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维生素 D 水平与系统性红斑狼疮患者的疾病活动和损伤累积有关。

Vitamin D Levels are Associated with Disease Activity and Damage Accrual in Systemic Lupus Erythematosus Patients.

机构信息

Instituto de Investigación Biosanitaria, IBS, Granada, Spain.

Department of Nursing, Health Sciences Faculty, 16741University of Granada (UGR), Spain.

出版信息

Biol Res Nurs. 2021 Jul;23(3):455-463. doi: 10.1177/1099800420983596. Epub 2020 Dec 30.

Abstract

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.

摘要

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。

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