Vitamin D Deficiency in Egyptian Systemic Lupus Erythematosus Patients: How Prevalent and Does It Impact Disease Activity?
BACKGROUND
The emerging role of vitamin D in immunology and autoimmune disorders has been a worldwide interest in the last decade. Systemic lupus erythematosus (SLE) patients are particularly at a delicate position predisposing them to suffer from vitamin D deficiency due to the multiple risk factors accompanying the disease. Whether vitamin D deficiency is also involved as a risk factor for developing SLE and affecting its course is a considerable concern.


OBJECTIVE
The objective of this study was to estimate the prevalence of vitamin D deficiency in SLE patients and its relation to disease.


METHODS
In our observational cross-sectional study, serum levels of vitamin D [25(OH)D] in 60 SLE patients and 30 age- and sex-matched healthy controls were assessed and estimated for deficiency and insufficiency at 10 and 30 ng/mL, respectively. Disease activity was evaluated by SLE disease activity index (SLEDAI), irreversible organ damage by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI), and severity by Severity of Disease Index. Fatigue was measured by visual analog scale.


RESULTS
Significantly lower levels of 25(OH)D were found in SLE patients (17.6 ± 6.9 ng/mL) in comparison to controls (79.0 ± 28.7 ng/mL), with a statistically high significant difference (t= -11.2,P< 0.001). High prevalence of vitamin D insufficiency and deficiency was detected as 73.3% and 23.3%, respectively. Vitamin D had a highly significant negative correlation with SLEDAI (r= -0.495,P< 0.001), SLICC (r= -0.431,P< 0.05), and fatigue (r= -0.436,P< 0.05).


CONCLUSIONS
Vitamin D deficiency and insufficiency were found to be prevalent in SLE patients in our study and related to disease activity and fatigue. If needed, routine screening and consequent repletion of vitamin D are recommended in SLE patients. Restoring adequate vitamin D levels in SLE patients should be more explored as a potential yet simple measure to their usual management to improve their condition.
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Nouran M
NM
Abaza
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Reem M
RM
El-Mallah
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Asmaa
A
Shaaban
Internal Medicine - Rheumatology Division, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Sameh A
SA
Mobasher
Internal Medicine - Rheumatology Division, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Khaled F
KF
Al-Hassanein
Internal Medicine - Rheumatology Division, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Amr A
AA
Abdel Zaher
Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Rania H
RH
El-Kabarity
SLEDAI; SLICC; disease activity; systemic lupus erythematosus; vitamin D
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