Vitamin D deficiency in patients with active systemic lupus erythematosus

Autor(es)

Borba, V. Z. C. ^{[1, 2]} ; Vieira, J. G. H. ^[1] ; Kasamatsu, T. ^[1] ; Radominski, S. C. ^[3] ; Sato, E. I. ^[4] ; Lazaretti-Castro, M. ^[1]

Afiliação do(s) autor(es)

^[1] Univ Fed Sao Paulo, Div Endocrinol, Sao Paulo - Brazil

^[2] Univ Fed Parana, Div Endocrinol, Serv Endocrinol, SEMPR, BR-80060000 Curitiba, Parana - Brazil

^[3] Univ Fed Parana, Div Rheumatol, BR-80060000 Curitiba, Parana - Brazil

^[4] Univ Fed Sao Paulo, Div Rheumatol, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: OSTEOPOROSIS INTERNATIONAL; v. 20, n. 3, p. 427-433, MAR 2009.
• Citações Web of Science: 117

Resumo

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. We investigated the effects of SLE disease activity on bone metabolism, their relation to inflammatory cytokines and vitamin D levels. 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-alpha (TNF), 25-hydroxivitamin D (25OHD), and 1,25-dihydroxyvitamin D3 were measured, plus bone mineral density. 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). 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. (AU)

• Processo FAPESP: 97/02856-5 - Alterações osteo-metabolicas no lúpus eritematoso sistêmico (LES) em atividade e sua correlação com as citoquinas circulantes, interleucinas 1(IL-1), 6(IL-6), fator de necrose tumoral (TNF) e receptor solúvel da IL-6 (sIL-6R) circulantes
• Beneficiário: Marise Lazaretti Castro
• Modalidade de apoio: Auxílio à Pesquisa - Regular