Osteoporosis International

, Volume 20, Issue 3, pp 427–433

Vitamin D deficiency in patients with active systemic lupus erythematosus

  • V. Z. C. Borba
  • J. G. H. Vieira
  • T. Kasamatsu
  • S. C. Radominski
  • E. I. Sato
  • M. Lazaretti-Castro
Original Article

DOI: 10.1007/s00198-008-0676-1

Cite this article as:
Borba, V.Z.C., Vieira, J.G.H., Kasamatsu, T. et al. Osteoporos Int (2009) 20: 427. doi:10.1007/s00198-008-0676-1

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.

Keywords

Bone markersBone metabolismCytokinesOsteoporosisSystemic lupus erythematosusVitamin D

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2008

Authors and Affiliations

  • V. Z. C. Borba
    • 1
    • 2
    • 4
  • J. G. H. Vieira
    • 1
  • T. Kasamatsu
    • 1
  • S. C. Radominski
    • 3
  • E. I. Sato
    • 5
  • M. Lazaretti-Castro
    • 1
  1. 1.Division of EndocrinologyUniversidade Federal de São PauloSão PauloBrazil
  2. 2.Division of EndocrinologyServiço de Endocrinologia da Universidade Federal do Paraná (SEMPR), Universidade Federal do ParanáCuritibaBrazil
  3. 3.Division of RheumatologyUniversidade Federal do ParanáCuritibaBrazil
  4. 4.CuritibaBrazil
  5. 5.Division of RheumatologyUniversidade Federal de São PauloSão PauloBrazil