Vitamin D deficiency in systemic lupus erythematosus: prevalence, predictors and clinical consequences
Vitamin D deficiency in systemic lupus erythematosus: prevalence, predictors and clinical consequences
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DOI：
10.1093/rheumatology/ken121
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发表时间：
2008-06-01
期刊：
影响因子：
5.5
通讯作者：
Aguirre, C.
中科院分区：
文献类型：
--
作者：
Ruiz-Irastorza, G.;Egurbide, M. V.;Aguirre, C.
目标。我们的目的是确定睡眠不足患者维生素D缺乏的患病率、预测因素和临床后果。横断面研究包括满足ACR标准的SLE患者。血清25(OH)D水平在30和10 ng/ml时分别是维生素D不足和维生素D缺乏的临界值。SLE活动度用SLEDAI测量，不可逆器官损伤用SLICC-ACR指数测量。采用010视觉模拟量表（VAS）对疲劳进行量化。92名患者（90名女性，98名白人）被纳入研究。69例（75）和14例（15）患者分别出现维生素D不足和缺乏。女性（P = 0.001）、HCQ治疗（P = 0.014）和钙和维生素D治疗（P = 0.049）预测25(OH)D水平升高。光敏性[比值比（OR） 3.5]和光保护（OR）分别预测维生素D不足和缺乏。较高的年龄（OR 0.95）和使用HCQ （OR 0.29）可以预防维生素D缺乏症。通过0-10 VAS量化，维生素D缺乏症患者的疲劳程度更高（平均5.32 vs 4.03, P = 0.08）。维生素D不足或缺乏与病程、SLEDAI、SLICC-ACR指数无相关性。维生素D不足和缺乏在SLE患者中很常见，并与避光有关。HCQ可以预防维生素D缺乏。维生素D缺乏与高度疲劳有关。维生素D水平与SLE严重程度无关。
Objectives. We aimed to establish the prevalence, predictors and clinical consequences of vitamin D deficiency in patients with SLE.Methods. Cross-sectional study including patients fulfilling ACR criteria for the classification of SLE. Serum 25(OH)D levels at 30 and 10 ng/ml were the cut-off values for vitamin D insufficiency and vitamin D deficiency, respectively. SLE activity was measured by SLEDAI and irreversible organ damage by the SLICC-ACR index. Fatigue was quantified using a 010 visual analogue scale (VAS).Results. Ninety-two patients (90 women, 98 white) were included in the study. Sixty-nine (75) and 14 (15) patients presented with vitamin D insufficiency and deficiency, respectively. Female sex (P = 0.001), treatment with HCQ (P = 0.014) and treatment with calcium and vitamin D (P = 0.049) predicted higher levels of 25(OH)D. Photosensitivity [odds ratio (OR) 3.5] and photoprotection (OR 5.7) predicted vitamin D insufficiency and deficiency, respectively. Higher age (OR 0.95) and HCQ use (OR 0.29) protected against vitamin D deficiency. Patients with vitamin D deficiency had a higher degree of fatigue as quantified by a 0-10 VAS (mean 5.32 vs 4.03, P = 0.08). No relation was seen between vitamin D insufficiency or deficiency and disease duration, SLEDAI or SLICC-ACR indexes.Conclusions. Vitamin D insufficiency and deficiency are common in patients with SLE and are associated with sun avoidance. HCQ prevented vitamin D deficiency. Vitamin D deficiency was related to a higher degree of fatigue. Vitamin D levels had no relation with SLE severity.