Vitamin D status in Egyptian patients with juvenile-onset systemic lupus erythematosus

Abstract

There are scanty data on the prevalence of vitamin D deficiency and its relation to disease activity among patients with juvenile-onset systemic lupus erythematosus (JoSLE) in the Middle East and North Africa, an area known to be endemic for vitamin D deficiency and insufficiency. The aim of this study was, therefore, to study vitamin D status and its relation to disease activity and parameters in Egyptian patients with JoSLE. Serum levels of 25(OH) D3 in 70 JoSLE patients were compared to 40 age-, sex-, and body mass index-matched healthy controls. The 25(OH) D3 was determined by enzyme-linked immunosorbent assay. Information regarding the medical history, clinical symptoms, and signs was registered at the time of serum sampling. Disease activity of SLE was evaluated according to the SLEDAI score. The mean level of serum 25(OH) D3 was 12 ± 3.7 in JoSLE patients compared to 21 ± 3.5 ng/mL in normal controls (p < 0.001). Forty percent (28/70) of the JoSLE patients has severe 25(OH) D3 deficiency (≤10 ng/mL), and 60 % of the JoSLE patients has 25(OH) D3 insufficiency (≤30 ng/mL). None of the JoSLE patients has 25(OH) D3 level >30 ng/mL. There was no significant correlation between serum levels of 25(OH) D3 and the demographic data, medication used, and some laboratory data of patients with JoSLE. Disease activity score in our patients was insignificantly correlated with serum levels of 25(OH) D3. In spite of vitamin D supplementation in Egyptian JoSLE patients and the presence of vitamin D insufficiency in the control group, there are still significantly lower levels of vitamin D in JoSLE compared to normal controls.

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].…”

“…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]. Recently, a meta-analysis of 18 studies consisting of 1083 patients with SLE and 1273 healthy controls showed that the SLE patients had a significantly lower level of vitamin D compared with the healthy controls [76]. In addition, vitamin D deficiency was significantly more prevalent in the SLE patients when compared with the healthy controls, with a relative risk of 2.3 ( p = 0.002) [80].…”

Belomor

“…251 Thieves' slang eloquently captures the artful connotations of crime: risovat', or to draw, means to kill; pero, or quill pen, is a knife. 252 The craft of pickpocketing, which a criminal in RUR described as the most "clever" of all types of theft, 253 at times required some unusual techniques. The prisoner Praskov'ia Skachko writes in her autobiography about the skill of stealing in church, an art form her husband taught her:…”

<i>Big Tokyo</i> (1933) and the Ideology of Sound

“…This will be extremely embarrassing and will leave a bad impression in Japan." 41 In the same letter, written in February 1933, Shneiderov complains that, despite his promise to Tokyo Asahi to send five copies of his film within three months of his departure, the developed film footage had not even been printed a month later.…”