title: Vitamin D levels in children, adolescents, and young adults with juvenile-onset systemic lupus erythematosus: a cross-sectional study.
abstract: BACKGROUND
  SS and LC contributed equally to this manuscript. Hypovitaminosis D is common in the general population. Although many studies on 25-hydroxyvitamin D (25(OH)D) are available on systemic lupus erythematosus (SLE), few data are reported in juvenile-onset SLE (JSLE) patients.
  
  
  METHODS
  This study aimed to assess serum 25(OH)D levels in JSLE patients and to identify risk factors for vitamin D deficiency in this population.
  
  
  METHODS
  Forty-five Caucasian JSLE patients (36 females, nine males; mean age 18.9±6.3 years) and 109 age- and sex-matched healthy controls entered the study. Dual-energy X-ray absorptiometry (DXA) scans of the lumbar spine, serum calcium and phosphate, bone-specific alkaline phosphatase (BSAP), parathyroid hormone (PTH), and 25(OH)D were assessed. The data were compared with an age- and sex-matched control group including 109 Caucasian healthy subjects.
  
  
  RESULTS
  JSLE patients exhibited lower 25(OH)D levels than controls (p<0.005), with the lower values observed in patients with active vs. inactive disease (p<0.05). JSLE patients exhibited reduced total calcium levels (p<0.001) and higher phosphate levels (p<0.001), BSAP (p<0.001) and PTH (p<0.001) than controls. In addition, JSLE patients exhibited lower spine bone mineral apparent density (BMAD) SDS values than controls (p<0.001), with higher values in patients with 25(OH)D sufficiency and insufficiency than in those with 25(OH)D deficiency (p<0.001).
  
  
  CONCLUSIONS
  Patients with JSLE have significantly lower 25(OH)D levels than controls. Therefore, vitamin D supplementation may be useful to normalize bone mass and quality in subjects with JSLE.
authors.affiliation: Health Sciences Department, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Stagi
authors.affiliation: Department of Surgery and Translational Medicine, Endocrinology Unit.
authors.forename: L
authors.initials: L
authors.lastname: Cavalli
authors.affiliation: Department of Internal Medicine, Section of Rheumatology, Transition Clinic, University of Florence, Florence, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bertini
authors.affiliation: Health Sciences Department, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy.
authors.forename: M
authors.initials: M
authors.lastname: de Martino
authors.affiliation: Department of Internal Medicine, Section of Rheumatology, Transition Clinic, University of Florence, Florence, Italy.
authors.forename: M Matucci
authors.initials: MM
authors.lastname: Cerinic
authors.affiliation: Department of Surgery and Translational Medicine, Endocrinology Unit.
authors.forename: M L
authors.initials: ML
authors.lastname: Brandi
authors.affiliation: Department of Internal Medicine, Section of Rheumatology, Transition Clinic, University of Florence, Florence, Italy falcini@unifi.it.
authors.forename: F
authors.initials: F
authors.lastname: Falcini
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: 25 OH vitamin D; 25(OH)D; BMAD; Bone mass; DXA; PTH; bone mineral density; juvenile systemic lupus erythematosus; osteoporosis; parathyroid hormone