Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Microbiology and Immunology, Chang Gung University, Taoyuan, Taiwan.
J Microbiol Immunol Infect. 2018 Feb;51(1):110-114. doi: 10.1016/j.jmii.2015.12.005. Epub 2016 Jan 12.
Vitamin D deficiency has been associated with systemic lupus erythematosus (SLE), but there is no consensus on the role of serum vitamin D in evaluating or predicting disease activity. This study aimed to demonstrate the direct correlation between vitamin D level and pediatric-onset SLE disease activity by a retrospective cohort study design.
Thirty-five patients with pediatric-onset SLE and paired sera at the active and inactive disease states were enrolled. Disease activity was defined by Systemic Lupus Erythematosus Disease Activity Index 2000, and active lupus nephritis (LN) was defined as active urine sediment, and proteinuria >2+ on stick or >500 mg/day. All data were reviewed and calculated from previous medical records. The levels of both vitamin D2 and vitamin D3 were checked by electrochemiluminescence immunoassay.
Serum 25-hydroxyvitamin D (25-OH D) levels in the active status were significantly lower compared to that in inactive disease status (12.0 ± 7.2 ng/mL vs. 15.4 ± 7.4 ng/mL, p = 0.005). A subgroup analysis revealed that at active disease status, patients with LN had lower 25-OH D levels than patients without LN (16.3 ± 8.2 ng/mL vs. 9.8 ± 5.6 ng/mL, p = 0.023). Moreover, there is a significant inverse correlation between serum 25-OH D levels and Systemic Lupus Erythematosus Disease Activity Index 2000 at both inactive (r = -0.335, p = 0.003) and active (r = -0.373, p = 0.016) disease status.
Serum vitamin D levels are inversely correlated with SLE disease activity at both active and inactive disease status, and also with the presence of LN at active disease stage.
维生素 D 缺乏与系统性红斑狼疮（SLE）有关，但血清维生素 D 在评估或预测疾病活动中的作用尚无共识。本研究旨在通过回顾性队列研究设计证明维生素 D 水平与儿童发病的 SLE 疾病活动之间的直接相关性。
纳入 35 例儿童发病的 SLE 患者和配对的疾病活动期和缓解期血清。疾病活动度由系统性红斑狼疮疾病活动指数 2000 定义，活动期狼疮肾炎（LN）定义为活动期尿沉渣，尿蛋白>2+ 条带或>500mg/天。所有数据均从前瞻性病历中回顾和计算。用电化学发光免疫分析法检测维生素 D2 和维生素 D3 的水平。
活动期血清 25-羟维生素 D（25-OH D）水平明显低于缓解期（12.0±7.2ng/ml 比 15.4±7.4ng/ml，p=0.005）。亚组分析显示，在活动期疾病状态下，有 LN 的患者 25-OH D 水平低于无 LN 的患者（16.3±8.2ng/ml 比 9.8±5.6ng/ml，p=0.023）。此外，在疾病缓解期（r=-0.335，p=0.003）和活动期（r=-0.373，p=0.016），血清 25-OH D 水平与系统性红斑狼疮疾病活动指数 2000 呈显著负相关。
在疾病活动期和缓解期，血清维生素 D 水平与 SLE 疾病活动度呈负相关，在活动期也与 LN 的存在呈负相关。
