Vitamin D deficiency in patients with active systemic lupus erythematosus
Vitamin D deficiency in patients with active systemic lupus erythematosus
复制标题
DOI：
10.1007/s00198-008-0676-1
复制
发表时间：
2009-03-01
影响因子：
4
通讯作者：
Lazaretti-Castro, M.
中科院分区：
文献类型：
--
作者：
Borba, V. Z. C.;Vieira, J. G. H.;Lazaretti-Castro, M.
我们调查了36例系统性红斑狼疮（SLE）患者疾病活动对骨代谢的影响。皮质类固醇的使用不能解释骨重建的变化。SLE患者中25 OHD缺乏症的高患病率表明需要补充维生素D，主要是在疾病活动性高的时期。我们对36例SLE患者进行了横断面分析，根据系统性红斑狼疮疾病活动指数（SLEDAI），（第一组：12例患者，平均年龄29.6岁）或最小活动（组II：24例患者，平均年龄30.0岁），并将其与正常对照组（组III：26例女性，32.8岁）进行比较。检测血清钙、磷、甲状旁腺激素、性激素、骨重建标志物、白细胞介素（IL）-6、可溶性IL-6受体（sIL-6 R）、IL-1、肿瘤坏死因子-α（TNF）、25-羟维生素D（25 OHD）和1，25-二羟维生素D3，以及骨密度。I组25 OHD水平较低（P < 0.05），且与SLEDAI相关（R =-0.65，P < 0.001）。多元回归分析显示，25 OHD水平与SLEDAI、骨钙素和骨特异性碱性磷酸酶相关。SLEDAI评分与细胞因子尤其是TNF呈正相关（R = 0.75，P < 0.001），SLE患者骨重建改变与疾病活动性密切相关。在SLE患者中观察到25 OHD缺乏的高患病率，表明需要补充维生素D。
We investigated the effects of disease activity on bone metabolism in 36 patients with systemic lupus erythematosus (SLE). Changes in bone remodeling were not explained by corticosteroid use. A high prevalence of 25OHD deficiency in SLE patients indicates the need for vitamin D replacement, mainly during high disease activity periods.We investigated the effects of SLE disease activity on bone metabolism, their relation to inflammatory cytokines and vitamin D levels.We performed a cross-sectional analysis of 36 SLE patients classified according to the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) in high activity (group I: 12 patients, mean age 29.6 years) or in minimal activity (group II: 24 patients, mean age 30.0 years), and compared them to normal controls (group III: 26 women, 32.8 years). Serum calcium, phosphorus, parathyroid and sex hormones, bone remodeling markers, interleukin (IL)-6, soluble IL-6 receptor (sIL-6R), IL-1, tumor necrosis factor-alpha (TNF), 25-hydroxivitamin D (25OHD), and 1,25-dihydroxyvitamin D3 were measured, plus bone mineral density.All cytokines were significantly higher in SLE groups; IL-6 could differentiate SLE patients from controls. In group I, 25OHD levels were lower (P < 0.05), which was related to the SLEDAI (R = -0.65, P < 0.001). In multiple regression analysis, the 25OHD level was associated with SLEDAI, osteocalcin and bone-specific alkaline phosphatase. The SLEDAI score was positively correlated with all measured cytokines and especially TNF (R = 0.75, P < 0.001).SLE patients demonstrated changes in bone remodeling strongly related to disease activity. A high prevalence of 25OHD deficiency was observed in SLE patients, indicating the need for vitamin D replacement.