Ranjan Shovit, Das Bidyut K, Tripathy Rina, Pattanaik Sarit S, Parida Manoj, Tripathy Saumya Ranjan, Panda Aditya K
University Department of Zoology, Kolhan University, Chaibasa, Jharkhand, India.
Department of Clinical Immunology and Rheumatology, SCB Medical College, Cuttack, Odisha, India.
Int J Rheum Dis. 2025 Aug;28(8):e70379. doi: 10.1111/1756-185x.70379.
Vitamin D, recognized for its immunomodulatory properties, is potentially associated with autoimmune diseases like systemic lupus erythematosus (SLE). This systematic review and meta-analysis assessed the relationship between Vitamin D levels and SLE, highlighting its role in modulating disease activity and immunological markers like anti-dsDNA, C3, and C4.
Case-control studies reporting Vitamin D, disease activity indices, C3, C4, and anti-dsDNA antibody levels in SLE patients and healthy controls were evaluated. Systematic searches in PubMed, Scopus, ScienceDirect, Web of Science, and Embase were last updated on April 6, 2024. Inclusion criteria targeted studies on SLE patients and healthy controls reporting these specific markers. Study quality was assessed with the Newcastle-Ottawa Scale (NOS), and publication bias was checked using Egger's test and Begg's funnel plot. The meta-analyses were conducted with CMAv4.
Analysis of 43 studies with 2940 SLE patients and 2458 healthy controls showed significantly lower Vitamin D levels in SLE patients (mean difference: -10.070 ng/mL; 95% CI: -12.85 to -7.28; p < 0.001). Vitamin D levels negatively correlated with SLEDAI scores (correlation: -0.427; 95% CI: -0.541 to -0.298; p < 0.001) and anti-dsDNA antibodies (correlation: -0.397; 95% CI: -0.611 to -0.130; p = 0.004), and positively correlated with complement components C3 (correlation: 0.268; 95% CI: 0.077-0.440; p = 0.006) and C4 (correlation: 0.299; 95% CI: 0.192-0.400; p < 0.001). Sensitivity analyses confirmed these findings.
The findings revealed a strong association between low Vitamin D levels and increased SLE severity. However, limitations like some inconsistency, small-study biases, and possible language restrictions in study inclusion necessitate cautious interpretation.
维生素D因其免疫调节特性而被认可，它可能与系统性红斑狼疮（SLE）等自身免疫性疾病有关。本系统评价和荟萃分析评估了维生素D水平与SLE之间的关系，突出了其在调节疾病活动以及抗双链DNA、C3和C4等免疫标志物方面的作用。
对报告SLE患者和健康对照中维生素D、疾病活动指数、C3、C4和抗双链DNA抗体水平的病例对照研究进行评估。在PubMed、Scopus、ScienceDirect、Web of Science和Embase上的系统检索于2024年4月6日最后更新。纳入标准针对报告这些特定标志物的SLE患者和健康对照的研究。使用纽卡斯尔-渥太华量表（NOS）评估研究质量，并使用Egger检验和Begg漏斗图检查发表偏倚。使用CMAv4进行荟萃分析。
对43项研究（2940例SLE患者和2458例健康对照）的分析显示，SLE患者的维生素D水平显著较低（平均差异：-10.070 ng/mL；95%可信区间：-12.85至-7.28；p < 0.001）。维生素D水平与SLE疾病活动指数（相关性：-0.427；95%可信区间：-0.541至-0.298；p < 0.001）和抗双链DNA抗体（相关性：-0.39７；95%可信区间：-0.611至-0.130；p = 0.004）呈负相关，与补体成分C3（相关性：0.268；95%可信区间：0.077 - 0.440；p = 0.006）和C4（相关性：0.299；95%可信区间：0.192 - 0.400；p < 0.001）呈正相关。敏感性分析证实了这些发现。
研究结果揭示了低维生素D水平与SLE严重程度增加之间的密切关联。然而，一些不一致性、小研究偏倚以及研究纳入中可能存在的语言限制等局限性使得需要谨慎解读。
