AlSaleem Alhanouf, AlE'ed Ashwaq, AlSaghier Afaf, Al-Mayouf Sulaiman M
Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Po Box 3354, Riyadh, 11211, Saudi Arabia.
Clin Rheumatol. 2015 Jan;34(1):81-4. doi: 10.1007/s10067-014-2811-z. Epub 2014 Nov 4.
To assess serum 25-hydroxyvitamin D (25-OH vitamin D) status in Saudi children with systemic lupus erythematosus (SLE) and determined its association with clinical, laboratory variables and disease activity. This cross-sectional study comprised children with SLE who are followed at Pediatric Lupus Clinic. All patients reviewed for demographic data, age of first disease manifestations, and disease duration. All included patients evaluated for disease activity, which is completed by using the SLE Disease Activity Index (SLEDAI) and laboratory parameters included a vitamin D profile, bone markers at enrollment and 3 months later. All patients treated with Cholecalciferol (vitamin D3 2000 IU daily) and calcium supplement (Caltrate 600 mg twice daily). Twenty-eight patients (26 female) with mean age of 9.7 years completed the evaluation. Fifteen patients had more than one major organ involvement. Most of the patients are on daily vitamin D3 supplement (800 IU) prior enrollment. The baseline assessment revealed 24 patients had low levels of serum 25-OH vitamin D levels, with a mean of 51.1 ± 33.6 nmol/L; 25 patients had high autoantibodies; and 18 patients had high protein/creatinine ratio, with a mean of 0.9 ± 1.7. Bone density was subnormal with a mean of 0.9 ± 1. The mean disease activity was 6 ± 5.6. Levels of 25-OH vitamin D correlated inversely with autoantibodies and SLEDAI and positively with bone density but not statistically significant. After 3 months, treatment of vitamin D3 (2000 IU daily) and Caltrate (600 mg twice daily), 17 patients had improvement in SLEDAI score and autoimmune markers. Disease activity of childhood SLE is probably linked with low serum 25-OH vitamin D levels. Accordingly, high daily vitamin D3 supplement could potentially impact disease activity of childhood SLE. Further follow up and more patients needed to confirm this finding.
评估沙特系统性红斑狼疮（SLE）患儿的血清25-羟维生素D（25-OH维生素D）状态，并确定其与临床、实验室指标及疾病活动度的关联。这项横断面研究纳入了在儿科狼疮诊所随访的SLE患儿。所有患者均回顾了人口统计学数据、首次发病表现的年龄及病程。所有纳入患者均评估了疾病活动度，采用系统性红斑狼疮疾病活动指数（SLEDAI）完成评估，实验室指标包括维生素D水平、入组时及3个月后的骨标志物。所有患者均接受胆钙化醇（维生素D3，每日2000IU）和钙剂补充（钙尔奇600mg，每日两次）治疗。28例患者（26例女性）完成评估，平均年龄9.7岁。15例患者有一个以上主要器官受累。大多数患者在入组前每日补充维生素D3（800IU）。基线评估显示，24例患者血清25-OH维生素D水平较低，平均为51.1±33.6nmol/L；25例患者自身抗体水平较高；18例患者蛋白/肌酐比值较高，平均为0.9±1.7。骨密度低于正常，平均为0.9±1。平均疾病活动度为6±5.6。25-OH维生素D水平与自身抗体及SLEDAI呈负相关，与骨密度呈正相关，但无统计学意义。3个月后，给予维生素D3（每日2000IU）和钙尔奇（600mg，每日两次）治疗后，17例患者的SLEDAI评分及自身免疫标志物有所改善。儿童SLE的疾病活动度可能与血清25-OH维生素D水平低有关。因此，每日高剂量补充维生素D3可能会影响儿童SLE的疾病活动度。需要进一步随访及纳入更多患者以证实这一发现。
