Vitamin D Status in Patients with Systemic Lupus Erythematosus in Serbia: Correlation with Disease Activity and Clinical Manifestations

Abstract

BACKGROUND:Numerous studies indicate potential role of vitamin D as an important factor in the development of many autoimmune diseases including systemic lupus erythematosus (SLE). Patients with SLE are especially prone to the development of vitamin D deficiency due to the nature of their illness.AIM:The aims of our study were to determine the prevalence of vitamin D insufficiency and deficiency in patients with SLE in Serbia, to identify clinical variables associated with vitamin D status and to examine the impact of vitamin D status on disease activity and presence of specific lupus autoantibodies.MATERIAL AND METHODS:The study included 46 patients with SLE. Serum 25(OH)D concentration was measured by electrohemiluminiscent immunoassay.RESULTS:The mean serum concentration of 25(OH)D was 11.9 ± 7.3 ng/ml. The prevalence of insufficiency was 32.6%, while the prevalence of deficiency was 67.4%. There was no association between vitamin D status and photosensitivity, skin lesions, arthritis and lupus nephritis. Vitamin D status was not associated with the presence of specific autoantibodies. There was no correlation between disease activity assessed by SLEDAI scale with the concentration of 25(OH)D. Patients who used vitamin D supplements and calcium did not have a significantly higher concentration of 25(OH)D.CONCLUSION:In conclusion, vitamin D deficiency is common in patients with SLE.

Serum vitamin D in Egyptian patients with systemic lupus erythematous and its association with lupus nephritis

“…In contrast, many other studies did not find this association [2,7,29]. The discrepancy between the findings of these studies and the present study can be attributed to the characteristics of the enrolled population since patients with VD supplements were not excluded from these studies.…”

“…Also, in agreement with our findings, previous studies observed that the average serum VD in SLE patients was significantly lower than in the healthy matched controls [2,28]. One study reported that 75% of SLE patients had VD deficiency and 15.2% VD insufficiency [29].…”

“…In agreement with our results, a strong association between VD deficiency and LN was reported [23] and SLE patients with LN showed higher prevalence of VD deficiency [17]. Another study found that SLE patients with LN exhibited a higher prevalence of VD deficiency in comparison to patients without LN albeit that it is not statistically significant [2].…”

“…The main source of VD in our body comes from the conversion of 7-dehydrocholesterol into pre-VD3 in the skin, while smaller amounts of VD come from dietary sources [1]. However, it had been reported that several immune cells express VD receptors (VDRs) on their surfaces [2], and many immune cells synthesize the 1α-hydroxylase enzyme responsible for synthesis of the active form of VD in the microenvironment of lymph tissues [3]. These findings indicate that VD is involved in the immune modulation [4,5].…”

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“…3 Vitamin D deficiency is more prevalent among South Asian, Middle Eastern and African healthy women exactly as in patients with SLE in these regions. [4][5][6][7] Inadequate VD status can compound the problem of low BMD or osteoporosis, commonly seen in patients with SLE induced by corticosteroids. 8 A longitudinal study in 2012 highlighted the importance of prevention and treatment of VD deficiency and osteoporosis in SLE patients, especially those using glucocorticoids or anti-malarial drugs.…”