补充维生素D与系统性红斑狼疮患者的疾病活动性有关

María Correa-Rodríguez, G. Pocovi-Gerardino, Irene Medina-Martínez, Sara Del Olmo-Romero, N. Ortego-Centeno, B. Rueda-Medina
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摘要

系统性红斑狼疮(SLE)是一种以炎症反应和异常自身免疫性疾病为特征的慢性疾病。维生素D在磷钙代谢中是必需的,具有免疫抑制特性,被认为是一种治疗选择。关于这种维生素在SLE发病机制中的作用存在争议。因此,本研究的目的是研究膳食摄入维生素D及其补充对SLE患者队列的影响。对285例SLE患者进行了横断面研究(248名女性,26名男性;平均年龄46.99±12.89岁)。SLE疾病活动性指数(SLEDAI-2K)和SLICC/ACR损伤指数(SDI)分别用于评估疾病活动性和疾病相关损伤。c反应蛋白(CRP)水平;mg/dL),同型半胱氨酸(Hcy;mol/L)、抗双链DNA抗体(抗dsdna) (IU/mL)、补体C3 (mg/dL)、补体C4 (mg/dL)等生化指标的测定。通过24小时患者日记获取膳食维生素D摄入量和维生素D补充剂摄入量。有57.1%的患者服用维生素D补充剂,膳食维生素D平均为2.08±2.94 μ g/ D。注意98.2%的患者没有达到推荐的维生素D摄入量。多变量回归分析显示,在调整了年龄、性别、能量摄入和药物治疗(免疫抑制剂、皮质类固醇和抗疟药)后,临床和实验室变量不受维生素D摄入水平的显著影响。校正协变量后,服用维生素D补充剂的SLE患者血清补体C3水平明显高于未服用的患者(110.28±30.93∶107.38±24.18;P = 0.018)。我们的研究结果表明补充维生素D对SLE的活性有潜在的影响。未来对SLE患者的纵向研究,包括干预试验,需要验证这些初步数据。
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Vitamin D supplementation is association with disease activity in systemic lupus erythematosus patients
: Systemic lupus erythematosus (SLE) is a chronic disease characterized by inflammatory response and abnormal autoimmune disease. Vitamin D is essential in phosphorus-calcium metabolism, has immunosuppressive properties, and is considered a therapeutic option. Controversy exists about the role of this vitamin in the pathogenesis of SLE. Thus, the aim of this study was to investigate the influence of the dietary intake of vitamin D and its supplementation in a cohort of patients with SLE. A cross-sectional study including a total 285 patients with SLE was conducted (248 females and 26 males; mean age 46.99 ± 12.89 years). The SLE disease activity index (SLEDAI-2K) and the SLICC/ACR damage index (SDI) were used to assess disease activity and disease-related damage, respectively. Levels of C-reactive protein (CRP; mg/dL), homocysteine (Hcy; mol/L), anti-double stranded DNA antibodies (anti-dsDNA) (IU/mL), complement C3 (mg/dL), and complement C4 (mg/dL), among other biochemical markers, were measured. The dietary intake of vitamin D and the intake of vitamin D supplement were obtained via a 24-h patient diary. A share of 57.1% of the patients took vitamin D supplements and the average of dietary vitamin D was 2.08 ± 2.94 μ g/day. Note that 98.2% of patients did not reach the recommended dietary intakes for vitamin D intake. Multivariate regression analysis revealed that clinical and laboratory variables are not significantly affected by vitamin D intake levels after adjusting for age, gender, energy intake, and medical treatment (immunosuppressants, corticosteroids, and antimalarials). Patients with SLE who took vitamin D supplements had significantly higher serum complement C3 levels compared to patients who did not take them after adjusting for covariates (110.28 ± 30.93 vs. 107.38 ± 24.18; p = 0.018). Our findings suggest a potential impact of supplementation of vitamin D on the activity of SLE. Future longitudinal research on SLE patients, including intervention trials, are required to validate these preliminary data.
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