Effect of vitamin D on serum markers of bone turnover in SLE in a randomised controlled trial.
Effect of vitamin D on serum markers of bone turnover in SLE in a randomised controlled trial.
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一项随机对照试验中维生素 D 对 SLE 患者骨转换血清标志物的影响。
DOI：
10.1136/lupus-2019-000352
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发表时间：
2019
影响因子：
3.9
通讯作者：
Costenbader,KarenH
中科院分区：
文献类型：
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作者：
Tedeschi,SaraK;Aranow,Cynthia;Kamen,DianeL;LeBoff,Meryl;Diamond,Betty;Costenbader,KarenH
SLE患者的骨骼健康受到维生素D缺乏、炎性细胞因子和糖皮质激素使用的不利影响。我们假设，维生素D补充剂将增加骨形成的标志物和减少骨吸收的标志物在SLE subjects.MethodsWe研究了43维生素D缺乏的SLE受试者谁参加了为期12周的随机对照试验2000-4000 IU/天的维生素D补充剂与安慰剂。受试者患有非活动性SLE（SLE疾病活动指数≤4），基线时每天服用<20 mg泼尼松。我们测定了基线和12周血清25-羟基维生素D，1型胶原N-末端前肽（P1 NP）和C-端肽（CTX）。我们在意向治疗分析中检测了维生素D与安慰剂对P1 NP和ΔCTX变化（Δ）的影响。次要分析评价了维生素D是否影响维生素D补充（≥30 ng/mL）或目前正在服用糖皮质激素的受试者的骨转换。平均年龄为39岁，40%在入组时使用糖皮质激素。在维生素D组中，46%的人达到了饱腹，而安慰剂组中没有。维生素D组与安慰剂组的骨转换标志物变化无显著差异（维生素D组的中位Δ P1 NP −0.2 vs安慰剂组的中位Δ P1 NP −1.1（p=0.83）;维生素D组的中位ΔCTX +3.5 vs安慰剂组的中位ΔCTX +37.0（p=0.50））。维生素D的效果并没有不同的基础上实现维生素D repletion或基线糖皮质激素use.ConclusionVitamin D补充剂并没有影响12周的变化骨转换标志物之间的SLE受试者在这项试验中。
ObjectiveBone health in SLE is adversely affected by vitamin D deficiency, inflammatory cytokines and glucocorticoid use. We hypothesised that vitamin D supplementation would increase markers of bone formation and decrease markers of bone resorption in SLE subjects.MethodsWe studied 43 vitamin D-deficient SLE subjects who participated in a 12-week randomised controlled trial of 2000–4000 IU/day vitamin D supplementation versus placebo. Subjects had inactive SLE (SLE Disease Activity Index ≤4) and were taking <20 mg prednisone daily at baseline. We assayed baseline and week 12 serum 25-hydroxyvitamin D, N-terminal propeptide of type 1 collagen (P1NP) and C-telopeptide (CTX). We tested the effect of vitamin D versus placebo on change (Δ) in P1NP and ΔCTX in an intention-to-treat analysis. Secondary analyses evaluated whether vitamin D affected bone turnover among subjects achieving vitamin D repletion (≥30 ng/mL) or currently taking glucocorticoids.Results28 subjects were randomised to vitamin D and 15 to placebo. Mean age was 39 years and 40% were using glucocorticoids at enrolment. Repletion was achieved by 46% in the vitamin D group versus none in the placebo group. Changes in bone turnover markers were not significantly different in the vitamin D group versus placebo group (median ΔP1NP −0.2 vitamin D group vs −1.1 placebo group (p=0.83); median ΔCTX +3.5 vitamin D group vs −37.0 placebo group (p=0.50)). The effect of vitamin D did not differ based on achieving vitamin D repletion or baseline glucocorticoid use.ConclusionVitamin D supplementation did not affect the 12-week change in bone turnover markers among SLE subjects in this trial.