Association between Serum Vitamin D Level and Clinical Manifestations of Systemic Lupus Erythematous Patients in Dr. Sardjito General Hospital
Anggi Wahyu Nugroho(1*), Ayu Paramaiswari(2), Deddy Nur Wachid Achadiono(3)
(1) 
(2) 
(3) 
(*) Corresponding Author
Abstract
Background. Vitamin D played a role in the pathogenesis of systemic lupus erythematosus (SLE). Vitamin D made dendritic cells more tolerogenic to autoantigens and inhibited B cells from producing autoantibodies. Vitamin D deficiency would make dendritic cells intolerant, increased production of interferons, and B cells produce excessive autoantibodies. These excessive autoantibodies and interferons would have caused severe clinical manifestations in SLE patients.
Aims. This study was to find out vitamin D deficiency would increase the proportion of severe clinical manifestations in SLE patients in the Dr. Sardjito General Hospital.
Methods. We conducted a cross-sectional study. Data was taken from medical records of SLE patients who went to Dr. Sardjito General Hospital in 2018. The independent variable was serum 25(OH) D levels, which were divided into deficiency (≤12 ng/ml) and not deficiency (>12ng/ml). The dependent variable was the clinical manifestations of SLE patients, which were divided into mild-moderate and severe. Association between two variables was analyzed using Chi-Square.
Results. Vitamin D deficiency was observed in 19(54%) and not deficiency in 16(46%) subjects. SLE patients who underwent vitamin D deficiency more often experienced severe clinical manifestations than those without (52.6% versus 12.5%), prevalence ratio 4.2 CI 1.1-16.5 p=0.015. SLE patients who underwent vitamin D deficiency were more likely to suffer mucocutan, musculoskeletal, and kidney disorders. Also more likely to suffer more than 2 organ disorders than those without (57.9% versus 12.5%), prevalence
ratio 4.6 CI 1.2-17.9 p=0.007.
Conclusions. Vitamin D deficiency increased the proportion of severe clinical manifestations in SLE patients at Dr. Sardjito General Hospital. It also increased the proportion of mucocutan disorder, musculoskeletal disorder, and kidney disorder. Also, it increased the proportion of occurrence of more than 2 organ disorders in SLE patients at Dr. Sardjito General Hospital.
Keywords
Full Text:
PDFReferences
Miskovic, R., Plavsic, A., Raskovic, S., Jovicic, Z., Bolpacic, J. Vitamin D status in patients with systemic lupus erythematosus in Serbia: correlation with disease activity and clinical manifestations. Open access Macedonian journal of medical sciences. 2015; 3(2), 256. 2. Iruretagoyena, M., Hirigoyen, D., Naves, R., Burgos, P. I. Immune response modulation by vitamin D: role in systemic lupus erythematosus. Frontiers in immunology. 2015; 6, 513. 3. Kasjmir, Y.I., Handono, K., Wijaya, L.K., Hamijoyo, L., Labar, Z. Diagnosis dan Pengelolaan Lupus Eritematosus Sistemik. Interna Publishing. 2014; 3360-77. 4. Dall'Ara, F., Cutolo, M., Andreoli, L., Tincani, A., Paolino, S. Vitamin D and systemic lupus erythematous: a review of immunological and clinical aspects. Clinical and Experimental Rheumatology. 2017;36(1), 153-162. 5. Pons-Estel, G. J., Ugarte-Gil, M. F., Alarcón, G. S. Epidemiology of systemic lupus erythematosus. Expert review of clinical immunology. 2017; 13(8), 799-814 6. Saulescu, I., Belinski, D. O., Borangiu, A., Groseanu, L., Daia-Iliescu, S., Mazilu, D., Constantinescu, C. 2018. AB0519 Impact of higher body mass index (BMI) in patients with systemic lupus erythematosus. 2018 7. Teke, H. Ü., Cansu, D. Ü.,Korkmaz, C. Detailed features of hematological involvement and medication-induced cytopenia in systemic lupus erythematosus patients: single center results of 221 patients. European journal of rheumatology.2017; 4(2), 87. 8. Gaik, O. S., Jen, D. H. Vitamin D status in a monocentric cohort of systemic lupus erythematosus (SLE) patients and correlations with clinical and immunological profile. Med J Malaysia. 2019; 74(6), 493. 9. Handono, K., Puspitasari, L., Rudijanto, A.,Wahono, S., Kalim, H. Vitamin D serum level and disease activity in patients with systemic lupus erythematosus. International Journal of Pharmaceutical Science Invention.2013; 2(2), 35-40. 10. Mahmoud, K., Zayat, A., Vital, E. M. Musculoskeletal manifestations of systemic lupus erythmatosus. Current opinion in rheumatology. 2017; 29(5), 486-492. 11. Teke, H. Ü., Cansu, D. Ü.,Korkmaz, C. Detailed features of hematological involvement and medication-induced cytopenia in systemic lupus erythematosus patients: single center results of 221 patients. European journal of rheumatology. 2017; 4(2), 87. 12. Yu, Q., Qiao, Y., Liu, D., Liu, F., Gao, C., Duan, J., Cui, S. Vitamin D protects podocytes from autoantibodies induced injury in lupus nephritis by reducing aberrant autophagy. Arthritis research & therapy. 2019; 21(1), 19. 13. Kang, J. H., Lee, S. S., Choi, S. E., Xu, H., Park, D. J. Obesity Increases The Incidence of New Onset Lupus Nephr itis and Organ Damage During Follow Up in Patients with Systemic Lupus Erythematosus. Sagepub. 2020;0(0)1-9.
DOI: https://doi.org/10.22146/actainterna.62844
Article Metrics
Abstract views : 2377 | views : 1353Refbacks
- There are currently no refbacks.
Copyright (c) 2021 Acta Interna: The Journal of Internal Medicine
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Acta Interna The Journal of Internal Medicine Indexed by:
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.