AB1090 VITAMIN D LEVEL IN FEMALE PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND ITS ASSOCIATION WITH THE DISEASE COURSE
Authors: S. Shevchuk, T. Malovana, L. Marynych, I. Kuvikova
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The results of the conducted studies suggest that vitamin D insufficiency and deficiency is observed in 2/3 and in every 5 systemic lupus erythematosus (SLE) patients, respectively. In recent years, both <i>in vitro</i> and <i>in vivo</i> studies have demonstrated an immunological basis of potentially beneficial vitamin D effects in SLE patients. The effect of vitamin D on the specific immune response is realized due to suppression of T-cell proliferation and switching of T-helper phenotypes, a decrease of the Th 1 immune response, inhibition of the production of type 1 (pro-inflammatory) cytokines, an increase of the synthesis of type 2 (anti-inflammatory) cytokines, a decrease in the proliferation and differentiation of B-lymphocytes, and an inhibition of autoantibody production. Thus, it becomes evident that vitamin D is capable of regulating at least some immune responses, acting primarily as anti-inflammatory agent. However, the relationship between vitamin D level and SLE severity and activity remains controversial and needs further study. <h3>Objectives:</h3> To determine vitamin D levels in SLE female patients and evaluate their association with the disease course. <h3>Methods:</h3> The main group consisted of 90 female patients with SLE, whose average age was 45.28±1.06 years. 52 (57.8%) of these patients were of reproductive age, while the rest were postmenopausal women. The mean disease duration was 12.88±0.99 years. The control group consisted of 29 apparently healthy persons. The vitamin D levels were measured using the immunoenzymatic method and graded as optimal (30–100 ng/ml), insufficient (20–29 ng/ml) and deficient (&lt;20 ng/ml) ones. The SLEDAI was used to determine the disease activity in the group of SLE patients. The SLICC/ACR DI was used to assess the severity of organ damage. The study subjects were also tested for ESR, CRP, and pro-inflammatory cytokine IL-6. <h3>Results:</h3> Vitamin D level was 18.30±0.92 ng/ml and 27.2±1.3 ng/ml in SLE female patients and in the control group, respectively. In the main group, only 6 (6.7%) study subjects had the optimal vitamin D level. The vitamin D insufficiency and vitamin D deficiency had 25 (27.8%) and 59 (65.6%) female SLE patients, accordingly. In the control group, the optimal vitamin D level was registered in 10 (34.5%) people, while another 10 (34.5%) and 9 (31%) persons had vitamin D insufficiency and deficiency, respectively. The patients with an optimal vitamin D level had CRP, IL-6 and ESR readings equal to 7.5±0.38 mg/l, 13.32±1.44 pg/ml and 11.0±2.24 mm/h, respectively; in other words, were lower by 23.2%, 11.1% and 51.4% than in patients with vitamin D insufficiency. The average inflammatory laboratory markers in the group of patients with vitamin D deficiency were 36.5%, 22.9 % and 56.6% higher than in the group of patients which had the optimal vitamin D level, respectively. Similar patterns were also found when assessing the association between the vitamin D concentration, SLEDAI and SLICC/ACR DI. The average indices in SLE female patients with vitamin D deficiency were 16.08±0.78 and 4.05±0.28. At the same time, patients with optimal supply of vitamin D had these indicators 39.9% and 25.9% lower, respectively. <h3>Conclusion:</h3> Hypovitaminosis D is a widespread condition in the Ukrainian population of SLE female patients, associated with high inflammatory activity (SLEDAI, ESR, CRP, IL-6) and organ damage severity (SLICC/ACR DI). <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>