ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2257

Association of Low Vitamin D with High Disease Activity in an Australian Systemic Lupus Erythematosus Cohort

Kristy S. Yap1, Alberta Y. Hoi2 and Eric F. Morand2, 1Rheumatology, Monash Medical Centre, Clayton, Australia, 2Centre for Inflammatory Diseases, Monash University, Melbourne, Australia

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Systemic Lupus Erythematosus: Clinical Aspects

Session Type: Abstract Submissions (ACR)

Background/Purpose: Previous cross-sectional studies suggest that low vitamin D may be associated with higher disease activity in SLE. Vitamin D status varies with geographic location and no studies have been reported in the Southern hemisphere. The aim of this study was to determine the relationship between Vitamin D and disease activity in SLE patients in an Australian centre.

Methods: Data was collected prospectively on patients with SLE (>4 criteria) in the Monash Lupus Clinic in Melbourne Australia between January 1 2008 and January 1 2011 who had disease activity (SLEDAI-2k) and serum 25-hydroxyvitamin D concentration (VD25) measured at the same visit. Where multiple values were available, the assessment with lowest VD25 was used (n=119). 

Results: Patients with VD25 in the lowest quartile had significantly higher SLEDAI (7.7±1.3) compared to those in the highest quartile (3.9±0.8, p=0.014). Accordingly, VD25 deficiency (VD25 ≤40, n=28) was associated with significantly increased SLEDAI (7.7±1.3) compared to patients with VD25 >40 (4.8±0.6, P=0.02). The relative risk of high disease activity (SLEDAI>8) for patients with VD25 deficiency was 1.6 (95% CI 1.1–2.2, P=0.002). In parallel, high disease activity was associated with significantly lower VD25 compared to patients with SLEDAI<8 (P= 0.048) or patients with inactive disease (SLEDAI<4, P=0.0073). When assessing all values, a significant negative correlation between SLEDAI and VD25 was observed (Spearman r =0.2, p =0.03). There was no association of VD25 with corticosteroid use, SLICC SLE Damage Index (SDI), or ethnicity.Vitamin D supplement use (n=53) was significantly more common among patients using corticosteroids (P=0.0001) and was associated with significantly higher VD25 (P=0.009). However, there was no association between Vitamin D supplementation and SLEDAI.

Conclusion: In a cohort of Australian patients with SLE, Vitamin D correlates negatively with disease activity. Prospective studies should examine the predictive value of Vitamin D levels and therapeutic effect of Vitamin D.

Disclosure:

K. S. Yap,
None;

A. Y. Hoi,
None;

E. F. Morand,
None.

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