title: Serum 25-OH vitamin D levels in systemic sclerosis: analysis of 140 patients and review of the literature.
abstract: Hypovitaminosis D is increasingly reported in autoimmune diseases. We investigated the 25-OH-vitamin D (25-OH-vitD) levels in systemic sclerosis (SSc) patients, in correlation with disease's features. We measured the 25-OH-vitD serum levels in 140 consecutive patients (F/M 126/15; mean age 61 ± 15.1 years), 91 without (group A) and 49 with (group B) 25-OH-cholecalciferol supplementation. Patients of group A invariably showed low 25-OH-vitD levels (9.8 ± 4.1 ng/ml vs. 26 ± 8.1 ng/ml of group B); in particular, 88/91 (97%) patients showed vitamin D deficiency (<20 ng/ml), with very low vitamin D levels (<10 ng/ml) in 40 (44%) subjects. Only 15/49 (30.6%) patients of group B reached normal levels of 25-OH-vitD (≥30 ng/ml), whereas vitamin D deficiency persisted in 12/49 (24.5%) individuals. Parathormone levels inversely correlated with 25-OH-vitD (r = -0.3, p < 0.0001). Of interest, hypovitaminosis D was statistically associated with autoimmune thyroiditis (p = 0.008), while calcinosis was more frequently observed in patients of group A (p = 0.057). Moreover, we found significantly higher percentage of serum anticentromere antibodies in group B patients with 25-OH-vitD level ≥30 ng/ml (8/15 vs. 6/34; p = 0.017). In literature, hypovitaminosis D is very frequent in SSc patients. An association with disease duration, calcinosis, or severity of pulmonary involvement was occasionally recognized. Hypovitaminosis D is very frequent in SSc and severe in a relevant percentage of patients; furthermore, less than one third of supplemented subjects reached normal levels of 25-OH-vitD. The evaluation of 25-OH-vitD levels should be included in the routine clinical work-up of SSc. The above findings expand previous observations and may stimulate further investigations.
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41100, Modena, Italy. diliagiuggioli@hotmail.com.
authors.forename: Dilia
authors.initials: D
authors.lastname: Giuggioli
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41100, Modena, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Colaci
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41100, Modena, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Cassone
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41100, Modena, Italy.|Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Fallahi
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41100, Modena, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Lumetti
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41100, Modena, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Spinella
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41100, Modena, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Campomori
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41100, Modena, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Manfredi
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41100, Modena, Italy.
authors.forename: C U
authors.initials: CU
authors.lastname: Manzini
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41100, Modena, Italy.|Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Antonelli
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41100, Modena, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Ferri
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D012595:Scleroderma, Systemic / Q000097:blood* / Q000150:complications; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood* / Q000150:complications / Q000175:diagnosis
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Autoimmunity; Hypovitaminosis D; Scleroderma; Systemic sclerosis; Vitamin D