Vitamin D linked to disease activity in lupus

Thursday, 30 Apr 2015

Low vitamin D levels are associated with higher disease activity in people with lupus, reports the first study of its kind in the Southern hemisphere.

And an increase in serum vitamin D was associated with reduced disease activity over time, reported the rheumatologists from Monash Lupus clinic in Melbourne.

The prospective study of 119 consecutive patients attending the clinic found over a quarter of patients (28%) had vitamin D deficiency (<40 nmol/L) at baseline and 45% were taking vitamin  D supplements.

In the longitudinal follow-up, univariable analysis showed significant associations of vitamin D with subsequent increases in SLEDAI-2K or high disease activity (SLEDAI-2K >10), each with ORs greater than 3, the study authors reported in Lupus Science & Medicine.

However the predictive effect of low vitamin D on subsequent disease activity did not remain significant after adjustment for vitamin D supplementation, glucocorticoid use and immunosuppressive use, suggesting that the variables should be controlled for in future studies, the researchers said.

In multiple regression analysis they found a significant inverse correlation of SLEDAI-2K with baseline vitamin D concentration and with vitamin D supplementation.

“Importantly, there was a significant association between low vitamin D (<40 nmol/L) at a prior time point and a rise in SLEDAI-2K (1 or more units) at a subsequent time point (univariable OR 3.3, 95% CI 1.5 to 7.7, p=0.005) or having high disease activity (SLEDAI-2K>10) at a subsequent time point (univariable OR 3.1, 95% CI 1.4 to 6.8, p=0.004),” they noted. 

Future studies should include randomised trials which focus on the clinical effect of vitamin D supplementation in SLE and should control for variables that could affect the analysis of benefit, they concluded.

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