Vitamin D deficiency in undifferentiated connective tissue disease

Abstract

IntroductionBoth experimental and clinical data provide evidence that vitamin D is one of those important environmental factors that can increase the prevalence of certain autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, insulin-dependent diabetes mellitus, and inflammatory bowel disease. The aim of the present study was to investigate the prevalence of vitamin D insufficiency in patients with undifferentiated connective tissue disease (UCTD).MethodsPlasma 25(OH)D3 levels in 161 UCTD patients were measured in both summer and winter periods. Autoantibody profiles (antinuclear antibody, anti-U1-ribonucleoprotein, anti-SSA, anti-SSB, anti-Jo1, anti-Scl70, anti-double-stranded DNA, anti-centromere, anti-cardiolipin, rheumatoid factor, and anti-cyclic citrullinated peptide) and clinical symptoms of the patients were assessed.ResultsPlasma levels of 25(OH)D3 in UCTD patients were significantly lower compared with controls in both summer and winter periods (UCTD summer: 33 ± 13.4 ng/mL versus control: 39.9 ± 11.7 ng/mL, P = 0.01; UCTD winter: 27.8 ± 12.48 ng/mL versus control: 37.8 ± 12.3 ng/mL, P = 0.0001). The presence of dermatological symptoms (photosensitivity, erythema, and chronic discoid rash) and pleuritis was associated with low levels of vitamin D. During the average follow-up period of 2.3 years, 35 out of 161 patients (21.7%) with UCTD further developed into well-established connective tissue disease (CTD). Patients who progressed into CTDs had lower vitamin D levels than those who remained in the UCTD stage (vitamin D levels: CTD: 14.7 ± 6.45 ng/mL versus UCTD: 33.0 ± 13.4 ng/mL, P = 0.0001).ConclusionsIn patients with UCTD, a seasonal variance in levels of 25(OH)D3 was identified and showed that these levels were significantly lower than in controls during the corresponding seasons. Our results suggest that vitamin D deficiency in UCTD patients may play a role in the subsequent progression into well-defined CTDs.

Vitamin D may not be a good marker of disease activity in Korean patients with systemic lupus erythematosus

“…During 2.3 years follow-up, 21.7% of patients with UCTD developed into wellestablished connective tissue disease (CTD) including SLE. Patients who progressed into CTDs had lower vitamin D levels [28]. These results suggest that vitamin D deficiency in patients with UCTD may play a role in the subsequent progression into well-defined CTDs.…”

Hypovitaminosis D in Systemic Sclerosis

“…Several studies reported lower 25OHD levels in patients with SLE compared with controls and, although some results were contradictory, a correlation with disease activity scores was found 7 . Recently, Zold, et al achieved similar results investigating 25OHD concentration in UCTD; they also linked extremely low levels of 25OHD to development toward a definite CTD 8 .…”

“…An input to further investigations might result from recent research concerning rheumatoid arthritis (RA) 5 , systemic lupus erythematosus (SLE) 6,7 , and undifferentiated connective tissue disease (UCTD) 8 . A higher risk of developing RA was associated with low dietary vitamin D intake, despite subsequently published contrasting results 5 .…”

Role of vitamin D in immune responses and autoimmune diseases, with emphasis on its role in multiple sclerosis

“…Both laboratory and clinical studies have provided evidence that vitamin D deficiency is an important environmental factor that can increase the prevalence of certain autoimmune diseases, such as MS [55][56][57] , Crohn disease [58] , diabetes mellitus [59,60] , systemic lupus erythematosus (SLE) [61,62] , asthma [63] , RA [64] , Sjögren's syndrome, systemic vasculitis and antiphospholipid syndrome [65] . A correlation between reduced intake of vitamin D and prevalence of the diseases can be found, which raises the possibility that serum vitamin D level is important for the pathogenesis of autoimmune diseases.…”