RESEARCH - Vitamin D deficiency in undifferentiated connective tissue disease

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Arthritis Research & Therapy 2008, 10:R123doi:10.1186/ar2533

Published: 18 October 2008

Research article

Vitamin D deficiency in undifferentiated connective tissue disease

Eva Zold1 , Szodoray1 , Janos Gaal2 , János Kappelmayer3 ,

Laszlo Csathy3 , Edit Gyimesi1 , Margit Zeher1 , Gyula Szegedi1 and

Edit Bodolay1

1Division of Clinical Immunology, 3rd Department of Medicine, Medical

and Health Science Center, University of Debrecen, Moricz Zs. Str. 22,

Debrecen, 4032, Hungary

2Department of Rheumatology, Kenézy County Hospital, Bartok Bela Str.

4, 4043, Debrecen, Hungary

3Department of Clinical Biochemistry and Molecular Pathology, Medical

and Health Science Center, University of Debrecen, Moricz Zs. Str. 22,

Debrecen, 4032, Hungary

Abstract

Introduction

Both experimental and clinical data provide evidence that vitamin D is

one of those important environmental factors that can increase the

prevalence of certain autoimmune diseases such as systemic lupus

erythematosus, rheumatoid arthritis, insulin-dependent diabetes

mellitus, and inflammatory bowel disease. The aim of the present study

was to investigate the prevalence of vitamin D insufficiency in

patients with undifferentiated connective tissue disease (UCTD).

Methods

Plasma 25(OH)D3 levels in 161 UCTD patients were measured in both

summer and winter periods. Autoantibody profiles (antinuclear

antibody, anti-U1-ribonucleoprotein, anti-SSA, anti-SSB, anti-Jo1,

anti-Scl70, anti-double-stranded DNA, anti-centromere,

anti-cardiolipin, rheumatoid factor, and anti-cyclic citrullinated

peptide) and clinical symptoms of the patients were assessed.

Results

Plasma levels of 25(OH)D3 in UCTD patients were significantly lower

compared with controls in both summer and winter periods (UCTD summer:

33 ± 13.4 ng/mL versus control: 39.9 ± 11.7 ng/mL, P = 0.01; UCTD

winter: 27.8 ± 12.48 ng/mL versus control: 37.8 ± 12.3 ng/mL, P =

0.0001). The presence of dermatological symptoms (photosensitivity,

erythema, and chronic discoid rash) and pleuritis was associated with

low levels of vitamin D. During the average follow-up period of 2.3

years, 35 out of 161 patients (21.7%) with UCTD further developed into

well-established connective tissue disease (CTD). Patients who

progressed into CTDs had lower vitamin D levels than those who

remained in the UCTD stage (vitamin D levels: CTD: 14.7 ± 6.45 ng/mL

versus UCTD: 33.0 ± 13.4 ng/mL, P = 0.0001).

Conclusions

In patients with UCTD, a seasonal variance in levels of 25(OH)D3 was

identified and showed that these levels were significantly lower than

in controls during the corresponding seasons. Our results suggest that

vitamin D deficiency in UCTD patients may play a role in the

subsequent progression into well-defined CTDs.

http://arthritis-research.com/content/10/5/R123

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