ESPE2014 Poster Category 2 Bone (1) (12 abstracts)
Vitamin D Levels in Children, Adolescents, and Young Adults with Juvenile onset Systemic Lupus Erythematosus: a Cross-sectional Study
Stefano Stagi a , Laura Capirchio a , Federico Bertini b , Camilla Menchini a , Perla Scalini a , Salvatore Seminara a , Maurizio de Martino a & Fernanda Falcini b
aHealth Science Department, University of Florence, Anna Meyer Children’s University Hospital, Florence, Italy; bDepartment of Biomedicine, Section of Rheumatology, Transition Clinic, University of Florence, Florence, Italy
Background: Hypovitaminosis D is common in the general population. Although many studies on 25-hydroxyvitamin D (25(OH)D) are available on systemic lupus erythematosus (SLE), little data is present in juvenile onset SLE (JSLE) patients.
Objective and hypotheses: This study aimed to assess serum 25(OH)D levels in JSLE patients and to identify risk factors for vitamin D deficiency in this population.
Method: Forty-five consecutive Caucasian patients (36 females and nine males, mean age 18.9±6.3 years) with JSLE that was consistent with the American College of Rheumatology criteria entered the study Caucasian JSLE patients (36 females, 9 males; mean age 18.9±6.3 years). For every patient dual energy X-ray absorptiometry scans of the lumbar spine, serum calcium and phosphate, bone-specific alkaline phosphatase (BSAP), parathyroid hormone, and 25(OH)D were assessed. The data were compared with an age- and sex-matched control group including 109 healthy age- and sex-matched Caucasian subjects (81 females, 28 males; mean age 17.7±7.4 years) who were seen for non-inflammatory musculoskeletal complaints.
Results: Levels below the recommended 25(OH)D values were found in the 84.4% of the JSLE patients, comparable to that of controls (80.2%). Nevertheless, JSLE patients exhibited lower 25(OH)D levels than controls (P<0.005), with lower values observed in patients with active vs inactive disease (P<0.05). JSLE patients exhibited reduced total calcium levels (P<0.001) and higher phosphate levels (P<0.001), BSAP (P<0.001) and PTH (P<0.001) than controls. In addition, JSLE patients exhibited lower spine bone mineral apparent density SDS values than controls (P<0.001), with higher values in patients with 25(OH)D sufficiency and insufficiency than those with 25(OH)D deficiency (P<0.001).
Conclusion: Patients with JSLE have significantly lower 25(OH)D levels than controls. Therefore, supplementation with vitamin D may be a useful approach for promoting the normalization of bone mass and quality in subjects with JSLE.
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