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Published in: Osteoporosis International 3/2009

01-03-2009 | Original Article

Vitamin D deficiency in patients with active systemic lupus erythematosus

Authors: V. Z. C. Borba, J. G. H. Vieira, T. Kasamatsu, S. C. Radominski, E. I. Sato, M. Lazaretti-Castro

Published in: Osteoporosis International | Issue 3/2009

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Abstract

Summary

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.

Introduction

We investigated the effects of SLE disease activity on bone metabolism, their relation to inflammatory cytokines and vitamin D levels.

Methods

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-α (TNF), 25-hydroxivitamin D (25OHD), and 1,25-dihydroxyvitamin D3 were measured, plus bone mineral density.

Results

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).

Conclusions

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.
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Metadata
Title
Vitamin D deficiency in patients with active systemic lupus erythematosus
Authors
V. Z. C. Borba
J. G. H. Vieira
T. Kasamatsu
S. C. Radominski
E. I. Sato
M. Lazaretti-Castro
Publication date
01-03-2009
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 3/2009
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-008-0676-1

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