Serum 25-OH vitamin D levels in systemic sclerosis: analysis of 140 patients and review of the literature

• DOI: 10.1007/s10067-016-3535-z
• Publication Date: 2017-01-09T22:00:59Z
• Authors: Dilia Giuggioli; M. Colaci; G. Cassone; P. Fallahi; F. Lumetti; A. Spinella; F. Campomori; A. Manfredi; C. U. Manzini; A. Antonelli; C. Ferri
• Keywords: Adult; Male; 0301 basic medicine; Autoimmunity; Hypovitaminosis D; Scleroderma; Systemic sclerosis; Vitamin D; Adult; Aged; Female; Humans; Male; Middle Aged; Parathyroid Hormone; Scleroderma, Systemic; Vitamin D; Vitamin D Deficiency; Rheumatology; Scleroderma, Systemic; Autoimmunity; Hypovitaminosis D; Scleroderma; Systemic sclerosis; Vitamin D; Adult; Aged; Female; Humans; Male; Middle Aged; Parathyroid Hormone; Systemic; Vitamin D Deficiency; Rheumatology; Middle Aged; Vitamin D Deficiency; 3. Good health; 03 medical and health sciences; Parathyroid Hormone; Humans; Female; Vitamin D; Autoimmunity; Hypovitaminosis D; Scleroderma; Systemic sclerosis; Vitamin D; Rheumatology; Aged

Hypovitaminosis D is increasingly reported in autoimmune diseases. We investigated the 25-OH-vitamin D (25-OH-vitD) levels in systemic sclerosis (SSc) patients, in correlation with disease's features. We measured the 25-OH-vitD serum levels in 140 consecutive patients (F/M 126/15; mean age 61 ± 15.1 years), 91 without (group A) and 49 with (group B) 25-OH-cholecalciferol supplementation. Patients of group A invariably showed low 25-OH-vitD levels (9.8 ± 4.1 ng/ml vs. 26 ± 8.1 ng/ml of group B); in particular, 88/91 (97%) patients showed vitamin D deficiency (<20 ng/ml), with very low vitamin D levels (<10 ng/ml) in 40 (44%) subjects. Only 15/49 (30.6%) patients of group B reached normal levels of 25-OH-vitD (≥30 ng/ml), whereas vitamin D deficiency persisted in 12/49 (24.5%) individuals. Parathormone levels inversely correlated with 25-OH-vitD (r = -0.3, p < 0.0001). Of interest, hypovitaminosis D was statistically associated with autoimmune thyroiditis (p = 0.008), while calcinosis was more frequently observed in patients of group A (p = 0.057). Moreover, we found significantly higher percentage of serum anticentromere antibodies in group B patients with 25-OH-vitD level ≥30 ng/ml (8/15 vs. 6/34; p = 0.017). In literature, hypovitaminosis D is very frequent in SSc patients. An association with disease duration, calcinosis, or severity of pulmonary involvement was occasionally recognized. Hypovitaminosis D is very frequent in SSc and severe in a relevant percentage of patients; furthermore, less than one third of supplemented subjects reached normal levels of 25-OH-vitD. The evaluation of 25-OH-vitD levels should be included in the routine clinical work-up of SSc. The above findings expand previous observations and may stimulate further investigations.