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FRI0417 Vitamin D Deficiency Prevalence in Systemic Lupus Erythematous; Regardless A Cause or a Consequence does it Impact Disease Course, Activity or Severity?
  1. N. Abaza1,
  2. R. Elmallah1,
  3. A. Shaban1,
  4. S.A. Mobasher2,
  5. K.F. Alhassanein2,
  6. A.A. Abdelmageedb2,
  7. R.H. Elkabarity3
  1. 1Rheumatology & Rehabiitation department
  2. 2Internal Medicine department - Rheumatology division
  3. 3Clinical Pathology department, Faculty of Medicine Ainshams University, Cairo, Egypt

Abstract

Background 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.

Objectives To estimate prevalence of vitamin D deficiency in SLE and its relation to disease activity and severity.

Methods In our observational cross-sectional study, serum levels of vitamin D from 60 SLE patients and 30 age & sex matched healthy controls (HC) were assessed and estimated for deficiency or insufficiency at 10 and 30ng/ml respectively. Disease activity was evaluated by SLEDAI, irreversible organ damage by SLICC/ACR index and severity by Lupus SDI. Fatigue was measured by visual analogue scale (VAS).

Results Significantly 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 statistically high significant difference (t=-11.2, p<0.001).High prevalence of vitamin D insufficiency and deficiency was detected 73.3% & 23.3% respectively. Vitamin D had a highly significant negative correlation with SLEDAI (r =-0.495, p<0.001), see figure 1a, SLICC (r =- 0.431, p<0.05) as well as fatigue (r =- 0.436, p<0.05), see figure 1b. After standardization of all clinical variants, regression analysis study showed that there is significantly inverse correlated between vit D and VAS (standardized regression coefficient β=-0.443, p=0.024) and a highly significant correlation between vit D and SLEDAI score (β=-0.940, p=0.012).

Figure 1.

a. Correlation between serum vitamin D and SLEDAI. b. Correlation between serum vitamin D and VAS of fatigue.

Conclusions Vitamin D deficiency & insufficiency were found to be prevalent in SLE patients in our study and related to disease activity & fatigue. Routine screening and consequent repletion of vitamin D if needed is recommended in SLE. Restoring adequate vitamin D level in SLE should be more explored as a potential and simple yet valuable measure to be added to their usual management to alleviate their condition.

References

  1. Kamen DL, Cooper GS, Bouali H, Shaftman SR, Hollis BW, Gilkeson GS. Vitamin D deficiency in systemic lupus erythematosus. Autoimmun Rev 2006; 5: 114–117.

  2. Ruiz-Irastorza G, Egurbide MV, Olivares N, Martinez-Berriotxoa A, Aguirre C. Vitamin D deficiency in systemic lupus erythematosus: prevalence, predictors and clinical consequences. Rheumatology (Oxford) 2008;47:920–3.

  3. Fragoso TS, Dantas AT, Marques CD, Rocha Junior LF, Melo JH, Costa AJ, Duarte AL. 25-Hydroxyivitamin D3 levels in patients with systemic lupus erythematosus and its association with clinical parameters and laboratory tests. Rev Bras Reumatol. 2012 Jan-Feb;52(1):60-5

Disclosure of Interest None declared

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