The immunopathological role of vitamin D in patients with SLE: data from a single centre registry in Hungary.
OBJECTIVE
Disproportionate vitamin D levels may play an important role in the development of certain systemic autoimmune and rheumatic diseases. The aim of the present study was to investigate the prevalence of vitamin D insufficiency in patients with systemic lupus erythematosus (SLE) and to compare serological and clinical parameters in patients with different vitamin D levels from a single centre registry in Central-Eastern Europe.


METHODS
A total of 177 patients with SLE were enrolled in the study. 25-Hydroxyvitamin D [25(OH)D] levels were measured by chemiluminescent immunoassay (CLIA). Autoantibody profiles, complement 3 (C3) and C4, clinical symptoms, and disease activity (using the SLE disease activity index, SLEDAI) of the patients were assessed.


RESULTS
Vitamin D concentration in the total SLE group investigated was 26.88 ± 13.25 ng/mL. Vitamin D levels were normal (≥ 30 ng/mL) in 18.1% of patients, insufficient (15-30 ng/mL) in 44.6%, and deficient (< 15 ng/mL) in 37.3%. The vitamin levels were significantly reduced in postmenopausal compared to premenopausal patients (p = 0.02). Patients with pericarditis (p = 0.013), neuropsychiatric diseases (p = 0.01), and deep vein thrombosis (p = 0.014) had reduced vitamin D levels. SLEDAI score was significantly increased in patients with reduced vitamin D levels (p = 0.038). Anti-double-stranded (ds)DNA autoantibody concentrations increased from normal to insufficient and further increased from insufficient to deficient patient subsets (p = 0.021). Anti-Smith antigen (anti-Sm) concentrations increased (p < 0.001), C4 levels decreased (p = 0.027), and immunoglobulin (Ig)G concentration increased (p = 0.034) in patients with reduced vitamin D levels.


CONCLUSIONS
Our data suggest that vitamin D deficiency in SLE may play a role in perpetuation of the disease.
Institute of Immunology, Rikshospitalet, University of Oslo, Norway. szodoray@gmail.com
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Szodoray
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Tarr
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Bazso
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Poor
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Szegedi
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Kiss
D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D003181:Complement C4 / Q000378:metabolism; D004247:DNA / Q000276:immunology; D019587:Dietary Supplements; D018450:Disease Progression; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007074:Immunoglobulin G / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012042:Registries; D012720:Severity of Illness Index; D014807:Vitamin D / Q000502:physiology* / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000453:epidemiology* / Q000503:physiopathology* / Q000517:prevention & control; D055815:Young Adult
D001323:Autoantibodies; D003181:Complement C4; D007074:Immunoglobulin G; D014807:Vitamin D; D004247:DNA