Department of Medicine, Tuen Mun Hospital, Hong Kong, China.
Lupus. 2012 Jan;21(1):36-42. doi: 10.1177/0961203311422094. Epub 2011 Oct 12.
To study the sensitivity and specificity of vitamin D deficiency for predicting disease activity and damage of systemic lupus erythematosus (SLE) in comparison with anti-dsDNA and anti-C1q.
Consecutive patients who fulfilled four or more ACR criteria for SLE were studied. Levels of 25-hydroxyvitamin D3, anti-C1q, anti-dsDNA and complement levels were measured. Relationship among these markers, concurrent disease activity and damage scores of SLE was studied by Spearman's rank correlation method.
In total, 290 SLE patients were studied (95% women; mean age 38.9 ± 13.1 years; SLE duration 7.7 ± 6.7 years). Clinical or serological lupus activity (SLEDAI ≥ 1) was present in 225 (78%) patients. Vitamin D deficiency (< 15 ng/ml) was detected in 78 (27%) patients. Levels of 25-hydroxyvitamin D3 correlated inversely with the clinical SLE disease activity score (Rho = -0.26; p < 0.001). A negative correlation was also observed between 25-hydroxyvitamin D3 and anti-dsDNA levels (Rho = -0.13; p = 0.02), or anti-C1q (Rho = -0.14; p = 0.02). However, there was no significant relationship between levels of 25-hydroxyvitamin D3 and complement C3 (Rho = 0.09; p = 0.12) or C4 (Rho = 0.09; p = 0.13). Both 25-hydroxyvitamin D3 deficiency and anti-C1q were more specific but less sensitive than anti-dsDNA for concurrent clinical renal and non-renal SLE activity. Levels of 25-hydroxyvitamin D3, anti-dsDNA or anti-C1q did not correlate significantly with the SLE damage scores.
25-hydroxyvitamin D3 correlated inversely and significantly with clinical SLE activity, anti-C1q and anti-dsDNA titers, but not with complement levels or damage scores. Deficiency of 25-hydroxyvitamin D3 was as specific as anti-C1q, but less sensitive than anti-dsDNA, for detecting concurrent renal and non-renal clinical activity of SLE.
与抗 dsDNA 和抗 C1q 相比，研究维生素 D 缺乏症预测系统性红斑狼疮（SLE）疾病活动和损害的敏感性和特异性。
对符合 SLE 四项或更多 ACR 标准的连续患者进行研究。测量 25-羟维生素 D3、抗 C1q、抗 dsDNA 和补体水平。通过 Spearman 秩相关法研究这些标志物与 SLE 并发疾病活动和损害评分之间的关系。
共研究了 290 例 SLE 患者（95%女性；平均年龄 38.9±13.1 岁；SLE 病程 7.7±6.7 年）。225 例（78%）患者存在临床或血清学狼疮活动（SLEDAI≥1）。78 例（27%）患者存在维生素 D 缺乏症（<15ng/ml）。25-羟维生素 D3 水平与临床 SLE 疾病活动评分呈负相关（Rho=-0.26；p<0.001）。25-羟维生素 D3 与抗 dsDNA 水平（Rho=-0.13；p=0.02）或抗 C1q（Rho=-0.14；p=0.02）之间也存在负相关。然而，25-羟维生素 D3 水平与补体 C3（Rho=0.09；p=0.12）或 C4（Rho=0.09；p=0.13）之间无显著关系。25-羟维生素 D3 缺乏症和抗 C1q 对并发临床肾和非肾 SLE 活动的特异性均高于抗 dsDNA，但敏感性低于抗 dsDNA。25-羟维生素 D3、抗 dsDNA 或抗 C1q 水平与 SLE 损害评分无显著相关性。
25-羟维生素 D3 与临床 SLE 活动、抗 C1q 和抗 dsDNA 滴度呈负相关且显著相关，但与补体水平或损害评分无关。25-羟维生素 D3 缺乏症与抗 C1q 一样特异，但对检测 SLE 并发肾和非肾临床活动的敏感性低于抗 dsDNA。
