Clinical Rheumatology

, Volume 36, Issue 3, pp 583–590 | Cite as

Serum 25-OH vitamin D levels in systemic sclerosis: analysis of 140 patients and review of the literature

  • Dilia Giuggioli
  • M. Colaci
  • G. Cassone
  • P. Fallahi
  • F. Lumetti
  • A. Spinella
  • F. Campomori
  • A. Manfredi
  • C. U. Manzini
  • A. Antonelli
  • C. Ferri
Original Article


Hypovitaminosis D is increasingly reported in autoimmune diseases. We investigated the 25-OH-vitamin D (25-OH-vitD) levels in systemic sclerosis (SSc) patients, in correlation with disease’s features. We measured the 25-OH-vitD serum levels in 140 consecutive patients (F/M 126/15; mean age 61 ± 15.1 years), 91 without (group A) and 49 with (group B) 25-OH-cholecalciferol supplementation. Patients of group A invariably showed low 25-OH-vitD levels (9.8 ± 4.1 ng/ml vs. 26 ± 8.1 ng/ml of group B); in particular, 88/91 (97%) patients showed vitamin D deficiency (<20 ng/ml), with very low vitamin D levels (<10 ng/ml) in 40 (44%) subjects. Only 15/49 (30.6%) patients of group B reached normal levels of 25-OH-vitD (≥30 ng/ml), whereas vitamin D deficiency persisted in 12/49 (24.5%) individuals. Parathormone levels inversely correlated with 25-OH-vitD (r = −0.3, p < 0.0001). Of interest, hypovitaminosis D was statistically associated with autoimmune thyroiditis (p = 0.008), while calcinosis was more frequently observed in patients of group A (p = 0.057). Moreover, we found significantly higher percentage of serum anticentromere antibodies in group B patients with 25-OH-vitD level ≥30 ng/ml (8/15 vs. 6/34; p = 0.017). In literature, hypovitaminosis D is very frequent in SSc patients. An association with disease duration, calcinosis, or severity of pulmonary involvement was occasionally recognized. Hypovitaminosis D is very frequent in SSc and severe in a relevant percentage of patients; furthermore, less than one third of supplemented subjects reached normal levels of 25-OH-vitD. The evaluation of 25-OH-vitD levels should be included in the routine clinical work-up of SSc. The above findings expand previous observations and may stimulate further investigations.


Autoimmunity Hypovitaminosis D Scleroderma Systemic sclerosis Vitamin D 


Compliance with ethical standards

The study was approved by the local Ethical Committee (protocol n. 282/15); moreover, all patients gave their written consents.




No funding was received for this study.


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Copyright information

© International League of Associations for Rheumatology (ILAR) 2017

Authors and Affiliations

  • Dilia Giuggioli
    • 1
  • M. Colaci
    • 1
  • G. Cassone
    • 1
  • P. Fallahi
    • 1
    • 2
  • F. Lumetti
    • 1
  • A. Spinella
    • 1
  • F. Campomori
    • 1
  • A. Manfredi
    • 1
  • C. U. Manzini
    • 1
  • A. Antonelli
    • 1
    • 2
  • C. Ferri
    • 1
  1. 1.Rheumatology Unit, Department of Internal MedicineUniversity of Modena and Reggio EmiliaModenaItaly
  2. 2.Department of Clinical and Experimental MedicinePisaItaly

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