Instituto de Investigación Biosanitaria, IBS, Granada, Spain.
Department of Nursing, Health Sciences Faculty, 16741University of Granada (UGR), Spain.
Biol Res Nurs. 2021 Jul;23(3):455-463. doi: 10.1177/1099800420983596. Epub 2020 Dec 30.
Vitamin D has immunosuppressive properties and is considered a therapeutic option, although there is controversy about the role of this vitamin in the pathogenesis of systemic lupus erythematosus (SLE). We aimed to determine the prevalence of vitamin D insufficiency and deficiency and their potential association with disease activity, damage accrual, SLE-related clinical manifestations, and cardiovascular risk factors in SLE patients. A cross-sectional study of 264 patients was conducted (89.4% females; mean age 46.7 ± 12.9 years). The SLE Disease Activity Index (SLEDAI-2 K) and the SDI Damage Index were used to assess disease activity and disease-related damage, respectively. The mean 25(OH)D value was 25.1 ± 13.0 ng/ml. Eleven patients (4.2%) had 25(OH)D <10 (deficiency) and 178 patients (70.6%) had 25(OH)D <30 (insufficiency). In the 25(OH)D deficiency group, SLEDAI was significantly higher than the insufficiency ( = 0.001) and normal groups ( < 0.001). Also, patients with vitamin D deficiency presented significantly higher SDI scores than patients with 25(OH)D insufficiency ( = 0.033) and 25(OH)D normal levels ( = 0.029). There is a high prevalence of both vitamin D deficiency and insufficiency in Caucasian SLE patients and this status was associated with higher SLEDAI and SDI scores, supporting the impact of vitamin D levels on disease activity and damage accrual in SLE patients. Longitudinal studies on the relationship between vitamin D status and disease activity and progression are therefore required.
维生素 D 具有免疫抑制作用,被认为是一种治疗选择,尽管关于这种维生素在系统性红斑狼疮 (SLE) 发病机制中的作用存在争议。我们旨在确定维生素 D 不足和缺乏的患病率及其与 SLE 患者疾病活动度、损伤累积、与 SLE 相关的临床表现和心血管危险因素的潜在关联。对 264 例患者进行了横断面研究(女性占 89.4%;平均年龄 46.7 ± 12.9 岁)。使用 SLE 疾病活动指数 (SLEDAI-2 K) 和 SDI 损伤指数分别评估疾病活动度和疾病相关损伤。平均 25(OH)D 值为 25.1 ± 13.0ng/ml。11 例患者(4.2%)25(OH)D <10(缺乏),178 例患者(70.6%)25(OH)D <30(不足)。在 25(OH)D 缺乏组中,SLEDAI 明显高于不足( = 0.001)和正常组( < 0.001)。此外,维生素 D 缺乏症患者的 SDI 评分明显高于 25(OH)D 不足( = 0.033)和 25(OH)D 正常水平( = 0.029)患者。白种人 SLE 患者中维生素 D 缺乏和不足的患病率均较高,这种状态与较高的 SLEDAI 和 SDI 评分相关,提示维生素 D 水平对 SLE 患者的疾病活动度和损伤累积有影响。因此,需要进行关于维生素 D 状态与疾病活动度和进展之间关系的纵向研究。