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Vol. 13. Issue 2.
Pages 97-101 (March - April 2017)
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Vol. 13. Issue 2.
Pages 97-101 (March - April 2017)
Original Article
DOI: 10.1016/j.reumae.2016.02.013
Vitamin D Insufficiency and Deficiency in Mexican Patients With Systemic Lupus Erythematosus: Prevalence and Relationship With Disease Activity
Insuficiencia y deficiencia de vitamina D en pacientes mexicanas con lupus eritematoso sistémico: prevalencia y relación con actividad de la enfermedad
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Mario García-Carrascoa,b,
Corresponding author
, Claudia Mendoza-Pintoa,b, Ivet Etchegaray-Moralesa, Pamela Soto-Santillána, Erick Alejandro Jiménez-Herreraa, Viridiana Robles-Sáncheza, Alma Rodríguez-Gallegosc, Araceli Ramos-Varelaa, Margarita Muñoz-Guarnerosd, Alejandro Ruiz-Argüellesc,e
a Unidad de Investigación de Enfermedades Autoinmunes Sistémicas, Hospital General Regional N.° 36, Instituto Mexicano del Seguro Social, Puebla, Mexico
b Departamento de Reumatología e Inmunología, Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
c Laboratorios Clínicos de Puebla, Puebla, Mexico
d Secretaría de Estudios de Posgrado e Investigación, Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
e Universidad de las Américas Puebla, Puebla, Mexico
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Tables (3)
Table 1. Demographic, Clinical and Therapeutic Characteristics of 137 Women With Systemic Lupus Erythematosus.
Table 2. Comparison of Patients With Systemic Lupus Erythematosus With Normal Vitamin D Versus Vitamin D Insufficiency (Low Levels).
Table 3. Summary of Recent Studies on the Prevalence of Vitamin D Insufficiency and Deficiency in Patients With Systemic Lupus Erythematosus.
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Abstract
Objectives

To determine and compare the prevalence of vitamin D insufficiency and deficiency in patients with systemic lupus erythematosus (SLE) with and without disease activity.

Patients and methods

We made a comparative, observational, cross-sectional, prospective study of 137 women with SLE according to American College of Rheumatology criteria. Patients with chronic kidney disease, cancer, hyperparathyroidism, pregnancy, and lactation were excluded. Disease activity was assessed using the MEX-SLEDAI score: a score of ≥3 was considered as disease activity. Data were collected on diabetes mellitus, the use of corticosteroids, chloroquine, and immunosuppressants, photoprotection and vitamin D supplementation. Vitamin D levels were measured by chemiluminescent immunoassay: insufficiency was defined as serum 25-hydroxyvitamin D <30ng/mL and deficiency as <10ng/mL.

Results

137 women with SLE (mean age 45.9±11.6 years, disease duration 7.7±3.4 years) were evaluated. Mean disease activity was 2 (0–8): 106 patients had no disease activity and 31 had active disease (77.4% versus 22.6%). Vitamin D insufficiency and deficiency was found in 122 (89.0%) and 4 (2.9%) patients, respectively. There was no significant difference in vitamin D levels between patients with and without active disease (19.3±4.5 versus 19.7±6.8; P=.75). No correlation between the MEX-SLEDAI score (P=.21), photosensitivity, photoprotection, prednisone or chloroquine use and vitamin D supplementation was found.

Conclusions

Women with SLE had a high prevalence of vitamin D insufficient. No association between vitamin D levels and disease activity was found.

Keywords:
Systemic lupus erythematosus
Vitamin D
Insufficiency
Deficiency
Resumen
Objetivos

Determinar la prevalencia de insuficiencia y deficiencia de vitamina D en pacientes con lupus eritematoso sistémico (LES) y compararlas con actividad de la enfermedad.

Pacientes y métodos

Estudio comparativo, observacional, transversal y prolectivo. Se incluyeron 137mujeres con LES según los criterios del Colegio Americano de Reumatología. Se excluyeron pacientes con enfermedad renal crónica, cáncer, hiperparatiroidismo, embarazo y lactancia. La actividad fue medida mediante el índice MEX-SLEDAI, considerando actividad ≥3. Se obtuvieron los siguientes datos: diabetes mellitus, uso de glucocorticoides, cloroquina e inmunosupresores, fotoprotección y suplementación con vitamina D. Los niveles de vitamina D se midieron con inmunoanálisis quimioluminiscente considerando insuficiencia a niveles séricos de 25-hidroxivitamina D<30ng/ml y deficiencia<10ng/ml.

Resultados

Se evaluaron 137mujeres con LES (edad promedio 45,9±11,6años, duración de la enfermedad 7,7±3,4 años). La mediana de actividad mediante MEX-SLEDAI fue 2 (0-8),106pacientes en inactividad y 31 con actividad (77,4% versus 22,6%). La insuficiencia y deficiencia de vitamina D se encontró en 122 (89,0%) y 4 (2,9%) pacientes respectivamente. Al comparar los niveles de vitamina D entre pacientes con y sin actividad no existieron diferencias estadísticamente significativas (19,3±4,5 versus 19,7±6,8; p=0,75); tampoco se encontró una correlación con el puntaje MEX-SLEDAI (p=0,21) ni fotosensibilidad, fotoprotección, uso de prednisona, cloroquina ni suplementación con vitamina D.

Conclusiones

Las mujeres con LES presentaron elevada prevalencia de insuficiencia de vitamina D. No se encontró asociación de niveles de vitamina D con actividad de la enfermedad.

Palabras clave:
Lupus eritematoso sistémico
Vitamina D
Insuficiencia
Deficiencia

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