Vitamin D Deficiency in Egyptian Systemic Lupus Erythematosus Patients: How Prevalent and Does it Impact Disease Activity?

Abstract

BACKGROUNDThe emerging role of vitamin D in immunology and autoimmune disorders has been a worldwide interest in the last decade. Systemic lupus erythematosus (SLE) patients are particularly at a delicate position predisposing them to suffer from vitamin D deficiency due to the multiple risk factors accompanying the disease. Whether vitamin D deficiency is also involved as a risk factor for developing SLE and affecting its course is a considerable concern.OBJECTIVESThe objective of this study was to estimate the prevalence of vitamin D deficiency in SLE patients and its relation to disease.MATERIALS AND METHODSIn our observational cross-sectional study, serum levels of vitamin D [25(OH)D] in 60 SLE patients and 30 age- and sex-matched healthy controls were assessed and estimated for deficiency and insufficiency at 10 and 30 ng/mL, respectively. Disease activity was evaluated by SLE disease activity index (SLEDAI), irreversible organ damage by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI), and severity by Severity of Disease Index. Fatigue was measured by visual analog scale.RESULTSSignificantly lower levels of 25(OH)D were found in SLE patients (17.6 ± 6.9 ng/mL) in comparison to controls (79.0 ± 28.7 ng/mL), with a statistically high significant difference (t = −11.2, P < 0.001). High prevalence of vitamin D insufficiency and deficiency was detected as 73.3% and 23.3%, respectively. Vitamin D had a highly significant negative correlation with SLEDAI (r = −0.495, P < 0.001), SLICC (r = −0.431, P < 0.05), and fatigue (r = −0.436, P < 0.05).CONCLUSIONVitamin D deficiency and insufficiency were found to be prevalent in SLE patients in our study and related to disease activity and fatigue. If needed, routine screening and consequent repletion of vitamin D are recommended in SLE patients. Restoring adequate vitamin D levels in SLE patients should be more explored as a potential yet simple measure to their usual management to improve their condition.

Vitamin D status among the elderly Chinese population: a cross-sectional analysis of the 2010–2013 China national nutrition and health survey (CNNHS)

“…Vitamin D status is related to many types of health outcomes among the elderly population and can contribute to musculoskeletal complications (including proximal myopathy, bone and muscle pain, secondary hyperparathyroidism, osteoporosis, and osteomalacia) [1], chronic diseases (cancer and cardiovascular diseases) [2], autoimmune diseases (systemic lupus erythematosus, multiple sclerosis, scleroderma or systemic sclerosis, autoimmune thyroid diseases, rheumatoid arthritis and primary biliary cirrhosis) [3, 4], and psychotic disorders (depression, self-neglect and cognitive impairment) [5–7]. All these diseases can cause disability among the elderly.…”

Association between circulating 25‐hydroxyvitamin D and systemic lupus erythematosus: A systematic review and meta‐analysis

“…Ultimately, 19 studies were included in our meta‐analysis (Figure ). Sixteen studies compared circulating 25(OH)D levels between SLE patients and healthy controls (Table ); seven Studies provided the information about the deficiency, insufficiency, sufficiency of vitamin D in both SLE patients and healthy controls (Table ); 6 studies explored the correlations between disease activity of SLE and 25(OH)D levels (Table ). The NOS scores of included studies ranged from 6 to 8 stars, indicating each of the studies had high methodological quality (Table ).…”

“…Sixteen articles with 17 individual studies reported the circulating 25(OH)D levels of 1434 SLE patients and 1533 healthy controls. Compared with healthy controls, SLE patients had significantly lower 25(OH)D levels (pooled SMD = −1.63, 95% CI: −2.51 to −0.76), and significant heterogeneity was identified among these studies ( I 2 = 98.9%, P < .001) (Figure ).…”

“…Six studies involving 483 SLE patients disclosed the associations between circulating 25(OH)D levels and SLEDAI. Random‐effect model discovered that there was an inverse correlation between circulating 25(OH)D levels and SLEDAI (pooled correlation coefficient = −0.50, 95% CI: −0.8278 to −0.1689, I 2 = 96.9%, Figure ).…”

The Impact of Vitamin D on the Immunopathophysiology, Disease Activity, and Extra-Musculoskeletal Manifestations of Systemic Lupus Erythematosus

“…Thereafter, a number of larger-scale case-control studies confirmed the relationship between hypovitaminosis D and the prevalence of SLE [75,76,77,78], particularly in patients with lupus nephritis [75]. In our recent age- and gender-matched case-control study of 61 SLE patients and 61 healthy controls, we found that a deficiency of the total 25(OH)D 3 level, as measured by liquid chromatography-tandem mass spectrometry, was significantly more prevalent in the patient group (19.7% vs. 3.3%, p = 0.003) [79].…”