Institute of Immunology, Rikshospitalet, University of Oslo, Norway.
Scand J Rheumatol. 2011 Mar;40(2):122-6. doi: 10.3109/03009742.2010.507220. Epub 2010 Oct 26.
Disproportionate vitamin D levels may play an important role in the development of certain systemic autoimmune and rheumatic diseases. The aim of the present study was to investigate the prevalence of vitamin D insufficiency in patients with systemic lupus erythematosus (SLE) and to compare serological and clinical parameters in patients with different vitamin D levels from a single centre registry in Central-Eastern Europe.
A total of 177 patients with SLE were enrolled in the study. 25-Hydroxyvitamin D [25(OH)D] levels were measured by chemiluminescent immunoassay (CLIA). Autoantibody profiles, complement 3 (C3) and C4, clinical symptoms, and disease activity (using the SLE disease activity index, SLEDAI) of the patients were assessed.
Vitamin D concentration in the total SLE group investigated was 26.88 ± 13.25 ng/mL. Vitamin D levels were normal (≥ 30 ng/mL) in 18.1% of patients, insufficient (15-30 ng/mL) in 44.6%, and deficient (< 15 ng/mL) in 37.3%. The vitamin levels were significantly reduced in postmenopausal compared to premenopausal patients (p = 0.02). Patients with pericarditis (p = 0.013), neuropsychiatric diseases (p = 0.01), and deep vein thrombosis (p = 0.014) had reduced vitamin D levels. SLEDAI score was significantly increased in patients with reduced vitamin D levels (p = 0.038). Anti-double-stranded (ds)DNA autoantibody concentrations increased from normal to insufficient and further increased from insufficient to deficient patient subsets (p = 0.021). Anti-Smith antigen (anti-Sm) concentrations increased (p < 0.001), C4 levels decreased (p = 0.027), and immunoglobulin (Ig)G concentration increased (p = 0.034) in patients with reduced vitamin D levels.
Our data suggest that vitamin D deficiency in SLE may play a role in perpetuation of the disease.
维生素 D 水平的不均衡可能在某些系统性自身免疫性和风湿性疾病的发展中发挥重要作用。本研究的目的是调查系统性红斑狼疮（SLE）患者维生素 D 不足的患病率，并比较来自中东欧单一中心登记处不同维生素 D 水平患者的血清学和临床参数。
共纳入 177 例 SLE 患者进行研究。采用化学发光免疫分析法（CLIA）检测 25-羟维生素 D [25(OH)D]水平。评估患者的自身抗体谱、补体 3（C3）和 C4、临床症状和疾病活动（采用 SLE 疾病活动指数，SLEDAI）。
所研究的总 SLE 组的维生素 D 浓度为 26.88±13.25ng/mL。18.1%的患者维生素 D 水平正常（≥30ng/mL），44.6%的患者维生素 D 水平不足（15-30ng/mL），37.3%的患者维生素 D 水平缺乏（<15ng/mL）。与绝经前患者相比，绝经后患者的维生素水平显著降低（p=0.02）。患有心包炎（p=0.013）、神经精神疾病（p=0.01）和深静脉血栓形成（p=0.014）的患者维生素 D 水平降低。维生素 D 水平降低的患者 SLEDAI 评分显著升高（p=0.038）。抗双链（ds）DNA 自身抗体浓度从正常到不足，再从不足到缺乏患者亚组逐渐升高（p=0.021）。抗 Smith 抗原（抗 Sm）浓度升高（p<0.001），C4 水平降低（p=0.027），免疫球蛋白（Ig）G 浓度升高（p=0.034）。
我们的数据表明，SLE 患者的维生素 D 缺乏可能在疾病的持续存在中发挥作用。
