AB0540 CAN LOW SERUM VITAMIN D LEVELS AFFECT THE COGNITIVE FUNCTION IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS?
Authors: Radka Moravcova, Marie Posmurova, Marta Olejárova
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is a chronic autoimmune disease involving various organs and systems including the nervous system. Neuropsychiatric SLE (NPSLE) occurs in 30 - 40% of SLE patients. One of the most common manifestations of NPSLE is cognitive dysfunction (CD) which is found in 20 - 80% of SLE patients. Epidemiological studies have reported vitamin D to be a potentional risk factor of cognitive impairment within the general population. There have also been found associations between vitamin D levels and CD in multiple disease states, such as Alzheimers's disease, multiple sclerosis and SLE. It is hypothesized that vitamin D contributes to neuroprotection by modulating the production of proinflammatory cytokines. Vitamin D deficiency is highly prevalent in SLE patients due to photoprotection, renal insufficiency and use of different medication. <h3>Objectives</h3> To establish a possible association between serum vitamin D levels and cognitive function in SLE patients. To determine the presence of certain auto-antibodies (anti-dsDNA, antinucleosomal, anti-P protein, and antiphospholipid) in the serum, and the disease activity. <h3>Methods</h3> We included a total number of 70 patients diagnosed with SLE according to the American College of Rheumatology (ACR) classification criteria. We assessed disease activity according to SLE Disease Activity Index (SLEDAI). CD was evaluated on the basis of psychological analysis of cognitive functions with testing of attention, memory, psychomotor speed, visual spatial skills and speed of cognitive information processing. Serum vitamin D levels were measured by standardized immunochemical assay from blood samples. <h3>Results</h3> We analyzed 70 patients, 64 (91.4%) women and 6 (8.6%) men. The cognitive dysfunction with moderate to severe disability was found in 43 (61.4%) patients. There was found the statistically significant difference between two groups (with and without CD) in serum levels of vitamin D, 54.01 nmol/l (±22.6) and 68.48 nmol/l (±27.1), resp. (p&lt;0.01). The average value of the activity index (SLEDAI) in group with CD was 8.49 (±8.4), vs 5.07 (±4.9) in group without CD (p&lt;0.01). Antiphospholipid antibodies were positive in 17 (39.5%) patients with CD and in 6 (22.2%) patients without CD (p&lt;0.05). The other antibodies were positive in almost 50% (anti-dsDNA, antinucleosomal), P protein only in 8.8% in group of patients with CD. <h3>Conclusion</h3> On the basis of obtained results it can be stated that cognitive dysfunction was present in a high number of SLE patients. We demonstrated a high frequency of vitamin D deficiency among SLE patients with CD and statistically significant lower levels of vitamin D than in patients without CD. These results suggest that low vitamin D level could be associated with impaired cognitive function. <h3>References</h3> [1] Hussein HA Daker LI, Fouad NA, et al. Does Vitamin D Deficiency Contribute to Cognitive Dysfunction in Patients with Systemic Lupus Erythematosus? Innov Clin Neurosci. 2018;15(9-10):25-29. [2] Balion C, Griffith LE, Strifler L, et al. Vitamin D, cognition, and dementia: a systematic review and meta-analysis. Neurology. 2012;79(13):1397-405. [3] Tay SH, Ho CS, Ho RC, et al. 25-Hydroxyvitamin D3 Deficiency Independently Predicts Cognitive Impairment in Patients with Systemic Lupus Erythematosus. PLoS One. 2015;10(12) <h3>Disclosure of Interests</h3> None declared