was 9.47 mg/L, suggesting severe deficiency. Statistically significant cor relation was found in patients with chronic disease and low levels of serum vitamin 25(OH)D (Chi-Squar e=6.044; df=2; p=0.014). The patient group with vitamin D serum levels higher than 20 mg/L showed higher levels of the mean for ced vi tal capacity (FVC) by 380 mL, and for ced expiratory volume in one second (FEV1) by 220 mL, when compared to the patient group with lower serum vitamin D. A statistically significant role was established for serum vitamin 25(OH)D levels as the pr edictor of fatigue (R 2 =0.878; p=0.038 (b=0.216)) and depression in patients with sar coidosis (R 2 =0.8 0; p=0.000 (b=0.391)). The insufficiency of 25(OH)D seems to be an important factor in pr edicting the course of chr onic disease, significant lung function impair ments and cognitive failur es such as fatigue and depr ession. The fact that the majo rity of the analyzed sarcoidosis patients had totally deficient ser um 25(OH)D levels made this finding even mor e notable.

Statistical methods applied in pharmacotherapy

“…In regression models, one or more dependent variables are brought into operation with one or more independent variables (the predictor). When the dependent variable is continuous, the methods applied are ANOVA, MANOVA [19,20], ANCOVA, MANCOVA, nonlinear functions, multiple linear regression, survival methods, Cox proportional analysis, while in cases where the dependent variable is categorical, then logistic regression [21][22][23][24][25] or discriminatory analysis are applied, which in the narrower sense also belong to classifi cation techniques.…”

The Health Benefits of Vitamin D Relevant for Tuberculosis

“…Additionally, vitamin D deficiency is linked to many other autoimmune diseases including type one diabetes mellitus, rheumatoid arthritis, and SLE (10). Also, the majority of the analyzed patients with multisystem sarcoidosis had vitamin D deficiency (12).…”

Endobronchial ultrasound in diagnosing sarcoidosis

“…U najvećem procentu zahvaćena su pluća, mada je i zahvaćenost svakog drugog organa moguća. Klinički tok sarkoidoze, prirodni razvoj bolesti i prognoza su prilično varijabilne komponente sa mogućnošću kako spontane reemisije tako i reemisije na terapiju [1].…”

“…Kod bolesnika sa suspektnom sarkoidozom na osnovu kliničko-radioloških nalaza, neophodna je patohistološka potvrda sarkoidoze, radi isključivanja maligne bolesti ili tuberkuloze, pogotovo ukoliko je indikovan dalji terapijski tretman. Uzorak tkiva treba dobiti sa najpristupačnijeg mesta koristeći minimalno invazivni tretman [1,2]. Prema smernicama ERS (Evropsko udruženje pulmologa), ATS (Američko torakalno udruženje), i Svetskog udruženja za sarkoidozu i druge granulomatoze, fleksibilna bronhoskopija sa transbronhijalnom biopsijom je inicijalna procedura i metoda izbora [3,4].…”

“…Obe procedure su bezbedne i dozvoljavaju u realnom vremenu ultrazvučnu eksploraciju i biopsiju limfnih nodusa pluća i medijastinuma. EBUS-FNA omogućava detekciju limfnih nodusa na više nivoa, uključujući gornje i donje paratrahealne [2,4], supkarinalne [7] i hilarne limfne noduse [10,11] TBNA dijagnoza sarkoidoze potvrđena je u 91,8% slučajeva. NPV je bio 11%.…”