25-Hydroxivitamin D Serum Concentration, Not Free and Bioavailable Vitamin D, Is Associated with Disease Activity in Systemic Lupus Erythematosus Patients

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2017 Jan 14

PMID 28085957

Citations 16

Authors

Marina Eloi

Daniela Vargas Horvath

Joao Carlos Ortega

Monica Simon Prado

Luis Eduardo Coelho Andrade

Vera Lucia Szejnfeld

Charlles Heldan de Moura Castro

Affiliations

Soon will be listed here.

Abstract

We aim to evaluate the prevalence of vitamin D deficiency in patients with systemic lupus erythematosus (SLE) and investigate the association between total, free and bioavailable vitamin D serum concentrations and disease activity. Patients with SLE (ACR 1997) consecutively seen at UNIFESP's outpatient's clinics had disease activity measured after clinical and laboratory evaluation using SLEDAI (Systemic Lupus Erythematosus Disease Activity Index). 25-hydroxyvitamin D (25(OH)D) serum concentrations measured by chemiluminescence and vitamin D binding protein (DBP) measured by ELISA were used to calculate free and bioavailable vitamin D. Healthy blood donors were used as controls. A total of 142 patients (71.4%) had 25(OH)D serum concentrations below 30 ng/mL. Total 25(OH)D serum concentration was associated with disease activity categorized in 5 continuous groups of SLEDAI. 25(OH)D serum concentrations were higher among patients with SLEDAI 1-5 and lower in those with severe activity (SLEDAI≥20) (p <0.05). On the other hand, no statistically significant difference was observed for DBP, free and bioavailable vitamin D measurements in the disease activity subgroups evaluated. Vitamin D deficiency is highly prevalent among patients with SLE and was associated with higher disease activity. DBP serum level and calculation of free and bioavailable vitamin D were not associated with SLE disease activity.

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References

Hochberg M . Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997; 40(9):1725. DOI: 10.1002/art.1780400928. View

Behrens J, Rasche L, Giess R, Pfuhl C, Wakonig K, Freitag E . Low 25-hydroxyvitamin D, but not the bioavailable fraction of 25-hydroxyvitamin D, is a risk factor for multiple sclerosis. Eur J Neurol. 2015; 23(1):62-7. DOI: 10.1111/ene.12788. View

Denburg M, Kalkwarf H, de Boer I, Hewison M, Shults J, Zemel B . Vitamin D bioavailability and catabolism in pediatric chronic kidney disease. Pediatr Nephrol. 2013; 28(9):1843-53. PMC: 4053210. DOI: 10.1007/s00467-013-2493-9. View

Cutolo M . Vitamin D and autoimmune rheumatic diseases. Rheumatology (Oxford). 2008; 48(3):210-2. DOI: 10.1093/rheumatology/ken394. View

Amital H, Szekanecz Z, Szucs G, Danko K, Nagy E, Csepany T . Serum concentrations of 25-OH vitamin D in patients with systemic lupus erythematosus (SLE) are inversely related to disease activity: is it time to routinely supplement patients with SLE with vitamin D?. Ann Rheum Dis. 2010; 69(6):1155-7. DOI: 10.1136/ard.2009.120329. View

Lopes J, Fernandes G, Takayama L, Figueiredo C, Pereira R . A predictive model of vitamin D insufficiency in older community people: from the São Paulo Aging & Health Study (SPAH). Maturitas. 2014; 78(4):335-40. DOI: 10.1016/j.maturitas.2014.05.023. View

Holick M, Binkley N, Bischoff-Ferrari H, Gordon C, Hanley D, Heaney R . Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011; 96(7):1911-30. DOI: 10.1210/jc.2011-0385. View

Glendenning P, Chew G, Inderjeeth C, Taranto M, Fraser W . Calculated free and bioavailable vitamin D metabolite concentrations in vitamin D-deficient hip fracture patients after supplementation with cholecalciferol and ergocalciferol. Bone. 2013; 56(2):271-5. DOI: 10.1016/j.bone.2013.06.012. View

Ruiz-Irastorza G, Egurbide M, Olivares N, Martinez-Berriotxoa A, Aguirre C . Vitamin D deficiency in systemic lupus erythematosus: prevalence, predictors and clinical consequences. Rheumatology (Oxford). 2008; 47(6):920-3. DOI: 10.1093/rheumatology/ken121. View

10.

Borba V, Vieira J, Kasamatsu T, Radominski S, Sato E, Lazaretti-Castro M . Vitamin D deficiency in patients with active systemic lupus erythematosus. Osteoporos Int. 2008; 20(3):427-33. DOI: 10.1007/s00198-008-0676-1. View

11.

Sakthiswary R, Raymond A . The clinical significance of vitamin D in systemic lupus erythematosus: a systematic review. PLoS One. 2013; 8(1):e55275. PMC: 3559338. DOI: 10.1371/journal.pone.0055275. View

12.

Luporini Saraiva G, Cendoroglo M, Ramos L, Araujo L, Vieira J, Maeda S . [Prevalence of vitamin D deficiency, insufficiency and secondary hyperparathyroidism in the elderly inpatients and living in the community of the city of São Paulo, Brazil]. Arq Bras Endocrinol Metabol. 2007; 51(3):437-42. DOI: 10.1590/s0004-27302007000300012. View

13.

Gordon C, Bertsias G, Ioannidis J, Boletis J, Bombardieri S, Cervera R . EULAR points to consider for conducting clinical trials in systemic lupus erythematosus. Ann Rheum Dis. 2008; 68(4):470-6. DOI: 10.1136/ard.2007.083022. View

14.

Cook R, Gladman D, Pericak D, Urowitz M . Prediction of short term mortality in systemic lupus erythematosus with time dependent measures of disease activity. J Rheumatol. 2000; 27(8):1892-5. View

15.

Vermeulen A, Verdonck L, Kaufman J . A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab. 1999; 84(10):3666-72. DOI: 10.1210/jcem.84.10.6079. View

16.

Costenbader K, Feskanich D, Holmes M, Karlson E, Benito-Garcia E . Vitamin D intake and risks of systemic lupus erythematosus and rheumatoid arthritis in women. Ann Rheum Dis. 2007; 67(4):530-5. PMC: 2717608. DOI: 10.1136/ard.2007.072736. View

17.

Souto M, Coelho A, Guo C, Mendonca L, Argolo S, Papi J . Vitamin D insufficiency in Brazilian patients with SLE: prevalence, associated factors, and relationship with activity. Lupus. 2011; 20(10):1019-26. DOI: 10.1177/0961203311401457. View

18.

Bikle D, Gee E, Halloran B, Kowalski M, Ryzen E, Haddad J . Assessment of the free fraction of 25-hydroxyvitamin D in serum and its regulation by albumin and the vitamin D-binding protein. J Clin Endocrinol Metab. 1986; 63(4):954-9. DOI: 10.1210/jcem-63-4-954. View

19.

Bandeira F, Griz L, Freese E, Lima D, The A, Trovao Diniz E . Vitamin D deficiency and its relationship with bone mineral density among postmenopausal women living in the tropics. Arq Bras Endocrinol Metabol. 2010; 54(2):227-32. DOI: 10.1590/s0004-27302010000200020. View

20.

Autier P, Boniol M, Pizot C, Mullie P . Vitamin D status and ill health: a systematic review. Lancet Diabetes Endocrinol. 2014; 2(1):76-89. DOI: 10.1016/S2213-8587(13)70165-7. View