Lower Levels of Vitamin D Associated with Disease Activity in Colombian Patients with Systemic Lupus Erythematosus

Abstract

Background: Systemic Lupus Erythematosus (SLE) involves genetic, environmental, and hormonal alterations, including Vitamin D deficiency. Objective: To evaluate the association between vitamin D levels with anti-dsDNA, complement proteins, immunoglobulins levels and disease activity scores. Methods: : A cross-sectional study was performed. The levels of 25-OH vitamin D were measured in patients older than 18 years with SLE according to ACR/97 [American College of Rheumatology 1997] from 2013 to 2015. The association was assessed by Mann-Whitney U and Kruskal Wallis tests for continuous variables, and by the Chi or Fisher exact test for the nominal variables. Results: Sixty-nine patients were included; 82% were women; the mean age was 38.5 years; 36.2% had low levels of vitamin D with higher consumption [p=0.006] of C4 and C3 complement proteins, plus higher levels of anti-dsDNA. Lower values of vitamin D were observed in patients with moderate to severe activity [p=0.0001] by SLEDAI [Systemic Lupus Erythematosus Activity Index] and general domain [p=0.039] and renal domain [p=0.009] by BILAG [British Isles Lupus Assessment Group] 2004. The mean vitamin D levels were higher in the group not receiving steroids when compared to those groups with dosages of 0.5-1mg/kg/d [p=0.048]. Conclusion: Lower levels of vitamin D are associated with greater complement protein consumption and higher disease activity rates. Therefore, it is important to evaluate vitamin D supplementation in patients with SLE as part of the treatment, especially when it includes the use of steroids.</P>

Decreased Serum 25-(OH)-D Level Associated With Muscle Enzyme and Myositis Specific Autoantibodies in Patients With Idiopathic Inflammatory Myopathy

“…There were 22 (40%) healthy volunteers with insufficient vitamin D levels, which is suggested that vitamin D deficiency was also prevalent in healthy adult. It has been reported that vitamin D deficiency related with several autoimmune diseases, including rheumatoid arthritis (RA) (3), multiple sclerosis (MS) (4), and systemic lupus erythematosus (SLE) (5). Now, our results suggested that low levels of vitamin D might be a risk factor for IIM.…”

“…1,25dihydroxycholecalciferol [1,25(OH) 2 D 3 ], which was the active form of vitamin D, could influence the proliferation and differentiation of many immune cells and regulate the expression of cytokines and autoantibodies to play the role of immune regulation (2). Recent studies have related vitamin D deficiency with several autoimmune diseases, including rheumatoid arthritis (RA) (3), multiple sclerosis (MS) (4), and systemic lupus erythematosus (SLE) (5). It is reported that 1,25(OH) 2 D 3 plays a crucial role in immune regulation effect in these autoimmune diseases.…”

RETRACTED: Total Serum Calcium Level Is Negatively Correlated With Systemic Lupus Erythematosus Activity

“…Recent studies also found that lower levels of vitamin D were associated with more consumption of complement C3 and complement C4 and higher disease activity rate. 30 Furthermore, VDR messenger RNA level was shown to be positively associated with serum complement C3. 31 Calcium homeostasis is maintained and regulated by 1,25(OH) 2 D 3 , the active form of vitamin D and serum calcium is commonly measured in laboratory examination.…”

Vitamin D Deficiency in Renal Disease

“…Recent studies demonstrated the importance of VD axis in systemic lupus erythematosus (SLE) and lupus nephritis (LN). Poorer VD status correlated with higher SLE activity, whereas poorer VDR expression in renal tissue was linked to higher renal activity and more severe renal lesions in patients with LN [34,35]. Podocyte autophagy is a key factor in renal involvement in LN.…”