| Objective: Systemic lupus erythematosus(SLE) is a kind of disease involving multiple organ function damage caused by autoimmune disorders. The etiology is unclear, gene, environment and other factors may be involved in the occurrence of diseases. Recently, researchers have said that vitamin D(Vit D) level in patients of SLE is lower, and Vit D is likely to be an immune regulator, playing a role in the pathogenesis of SLE. The reducing of Vit D may be associated with vitamin D antibodies(VD-Ab). However, the question about whether Vit D is associated with SLE is controversial. This study is to verify whether the level of 25-Hydroxyvitamin D3(25-(OH)D3) in patients of SLE is lower than that of the healthy control, study on correlation between the level of Vit D and laboratory indicators of SLE patients, such as blood routine,liver function, kidney function, blood lipids, immune series and anti-double-stranded DNA antibody(Anti-ds DNA), etc., analysis on the relationship among the level of 25-(OH)D3 and skin lesions, arthritis, serositis, kidney damage and hematological system diseases, discussing whether taken Vit D supplements can influence the levels of Vit D and disease activity in SLE patients, and learn the relationship between VD-Ab and SLE. Thus, the role of Vit D on the pathogenesis of SLE was discussed preliminary.Methods:1 Select 85 SLE patients in department of rheumatology of Tangshan Worker Hospital as the SLE group; while 58 cases of healthy volunteers as the control group. Centrifuge venous blood collecting in the morning, then sent it to Peking University Third Hospital to examine the level of 25-(OH)D3. The Enzyme-linked Immunosorbent Assay(ELISA) method was employed to detect the level of VD-Ab. The level of 25-(OH)D3 and VD-Ab are compared between SLE group and control group.2 Collect the laboratory and clinical data of SLE patients, consult patient whether is newly diagnosis and ever have taken Vit D and its analogs supplements, record of laboratory indexes, such as blood routine, liver function, renal function, blood lipids, ion, immune series, C-reactive protein(CRP), Erythrocyte sedimentation rate( ESR) and Anti ds DNA, etc., evaluate whether skin lesions, arthritis, serositis, kidney damage and hematological system diseases, etc., calculate the SLE Disease Activity score(SLEDAI).3 The SLE group is divided based on with or without Vit D treated, and compare the level of serum 25-(OH)D3; analysis the correlation between the level of serum 25-(OH)D3 and both laboratory indexes and SLEDAI; grouped by whether skin lesions, arthritis, serositis, kidney damage and hematological system diseases, then compare the level of serum 25-(OH)D3; analysis the correlation between VD-Ab and Anti ds DNA.4 Data analysis is done with SPSS 13.0 statistical software.Results:1 Compare the level of serum 25-(OH)D3 between SLE group and the control: there was 85 cases in SLE group, the mean level of 25-(OH)D3 was 10.69 ± 5.69ng/ml; and 58 cases in control group, the mean level of 25-(OH)D3 was 13.44±5.26ng/ml, the level of serum 25-(OH)D3 of SLE group was lower than that of the control group, P= 0.004.2 Compare the level of serum 25-(OH)D3 between Vit D treated group and without Vit D treated group: the average level of serum 25-(OH)D3 of Vit D treated group was 11.16±5.33ng/ml, and without Vit D treated group was 10.39±5.93ng/ml, compare the level of serum 25-(OH)D3 between them, showed P>0.05, there was no statistically significant.3 The relationship between the level of serum 25-(OH)D3 and SLEDAI score: a significant negative correlation was demonstrated between the level of serum 25-(OH)D3 and SLEDAI score, r=-0.486,P=0.000; besides, there was negative relationships between 25-(OH)D3 and SLEDAI score of Vit D treated group and without Vit D treated group respectively, r=-0.452、P=0.008,r=-0.479、P=0.000.4 The relationship between the level of serum 25-(OH)D3 and common laboratory indicators of without Vit D treated SLE patients: a positive correlation was found between the levels of 25-(OH)D3 and red blood cells(RBC), hemoglobin(HGB), high-density lipoprotein cholesterol(HDL-C), calcium, cereal third transaminase(ALT), gamma-glutamyl transpeptidase(GGT) as well as albumin(r=0.393, P=0.004; r=0.402, P=0.003; r=0.378, P=0.006; r=0.514, P=0.000; r=0.357, P=0.009; r=0.378, P=0.006; r=0.418, P=0.002); a negative correlation was found between the levels of 25-(OH)D3 and 24 h urinary protein excretion, blood urea nitrogen, serum creatinine, serum β2 microglobulin, as well as triglycerides(TG)(r=-0.462, P=0.001; r=-0.378, P=0.006; r=-0.375, P=0.006; r=-0.385, P=0.005; r=-0.283, P=0.042); there was no significant relationships between the level of 25-(OH)D3 and the level of white blood cell(WBC), platelet(Plt), uric acid, total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), lipoprotein a, homocysteine, phosphorus, aspertate aminotransferase(AST), total protein as well as globulin, P> 0.05.5 The relationship among the level of serum 25-(OH)D3 and immune series, ESR, CRP: a positive correlation was found between the levels of 25-(OH)D3 and Complement C3, r=0.354, P=0.010; and a negative correlation with ESR, r=-0.379, P=0.006; there was no significant relationships among the level of serum 25-(OH)D3 and Complement C4, Immunoglobulin A(lg A), lg G, lg M, and CRP, P>0.05.6 According to the positive or negative of Anti ds DNA in the SLE patients were divided into groups: the level of serum 25-(OH)D3 of Anti ds DNA positive group was 7.8(3.9~11.3) ng/ml, and Anti ds DNA negative group was 11.4(7.5~13.75) ng/ml, the level of serum 25-(OH)D3 of Anti ds DNA positive group was lower than that of the Anti ds DNA negative group, P<0.05.7 The relationship between the level of serum 25-(OH)D3 and clinical manifestation of without Vit D treated of SLE patients: the level of serum 25-(OH)D3 of With and without skin lesions group were 9.60(5.90~13.00) ng/ml and 10.13 ± 4.96ng/ml respectively, compare the level of serum 25-(OH)D3 between them, there was no statistically significant, P=0.919; the level of serum 25-(OH)D3 of arthritis group was 10.66±6.42ng/ml, and the level of serum 25-(OH)D3 of without arthritis group was 10.26 ±5.79ng/ml,compare the level of serum 25-(OH)D3 between them, there was no statistically significant, P=0.826; the level of serum 25-(OH)D3 of serositis group was 6.75±3.92ng/ml, and the level of serum 25-(OH)D3 of without serositis group was 10.0(6.38~13.65) ng/ml,the level of serum 25-(OH)D3 of serositis group was lower than that of without serositis group, P=0.030; the level of serum 25-(OH)D3 of kidney damage group was 6.10(3.70~10.90) ng/ml, and the level of serum 25-(OH)D3 of without kidney damage group was 11.6(8.85~14.80) ng/ml,the level of serum 25-(OH)D3 of kidney damage group was lower than that of without kidney damage group obviously, P=0.001; the level of serum 25-(OH)D3 of hematological system diseases group was 10.55±4.05ng/ml, and the level of serum 25-(OH)D3 of without hematological system diseases group was 8.75(4.50~13.55) ng/ml,compare the level of serum 25-(OH)D3 between them, there was no statistically significant, P=0.364.8 Compare the level of serum VD-Ab between SLE group and the control: the levels of serum VD-Ab of Vit D treated group, of without Vit D treated group, of control group were 640.0±126.9 nmol/L,763.7±327.7 nmol/L and 707.6±284.7 nmol/L respectively, the levels of VD-Ab of the three groups were no significant difference, P=0.132.9 The correlation between the level of serum VD-Ab and the level of 25-(OH)D3 of SLE patients: there was no significant relationships between the level of serum 25-(OH)D3 and the level of VD-Ab, r=-0.261、P=0.062.10 The relationships between the level of VD-Ab and the level of Anti-ds DNA of SLE patients: the level of VD-Ab of Anti ds DNA positive group was 657.2(613.6~775.7) nmol/L, and Anti ds DNA negative group was 657.3(632.3~711.0) nmol/L, compare the level of VD-Ab between them, there was no statistically significant, P=0.875.Conclusions:1 The level of serum 25-(OH)D3 of SLE patients was lower than the healthy controls, and there was a negative relationship between 25-(OH)D3 and SLEDAI.2 SLE patients taken Vit D supplement might not much affect the level of serum 25-(OH)D3.3 The level of serum 25-(OH)D3 of SLE patients might positively relate to RBC, HGB, HDL-C, calcium, ALT, GGT, albumin, C3, and negatively relate to 24 h urinary protein excretion, blood urea nitrogen, serum creatinine, serum β2 microglobulin, TG, ESR and Anti ds DNA.4 The low level of serum 25-(OH)D3 might lead to serositis and lupus nephritis.5 The level of serum VD-Ab of SLE patients was no significant difference with that of control; and the level of VD-Ab might have nothing to do with the level of serum Vit D. |
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