血清25-羟维生素D与系统性红斑狼疮活动的关系

doi:10.19723/j.issn.1671-167X.2021.05.021

Abstract

Abstract:

Objective: To investigate the application value of serum 25-hydroxy vitamin D [25(OH)D] in systemic lupus erythematosus (SLE). Methods: Data of 158 patients with SLE in Department of Rheumatology and Immunology in the People’s Hospital of Xinjiang Uygur Autonomous Region from July 2016 to July 2019. All the SLE patients were divided into two groups by SLE scores of the disease activity index (SLEADI): 59 cases of active group (SLEADI>4), 99 cases of non-active group (SLEDAI ≤4). Fifty healthy people were selected as healthy control group. The patients’ general information and their laboratory data including serum 25(OH)D levels were collected. Statistical methods used were t-test, Spearman’s correalation analysis and Logistic regression analysis. Results: (1) A total of 208 cases were included in this study. The level of 25(OH)D in SLE group [10.4(5.6,15.8) μg/L] was significantly lower than that in healthy control group [25.5(22.8,32.3) μg/L, P<0.01]. 25(OH)D level in active SLE patients [6.2(3.7,13.8) μg/L] was significantly lower than that in remission SLE patients [12.3(7.2,16.7) μg/L, P<0.01]. The serum 25(OH)D level in lupus nephritis [6.7 (4.4, 12.9) μg/L] was significantly lower than that in SLE without renal involvement [13.3 (7.4, 18.7) μg/L, P<0.01]. (2) A significant negative correlation was demonstrated between the serum level of 25(OH)D and SLEDAI (r=-0.35,P<0.01), and the 24h urinary protein excretion (r=-0.39, P<0.01).Positive correlation was demonstrated between the serum level of 25(OH)D and C3 that decreased (r=0.249, P<0.05). (3) Univariate analysis showed anti- dsDNA antibodies(ds-DNA), anti-Sm antibodies(Sm), IgG, C3, C4, erythrocyte sedimentation rate (ESR), 24h urinary protein quantification(24h-pro) and 25(OH)D were associated with disease activity in the SLE patients; Multivariate Logistic regression analysis showed that 25(OH)D was associated with the disease activity of the lupus patients. Conclusion: The decrease of vitamin D level is related to the disease activity of SLE patients, and may be related to lupus nephritis, which plays an important role in the occurrence and development of SLE.

Key words: Systemic lupus erythematosus, Lupus nephritis, 25-hydroxy vitamin D, Disease activity

CLC Number:

R593.24

Jian-mei ZOU,Li-jun WU,Cai-nan LUO,Ya-mei SHI,Xue WU. Relationship of serum 25- hydroxy vitamin D and systemic lupus erythematosus[J].Journal of Peking University (Health Sciences), 2021, 53(5): 938-941.

Figures/Tables 1

Table 1

Epidemiological data of SLE patients"

Items	Active group	Non-active group	P
Cases, n(%)	59 (37)	99 (63)	0.95
Gender, n(%)
Female	55 (34.8)	92 (58.3)
Male	4 (2.5)	7 (4.4)
Age/year, $x ?$ ±s	25.1±12.9	24.8±12.7	0.88
Course of disease/month, M (P₂₅, P₇₅)	9.6 (4.8, 12.0)	13.2 (10.8, 36.0)	<0.01
ANA, n(%), M (P₂₅, P₇₅)	59 (100)	97 (98.0)	0.82
ds-DNA, n(%), M (P₂₅, P₇₅)	30 (50.8)	12 (12.1)	<0.01
Sm, n(%), M (P₂₅, P₇₅)	19 (32.2)	12 (12.2)	<0.05
SSA, n(%), M (P₂₅, P₇₅)	30 (50.8)	53 (54.1)	0.70
SSB, n(%), M (P₂₅, P₇₅)	7 (11.9)	10 (10.2)	0.75
Acl/(RU/mL), M (P₂₅, P₇₅)	3.4 (2.0, 8.3)	2.3 (2.0, 4.8)	0.06
β2-GPI/(RU/mL), M (P₂₅, P₇₅)	5.1 (2.0, 12.9)	5.9 (2.2, 13.3)	0.67
C1q/(AU/mL), M (P₂₅, P₇₅)	49.0 (8.3, 174.0)	7.7 (3.9, 26.9)	<0.01
Complement C1q/(mg/L), M (P₂₅, P₇₅)	169.0 (129.8, 210.9)	165.4 (138.0, 26.9)	0.98
IgG/(g/L), M (P₂₅, P₇₅)	13.5 (8.6, 22.1)	12.5 (10.1, 16.4)	0.33
IgA/(g/L), M (P₂₅, P₇₅)	2.6 (1.6, 3.4)	2.3 (1.5, 3.3)	0.61
IgM/(g/L), M (P₂₅, P₇₅)	1.0 (0.6, 1.3)	0.9 (0.6, 0.9)	0.61
C3/(g/L), M (P₂₅, P₇₅) C4/(g/L), M (P₂₅, P₇₅) ESR/(mm/H), M (P₂₅, P₇₅) CRP/(mg/L), M (P₂₅, P₇₅) 24h-pro/(g), M (P₂₅, P₇₅) BUN/(mmol/L), M (P₂₅, P₇₅) Cr/(μmol/L), M (P₂₅, P₇₅) BGP/(μg/L), M (P₂₅, P₇₅) 25(OH)D/(μg/L), M (P₂₅, P₇₅)	0.6 (0.4, 0.8) 0.1 (0.0, 0.1) 41.0 (20.3, 54.0) 5.0 (2.5, 15.0) 0.3 (0.1, 1.9) 5.6 (3.9, 8.2) 56.7 (48.2, 71.2) 8.0 (5.0, 13.8) 6.2 (3.7, 13.8)	0.8 (0.9, 0.6) 0.1 (0.1, 0.2) 18.0 (10.8, 28.0) 2.8 (1.9, 5.0) 0.1 (0.0, 0.1) 4.6 (3.6, 5.4) 57.8 (49.8, 64.3) 10.0 (7.0, 14.0) 12.3 (7.2, 16.7)	<0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.58 0.11 <0.01

Table 1

References 19

[1]	Cutolo M, Otsa K. Review: Vitamin D, immunity and lupus [J]. Lupus, 2008, 17(1):6-10. pmid: 18089676
[2]	Kamen DL. Vitamin D in lupus-new kid on the block? [J]. Bull NYU Hosp Jt Dis, 2010, 68(3):218-222.
[3]	Ritterhouse LL, Crowe SR, Niewold TB, et al. Vitamin D deficiency is associated with an increased autoimmune response in healthy individuals and in patients with systemic lupus erythematosus [J]. Ann Rheum Dis, 2011, 70(9):1569-1574. doi: 10.1136/ard.2010.148494 pmid: 21586442
[4]	Amital H, Szekanecz Z, Szücs G, et al. 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? [J]. Ann Rheum Dis, 2010, 69(6):1155-1157. doi: 10.1136/ard.2009.120329 pmid: 20439290
[5]	Yeap SS, Othman AZ, Zain AA, et al. Vitamin D levels: Its relationship to bone mineral density response and disease activity in premenopausal Malaysian systemic lupus erythematosus patients on corticosteroids [J]. Int J Rheum Dis, 2012, 15(1):17-24 doi: 10.1111/apl.2012.15.issue-1
[6]	Souto M, Coelho A, Guo C, et al. Vitamin D insufficiency in Brazilian patients with SLE: Prevalence, associated factors, and relationship with activity [J]. Lupus, 2011, 20(10):1019-1026. doi: 10.1177/0961203311401457 pmid: 21646315
[7]	De Souza VA, Bastos MG, Fernandes NM, et al. Association of hypovitaminosis D with systemic lupus erythematosus and inflammation [J]. Bras Nefrol, 2014, 36(4):430-436.
[8]	Leventis P, Patel S. Clinical aspects of vitamin D in the management of rheumatoid arthritis [J]. Rheumatology (Oxford), 2008, 47(11):1617-1621. doi: 10.1093/rheumatology/ken296 pmid: 18682414
[9]	Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus [J]. Arthritis Rheum, 1997, 40(9):1725-1734.
[10]	Ding Y, Liao W, He XJ, et al. Effects of 1,25(OH)₂ D₃ and vitamin D receptor on peripheral CD4⁺/CD8⁺double-positive T lymphocytes in a mouse model of systemic lupus erythematosus [J]. J Cell Mol Med, 2017, 21(5):975-985. doi: 10.1111/jcmm.13037 pmid: 28063200
[11]	Mok CC. Vitamin D and systemic lupus erythematosus: an update [J]. Expert Rev Clin Immunol, 2013, 9(5):453-463. doi: 10.1586/eci.13.19
[12]	张竞, 罗静, 王静, 等. 血清25(OH)D水平与初诊系统性红斑狼疮疾病活动度的相关性研究 [J]. 中华风湿病学杂志, 2019, 23(1):36-41.
[13]	方慧玲, 禹松林, 韩建华, 等. 中国北方健康人群血清 25羟维生素D₃和25羟维生素D₂水平 [J]. 中华骨质疏松和骨矿盐疾病杂志, 2014, 7(3):199-205.
[14]	Cashman KD, Dowling KG. Vitamin D deficiency in Europe: Pandemic? [J]. Am J Clin Nutr, 2016, 103(4):1033-1044. doi: 10.3945/ajcn.115.120873 pmid: 26864360
[15]	张永锋, 郑毅. 初发系统性红斑狼疮患者血清25-羟-维生素D和维生素D抗体水平变化及意义 [J]. 中华风湿病学杂志, 2012, 16(10):661-664.
[16]	卢勤燕, 蔡小燕, 林小军, 等. 系统性红斑狼疮患者外周血维生素D水平及其临床意义 [J]. 实用医学杂志, 2015, 31(7):1123-1125.
[17]	洪琼. 25羟基维生素D与类风湿关节炎及系统性红斑狼疮的相关性研究 [D]. 安徽, 安徽医科大学, 2013: 1-108.
[18]	Shoenfeld N, Amital H, Shoenfeld Y. The effect of melanism and vitamin D synjournal on the incidence of autoimmune disease [J]. Nat Clin Pract Rheumatol, 2009, 5(2):99-105. doi: 10.1038/ncprheum0989 pmid: 19182816
[19]	陈铭聿, 孙彬, 张波, 等. 狼疮肾炎患者血维生素D3水平与疾病活动度的相关性研究 [J]. 中华肾脏病杂志, 2015, 31(2):881-886.

Related Articles 11

[1]	Jia-yi TIAN,Xia ZHANG,Gong CHENG,Qing-hong LIU,Shi-yang WANG,Jing HE. Serum interleukin-2 receptor α as a clinical biomarker in patients with systemic lupus erythematosus [J]. Journal of Peking University (Health Sciences), 2021, 53(6): 1083-1087.
[2]	XIA Fang-fang,LU Fu-ai,LV Hui-min,YANG Guo-an,LIU Yuan. Clinical characteristics and related factors of systemic lupus erythematosus with interstitial pneumonia [J]. Journal of Peking University (Health Sciences), 2021, 53(2): 266-272.
[3]	Yan GENG,Bo-rui LI,Zhuo-li ZHANG. Musculoskeletal ultrasound findings of symptomatic joints in patients with systemic lupus erythematosus [J]. Journal of Peking University(Health Sciences), 2020, 52(1): 163-168.
[4]	Yu-hua WANG,Guo-hua ZHANG,Ling-ling ZHANG,Jun-li LUO,Lan GAO. Adrenal hemorrhage in a patient with systemic lupus erythematosus [J]. Journal of Peking University(Health Sciences), 2019, 51(6): 1178-1181.
[5]	Ying-ni LI,Xiao-hong XIANG,Jing ZHAO,Yun LI,Feng SUN,Hong-yan WANG,Ru-lin JIA,Fan-lei HU. Significance of anti-carbamylated fibrinogen antibodies in systemic lupus erythematosus [J]. Journal of Peking University(Health Sciences), 2019, 51(6): 1019-1024.
[6]	Ying WANG,Ming-hui LI,Yan ZHANG,Xiao-yan HU,Rui-xia MA. Relationship between podocyte injury and macrophage infiltration in renal tissues of patients with lupus nephritis [J]. Journal of Peking University(Health Sciences), 2019, 51(4): 723-727.
[7]	Fan YANG,Yun-shan ZHOU,Yuan JIA. Systemic lupus erythematosus with acquired hemophilia A: a case report [J]. Journal of Peking University(Health Sciences), 2018, 50(6): 1108-1111.
[8]	Shuang LIU,Yu-long GUO,Jing-yi YANG,Wei WANG,Jian XU. Efficacy of mesenchymal stem cells on systemic lupus erythematosus:a meta-analysis [J]. Journal of Peking University(Health Sciences), 2018, 50(6): 1014-1021.
[9]	Xiao-hui ZHANG,Xue-rong DENG,Fan Li,Ying ZHU,Zhuo-li ZHANG. Posterior reversible encephalopathy syndrome in systemic lupus erythematosus: a case report [J]. Journal of Peking University(Health Sciences), 2018, 50(6): 1102-1107.
[10]	GUO Xiao-yue, SHAO Hui, ZHAO Yang-yu. A case of systemic lupus erythematosus in pregnancy complicated by pulmonary hypertension [J]. Journal of Peking University(Health Sciences), 2018, 50(5): 928-931.
[11]	CHEN Xiao-mei, LI Jing, ZHANG Xiao-ying, JIN Yue-bo, YU Di, SUN Xiao-lin,WU Li-jun, HE Jing, LI Zhan-guo. Significance of different T follicular helper subsets in rheumatoid arthritis [J]. Journal of Peking University(Health Sciences), 2016, 48(6): 958-963.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed

Comments

Recommended 10

[1]	. [J]. Journal of Peking University(Health Sciences), 2009, 41(4): 456 -458 .
[2]	. [J]. Journal of Peking University(Health Sciences), 2009, 41(2): 125 -128 .
[3]	. [J]. Journal of Peking University(Health Sciences), 2009, 41(2): 135 -140 .
[4]	. [J]. Journal of Peking University(Health Sciences), 2009, 41(2): 217 -220 .
[5]	. [J]. Journal of Peking University(Health Sciences), 2009, 41(1): 52 -55 .
[6]	. [J]. Journal of Peking University(Health Sciences), 2009, 41(1): 109 -111 .
[7]	. [J]. Journal of Peking University(Health Sciences), 2009, 41(3): 297 -301 .
[8]	. [J]. Journal of Peking University(Health Sciences), 2009, 41(5): 599 -601 .
[9]	. [J]. Journal of Peking University(Health Sciences), 2009, 41(5): 516 -520 .
[10]	. [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 304 -309 .

Relationship of serum 25- hydroxy vitamin D and systemic lupus erythematosus

RICH HTML

PDF (PC)