Vitamin D deficiency and insufficiency in 2 independent cohorts of patients with systemic sclerosis.
OBJECTIVE
To investigate 25-OH vitamin D concentrations in 2 independent systemic sclerosis (SSc) populations from France and Italy.


METHODS
We studied 156 consecutive SSc patients comparable for demographic characteristics: 90 from Northern France and 66 from Southern Italy. 25-OH vitamin D, intact parathyroid hormone, and serum total calcium and phosphorus were measured in all patients. Vitamin D concentrations < 30 ng/ml were considered insufficiency, while values < 10 ng/ml were classified as deficiency.


RESULTS
Vitamin D insufficiency and deficiency rates were very high and comparable between the 2 populations: 74/90 (82%) versus 57/66 (86%) for insufficiency and 29/90 (32%) versus 15/66 (23%) for deficiency, respectively, in the French and Italian patients. They were not influenced by vitamin D supplementation, which was not statistically different in the 2 groups. In the combined populations, a significant negative correlation was found between low vitamin D levels and European Disease Activity Score (p = 0.04, r = -0.17) and an even more significant correlation was found with acute-phase reactants (p = 0.004, r = -0.23 for erythrocyte sedimentation rate), and low levels of vitamin D were associated with the systolic pulmonary artery pressure (sPAP) estimated by echocardiography (p = 0.004). In multivariate analysis, vitamin D deficiency was associated with sPAP (p = 0.02).


CONCLUSIONS
Vitamin D deficiency was very common in the 2 SSc populations, independent of geographic origin and vitamin D supplementation. This suggests that common vitamin D supplementation does not correct the deficiency in SSc patients, and that a higher dose is probably needed, especially in those with high inflammatory activity or severe disease.
Vacca
Alessandra
A
Rheumatology Unit, University of Cagliari, Azienda Ospedaliero-Universitaria, Cagliari, Italy.
Cormier
Catherine
C
Piras
Martina
M
Mathieu
Alessandro
A
Kahan
Andre
A
Allanore
Yannick
Y
D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010281:Parathyroid Hormone / Q000097:blood; D010641:Phenotype; D010758:Phosphorus / Q000097:blood; D015995:Prevalence; D012595:Scleroderma, Systemic / Q000097:blood* / Q000150:complications*; D012720:Severity of Illness Index; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology*
D010281:Parathyroid Hormone; D014807:Vitamin D; D010758:Phosphorus; C104450:25-hydroxyvitamin D; D002118:Calcium