Current daily glucocorticoid use and serum creatinine levels are associated with lower 25(OH) vitamin D levels in Thai patients with systemic lupus erythematosus

J Clin Rheumatol. 2013 Apr;19(3):121-5. doi: 10.1097/RHU.0b013e318289bd16.


Background and objective: Because vitamin D deficiency has been previously reported in patients with systemic lupus erythematosus (SLE), we decided to examine the prevalence of vitamin D deficiency in Thai SLE patients, to identify possible independent factors affecting serum 25-hydroxyvitamin D(2) and D(3) [25(OH)] vitamin D levels, and to examine the associations of serum 25(OH) vitamin D and disease activity and damage in Thai SLE patients.

Methods: A cross-sectional study was performed in 101 SLE patients. Blood samples were prospectively collected. The levels of 25(OH) vitamin D were measured by radioimmunoassay. The cutoffs for vitamin D deficiency and insufficiency were 30 and 20 ng/mL, respectively. Demographic, clinical, and laboratory data were collected, and their associations with 25(OH) vitamin D level were examined by univariate and multivariate linear regression analyses.

Results: The level of 25(OH) vitamin D (mean [SD]) was 27.9 (7.6). Seventeen patients (17%) had vitamin D deficiency, 41 patients (41%) had vitamin D insufficiency, and 43 patients (42%) had normal vitamin D levels. Two thirds of the patients were taking relatively low-dose vitamin D supplementations. Current daily glucocorticoid dose and serum creatinine levels were negatively correlated with vitamin D levels (β = -0.207, P = 0.023; and β = -3.770, P = 0.003, respectively). There were no associations between disease activity or damage and 25(OH) vitamin D levels.

Conclusions: Vitamin D deficiency and insufficiency are common in SLE patients despite more than half of them taking vitamin D supplementations. Higher serum creatinine level and higher current daily glucocorticoid dose are associated with lower serum 25(OH) vitamin D levels. These patients may require higher doses of vitamin D supplementations.

MeSH terms

  • 25-Hydroxyvitamin D 2 / blood*
  • Adult
  • Calcifediol / blood*
  • Comorbidity
  • Creatinine / blood*
  • Cross-Sectional Studies
  • Dietary Supplements
  • Dose-Response Relationship, Drug
  • Female
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use*
  • Humans
  • Lupus Erythematosus, Systemic / blood*
  • Lupus Erythematosus, Systemic / epidemiology*
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Regression Analysis
  • Thailand / epidemiology
  • Vitamin D / administration & dosage
  • Vitamin D / therapeutic use
  • Vitamin D Deficiency / drug therapy
  • Vitamin D Deficiency / epidemiology*


  • Glucocorticoids
  • Vitamin D
  • 25-Hydroxyvitamin D 2
  • Creatinine
  • Calcifediol