Vitamin D Deficiency in Systemic Lupus Erythematosus: Prevalence, Predictors and Clinical Consequences

Rheumatology (Oxford). 2008 Jun;47(6):920-3. doi: 10.1093/rheumatology/ken121. Epub 2008 Apr 14.

Abstract

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 0-10 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Antirheumatic Agents / therapeutic use
  • Calcifediol / blood
  • Cross-Sectional Studies
  • Fatigue / etiology
  • Female
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Lupus Erythematosus, Systemic / blood
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / drug therapy
  • Male
  • Middle Aged
  • Prognosis
  • Risk Factors
  • Severity of Illness Index
  • Sex Factors
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / etiology*

Substances

  • Antirheumatic Agents
  • Hydroxychloroquine
  • Calcifediol