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Serum vitamin D in Egyptian patients with systemic lupus erythematous and its association with lupus nephritis

Tamer omar El said, Basma A Nabih, Ahmed Elewa & Adel Shabana

Aim: To assess VD levels in serum of patients with LN in comparison with patients with extra-renal lupus and healthy controls, and to assess the relation between VD levels and the various clinical and laboratory disease parameters.

Subjects and Methods: Serum levels of 25(OH)D in 30 SLE without LN (SLE/noLN), 30 SLE with LN (SLE/LN), and 30 matched controls were assessed and estimated for deficiency and insufficiency at 10 and 30 ng/mL, respectively. SLE-related clinical and biochemical data were collected and the disease activity score for all patients was calculated. The association of serum VD with SLE-related features was evaluated Results - VD deficiency and insufficiency are more prevalent in SLE/LN patients (26.7% and 66.7%, respectively) than in SLE/noLN (20% and 63.3% respectively) and then in controls (13.3% and 43.3% respectively) (p=0.013). Serum VD levels were inversely correlated with the SLE-DAI score in SLE/LN patients (p=0.012) and in SLE/noLN (p=0.037). Low serum VD level is significantly associated with fatigue and photosensitivity in SLE/LN patients (p=0.002 and p=0.014 respectively) and in SLE/noLN patients (p=0.021 and p=0.044 respectively). In SLE/LN patients, low VD is associated with proteinuria and anti-dsDNA.

Conclusion: VD deficiency and insufficiency are prevalent in patients with SLE and is more prevalent in SLE/LN patients. Low serum VD is significantly correlated with higher disease activity and ESR. Low serum VD is significantly associated with presence of fatigue and photosensitivity. The strongest factors determining the serum VD level among the SLE patients was presence of LN and photosensitivity.