RESEARCH - Vitamin D deficiency in SLE: prevalence, predictors and clinical consequences

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Rheumatology Advance Access published online on April 14, 2008

Rheumatology, doi:10.1093/rheumatology/ken121

Vitamin D deficiency in systemic lupus erythematosus: prevalence,

predictors and clinical consequences

G. Ruiz-Irastorza, M. V. Egurbide, N. Olivares, A. ez-Berriotxoa

and C. Aguirre

Department of Internal Medicine, Hospital de Cruces, University of the

Basque Country, Bizkaia, Spain.

Abstract

Objectives. We aimed to establish the prevalence, predictors and

clinical consequences of vitamin D deficiency in patients with SLE.

Methods. Cross-sectional study including patients fulfilling ACR

criteria for the classification of SLE. Serum 25(OH)D levels at 30 and

10 ng/ml were the cut-off values for vitamin D insufficiency and

vitamin D deficiency, respectively. SLE activity was measured by

SLEDAI and irreversible organ damage by the SLICC-ACR index. Fatigue

was quantified using a 0–10 visual analogue scale (VAS).

Results. Ninety-two patients (90% women, 98% white) were included in

the study. Sixty-nine (75%) and 14 (15%) patients presented with

vitamin D insufficiency and deficiency, respectively. Female sex (P =

0.001), treatment with HCQ (P = 0.014) and treatment with calcium and

vitamin D (P = 0.049) predicted higher levels of 25(OH)D.

Photosensitivity [odds ratio (OR) 3.5] and photoprotection (OR 5.7)

predicted vitamin D insufficiency and deficiency, respectively. Higher

age (OR 0.95) and HCQ use (OR 0.29) protected against vitamin D

deficiency. Patients with vitamin D deficiency had a higher degree of

fatigue as quantified by a 0–10 VAS (mean 5.32 vs 4.03, P = 0.08). No

relation was seen between vitamin D insufficiency or deficiency and

disease duration, SLEDAI or SLICC-ACR indexes.

Conclusions. Vitamin D insufficiency and deficiency are common in

patients with SLE and are associated with sun avoidance. HCQ prevented

vitamin D deficiency. Vitamin D deficiency was related to a higher

degree of fatigue. Vitamin D levels had no relation with SLE severity.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/ken121v1?papetoc

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