AB1142 Vitamin d levels and association with disease activity in paraguayan sle patients
Authors: L Román, G Avila Pedretti, ME Acosta, M Melo, MT Martinez, D Margarita, I Acosta Colman
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Systemic Lupus Erythematosus (SLE) is a systemic inflammatory disease associated with genetic, environmental, hormonal and immunological factors. Vitamin D levels are nowadays considered as one possible factor associated with disease activity. Therefore, previous studies have analyzed vitamin D to the severity of SLE. <h3>Objectives</h3> To assess the Vitamin D status in paraguayan SLE patients and its association with disease activity. <h3>Methods</h3> An observational Trial has been performed on individuals diagnosed with SLE. Epidemiological, clinical and biochemical data have been recorded for each patient to study the association between vitamin D concentrations, the phospho-calcium metabolism parameters and disease activity. Quantitative determination of Vitamin D was perform using chemoluminescence ARCHITEC assay. Vitamin D status was interpreted as follows: deficiency ≤20 ng/ml and insufficiency 21–29 ng/ml. The statistical association tests were performed using linear (SLEDAI activity index) and logistic (Inactive/Mild vs Moderate/Severe) regressions. The epidemiological, clinical and biochemical variables were used as explanatory variables in these models.This study is a preliminary analysis of a trial supported by CONACYT (Paraguay) to investigate the role of vitamin D in patients diagnosed with SLE. <h3>Results</h3> We included 77 SLE patients, of whom 94.8% (73/77) were female. The average age of patients at the time of the study was 30.7±10.3 years. All patients received calcium supplements associated with vitamin D. The average vitamin D concentration was 32.2±12.10 ng /ml. 29.9% (23/77) of patients had vitamin D insufficiency and 13.0% had vitamin D deficiency. 94.8% (73/77) of the population had normal serum calcium and the total population had a normal phosphoremia. As for the dosage of PTH, it was found that 27.3% (21/77) have high values of PTH. 20.8% (16/77) of the patients had positive anti-DNA. Low C3 complement was observed in 30/77 (39%) and low C4 in 50/77 (64.9%) patients. The mean value of SLEDAI at the time of the study was 2.32±2.83. When we study the distribution of vitamin D concentration according to the disease activity (SLEDAI) a clear pattern is observed linking lower vitamin D concentrations with higher disease activity (Figure 1). Patients with lower vitamin D concentrations are more likely to have higher disease activity (OR 0.93, 95% CI 0.88–0.99;P-Value=0.059. The means and standard deviations of vitamin D depending on the SLEDAI activity index are provided in Table 1. <h3>Conclusions</h3> In this preliminary study of Paraguayan SLE patients, Vitamin D deficiency was frequent despite treatment with supplements. In addition, a clear association between SLEDAI and Vitamin D values was observed. The final analysis in a larger patient cohort will have to confirm these findings and clarify relation with disease activity. <h3>References</h3> Eloi M, Horvath DV, Ortega JC, Prado MS, Andrade LE, Szejnfeld VL, de Moura Castro CH. 25-Hydroxivitamin D Serum Concentration, Not Free and Bioavailable Vitamin D, Is Associated with Disease Activity in Systemic Lupus Erythematosus Patients. PLoS One. 2017 Jan 13;12(1). <h3>Disclosure of Interest</h3> None declared