Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Rheumatology and Rehabilitation

Objectives: To determine the 25-OHD3 levels and status and their relationship with disease manifestations and therapy in systemic lupus erythematosus (SLE) patients. Methods: Sixty premenopausal SLE women (mean age 30.58±8.36 years, mean disease duration 71.23±63.16 months) were compared to 30 healthy controls. The serum concentration 25-OHD3 was determined by ELISA (Deficiency < 20 ng/ml, insufficiency 21{u2013} 29 ng/ml). Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry (DXA). Disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Results: 25-OHD3 was significantly lower in patients than in controls (p<0.0001), with 77% and 17% being deficient and insufficient, respectively. BMD status was significantly worse in SLE patients compared to the BMD of controls in both spine (p value < 0.001), femur (p value <0.001). We found a significant negative correlation were found between 25-OHD3 level and both spine and femur BMD (p value 0.005, 0.006 respectively). We found a significant negative correlation between 25-OHD3 level and SLEDAI score (p value 0.004), renal affection (p value 0.002), 24 hour urinary proteins (p value 0.01), anti ds-DNA (p value of 0.002), ESR (p value 0.037), both cumulative and current steroid doses (p value 0.036, 0.021 respectively). Conclusion: low vitamin D status is prevalent in SLE patients and is significantly correlated with worse BMD status, disease activity, renal affection, and cumulative and current steroid doses

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