RESEARCH - Vitamin D deficiency in patients with active SLE

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Osteoporos Int. 2008 Jul 4.

Vitamin D deficiency in patients with active systemic lupus erythematosus.

Borba VZ, Vieira JG, Kasamatsu T, Radominski SC, Sato EI, Lazaretti-Castro M.

Division of Endocrinology, Universidade Federal de São o, São o, Brazil.

We investigated the effects of disease activity on bone metabolism in

36 patients with systemic lupus erythematosus (SLE). Changes in bone

remodeling were not explained by corticosteroid use. A high prevalence

of 25OHD deficiency in SLE patients indicates the need for vitamin D

replacement, mainly during high disease activity periods.

INTRODUCTION: We investigated the effects of SLE disease activity on

bone metabolism, their relation to inflammatory cytokines and vitamin

D levels. METHODS: We performed a cross-sectional analysis of 36 SLE

patients classified according to the Systemic Lupus Erythematosus

Disease Activity Index (SLEDAI) in high activity (group I: 12

patients, mean age 29.6 years) or in minimal activity (group II: 24

patients, mean age 30.0 years), and compared them to normal controls

(group III: 26 women, 32.8 years). Serum calcium, phosphorus,

parathyroid and sex hormones, bone remodeling markers, interleukin

(IL)-6, soluble IL-6 receptor (sIL-6R), IL-1, tumor necrosis

factor-alpha (TNF), 25-hydroxivitamin D (25OHD), and

1,25-dihydroxyvitamin D3 were measured, plus bone mineral density.

RESULTS: All cytokines were significantly higher in SLE groups; IL-6

could differentiate SLE patients from controls. In group I, 25OHD

levels were lower (P < 0.05), which was related to the SLEDAI (R =

-0.65, P < 0.001). In multiple regression analysis, the 25OHD level

was associated with SLEDAI, osteocalcin and bone-specific alkaline

phosphatase. The SLEDAI score was positively correlated with all

measured cytokines and especially TNF (R = 0.75, P < 0.001).

CONCLUSIONS: SLE patients demonstrated changes in bone remodeling

strongly related to disease activity. A high prevalence of 25OHD

deficiency was observed in SLE patients, indicating the need for

vitamin D replacement.

PMID: 18600287

http://www.ncbi.nlm.nih.gov/pubmed/18600287

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