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- Title
STATUSUL VITAMINEI D ŞI CORELAȚII CLINICO-BIOLOGICE LA UN LOT DE PACIENȚI CU SCLEROZĂ SISTEMICĂ.
- Authors
Groseanu, Laura; Berghea, Florian; Bălănescu, Andra; Predețeanu, Denisa; Bojincă, Violeta; Săulescu, Ioana; Constantinescu, Cosmin; Opriş, Daniela; Abobului, Mihai; Borangiu, Andreea; Negru, Maria-Magdalena; Vlad, Violeta; Ionescu, Ruxandra
- Abstract
Background. Epidemiological evidence indicates a significant association between vitamin D deficiency and an increased incidence of several autoimmune diseases. Low vitamin D levels have also been reported in patients with systemic sclerosis (SSc), but the number of studies is limited with conflicting data. Objective. To investigate vitamin D status in a group of systemic sclerosis (SSc) patients and establish connections with markers of SSc disease activity and severity score, clinical and immunologic features Material. 51 scleroderma patients were evaluated during JAN 2010 - JAN 2013 in Internal Medicine and Rheumatology Department of Sf. Maria Hospital, Bucharest, Romania. We performed a complete evaluation of all patients following: MEDS evaluation sheets (cutaneous, musculoarticular, gastrointestinal, cardiac, pulmonary or renal involvement; inflammatory markers, autoantibodies, complement, capilaroscopy), DXA evaluation of osteoporosis, disease activity was evaluated with the Disease Activity Score (DAS) according to the European Scleroderma Study Group guidelines, HAQ (Health assessment questionnaires) have been also completed. Vitamin D was measured with the RIA Diasorin kit or expressed as "RIA Diasorin equivalent". Results: 92,15% of all patients were women, 50,98% had diffuse skin involvement, mean age 55,65 (SD 12,45) years, medium disease duration 11,7 years (SD 6,9), mean Rodnan 9,59 (SD 5,9), mean activity score = 3,43 (2,14), mean Medsger6,8. (SD 3,15), mean HAQ 0,8 (SD0,6). Mean vitamin D was 17,06 ng/ml (SD9,13). Only 4 patients had optimal levels of 25(OH)2 D; most of the patients had an insufficient (68,62%) or deficient (23,52%) level. Although levels below normal were found in most of the patients significant correlations of vitamin d status were found only muscle weakness (p = 0,000), muscle atrophy (p = 0,02), gastrointestinal involvement (p = 0,005) and the use of immunosuppressive drugs (p = 0,02).Pulmonary fibrosis seems to be more frecquent in patients with insufficient levels no matter of disease subtype (p = 0,03). Other correlations found for the patients with insufficiency were with anticentromere antibodies (p = 0,04), scleroderma renala crisis for female (p = 0,003) with long disease duration (p = 0,004), hipocomplementemia (p = 0,03) in the diffuse subtype, activity scale for females (p = 0,02). In patients with long disease duration correlations were found with TLCO (p = 0,04), Medsger score (p = 0,04). In patients with short disease duration correlations were found with activity score Conclusions. Vitamin D deficiency and insufficiency were no mather of subtype, disease duration, visceral involvement and vitamin D supplementation. This suggests that common vitamin D supplementation does not correct the deficiency in SSc patients, and that a higher dose is probably needed. We are aware of the limitations of the study that are: small group, lack of control group and the fact that measurements of vitamin D were not done in the same period of the year. Given the most recent findings, we consider further research would be clinically important to elucidate the causes of hypovitaminosis D in SSc, its relevance to disease progression, its influence on immune functions and the potential effects of supplementation.
- Subjects
VITAMIN D; SYSTEMIC scleroderma; EPIDEMIOLOGICAL research; IMMUNOGLOBULINS; AUTOIMMUNITY
- Publication
Romanian Journal of Rheumatology / Revista Romana de Reumatologie, 2013, Vol 22, Issue 2, p84
- ISSN
1843-0791
- Publication type
Article