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Rheumatology Advance Access originally published online on April 14, 2008
Rheumatology 2008 47(6):920-923; doi:10.1093/rheumatology/ken121
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Vitamin D deficiency in systemic lupus erythematosus: prevalence, predictors and clinical consequences

G. Ruiz-Irastorza, M. V. Egurbide, N. Olivares, A. Martinez-Berriotxoa and C. Aguirre

Department of Internal Medicine, Hospital de Cruces, University of the Basque Country, Bizkaia, Spain.

Correspondence to: G. Ruiz-Irastorza, Servicio de Medicina Interna, Hospital de Cruces, 48903-Bizkaia, Spain. E-mail: r.irastorza{at}euskalnet.net; r.irastorza{at}hcru.osakidetza.net


  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.

KEY WORDS: Calcidiol, Calcitriol, Cholecalciferol, Hydroxychloroquine, Damage, Prognosis, Systemic lupus erythematosus

Submitted 5 December 2007; revised version accepted 19 February 2008.
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