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Vitamin D status and its relationship with systemic lupus erythematosus as a determinant and outcome of disease activity

  • Chayanika Dutta , Sanjeeb Kakati , Bhupen Barman EMAIL logo and Kaustubh Bora EMAIL logo
Published/Copyright: April 3, 2019
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Hormone Molecular Biology and Clinical Investigation
From the journal Hormone Molecular Biology and Clinical Investigation Volume 38 Issue 3

Abstract

Background

The importance of vitamin D (VD) in systemic lupus erythematosus (SLE) is being increasingly appreciated, with studies suggesting a relationship between VD deficiency and SLE onset/disease activity. We investigated VD status in SLE patients and its associations with disease activity in a geographical region of India receiving low solar ultraviolet-B (UV-B) index.

Materials and methods

We enrolled 109 SLE patients along with 109 healthy controls belonging to same ethnicity and localities. Demographic and clinico-laboratory information were recorded. VD status was assessed by estimating serum 25-hydroxyvitamin D (25-OH-D) concentrations (deficient: <20 ng/mL, insufficient: 21–29 ng/mL, and sufficient/normal: ≥30 ng/mL) using an enzyme-linked fluorescent assay (ELFA). The SLE Disease Activity Index (SLEDAI) scoring system was used to evaluate disease activity. The association between VD status and disease activity was assessed by univariate and multivariate approaches.

Results

Hypovitaminosis D was prevalent in 90.83% SLE patients [vs. 77.98% healthy controls; chi-squared (χ2) = 10.125, df = 2, p < 0.01]. SLEDAI scores and 25-OH-D values were inversely associated, which extended in a two-way manner as revealed by multiple logistic regression models. SLE patients with VD deficiency were more likely to have high/very high disease activity [adjusted odds ratio (OR) = 3.5, 95% confidence intervals (CI): 1.4–8.9]. Conversely, patients with high SLEDAI scores (>10) also had greater risks of being VD deficient (adjusted OR = 3.9, 95% CI: 1.5–10.8).

Conclusion

VD deficiency is widespread in SLE. The relationship appears to be bidirectional, with VD status associated both as determinant and outcome of disease activity in SLE.

Keywords: 25-hydroxyvitamin D; disease activity; risk factor; systemic lupus erythematosus; vitamin D deficiency

Author Statement

  1. Research funding: None.

  2. Conflict of interest: Authors state no conflicts of interest.

  3. Informed consent: Voluntary informed written consent was procured from all the participants of the study.

  4. Ethical approval: The research related to human use complied with all the relevant national regulations and institutional policies and was performed in accordance to the tenets of the Helsinki Declaration and has been approved by the institutional ethical committee.

  5. Authors’ contributions: SK and CD carried out the conceptualization. KB and BB contributed to the design and carried out the literature review. CD was involved in enrolment of study participants, and the collection of their clinico-laboratory information, under the supervision of SK. CD contributed to data management. KB analyzed and interpreted the data with inputs from BB. KB wrote the manuscript with inputs from CD. SK and BB helped in critically revising the manuscript. All authors accept responsibility of the manuscript.

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Supplementary Material

The online version of this article offers supplementary material (DOI: https://doi.org/10.1515/hmbci-2018-0064).

Received: 2018-08-25
Accepted: 2019-02-10
Published Online: 2019-04-03

©2019 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/hmbci-2018-0064
Keywords for this article
25-hydroxyvitamin D; disease activity; risk factor; systemic lupus erythematosus; vitamin D deficiency

Articles in the same Issue

  1. Original Articles
  2. Vitamin D status and its relationship with systemic lupus erythematosus as a determinant and outcome of disease activity
  3. The physical activity level and aerobic capacity estimation (VO2max) among the administrative staff of the Pars Special Economic Energy Zone (Assaluyeh, Iran) with different BMIs
  4. Review Article
  5. Novel strategies for clinical investigation and biomarker discovery: a guide to applied metabolomics
  6. Case Report
  7. A “miracle” pregnancy outcome of severe placental abruption
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