The Effect of Vitamin D Level on Systemic Lupus Erythematosus in Saudi Patients at a Tertiary Care Center
PDF (English)
HTML Full Text (English)
XML Full Text (English)

Keywords

vitamin D
systemic lupus erythematosus
disease activity

How to Cite

The Effect of Vitamin D Level on Systemic Lupus Erythematosus in Saudi Patients at a Tertiary Care Center. (2025). Universitas Medica, 66. https://doi.org/10.11144/Javeriana.umed66.evls
Almetrics
 
Dimensions
 

Google Scholar
 
Search GoogleScholar

Abstract

Objective: To assess the prevalence of insufficiency and deficiency of vitamin D, the correlation between vitamin D and disease activity and clinical parameters, and the effect of vitamin D supplementation on SLE activity. Methods: This retrospective study was carried out on 68 Saudi patients aged 15–57 and both sexes who received SLE treatment and met at least four of the 1997-revised classification criteria for SLE as outlined by the American College of Rheumatology. The Abcam ELISA kit catalog ab213966 was employed to quantify serum 25-hydroxycholecalciferol vitamin D (25(OH)D). Results: Post-treatment, SLEDAI score, ESR, bilirubin, and ALP significantly decreased, while RBCs, albumin, vitamin D, and Ca significantly increased. The prevalence of vitamin D insufficiency (45.6%) and deficiency (26.5%) pretreatment decreased to 13.2% and 7.4%, respectively, post-treatment. Pretreatment, vitamin D showed a significant inverse correlation with WBCs, ESR, ALP, and SLEDAI score, and a positive correlation with albumin and Ca. Post-treatment, vitamin D maintained a significant inverse correlation with bilirubin, ESR, ALP, and SLEDAI score and a positive correlation with albumin and Ca. Conclusions: Vitamin D correlated with bilirubin, ESR, ALP, albumin, and Ca. Deficiency is linked to high SLE activity; supplementation reduces it.

PDF (English)
HTML Full Text (English)
XML Full Text (English)

1. El Miedany Y, El Gaafary M, Gadallah N, Mahran S, Abu-Zaid MH, Hassan W, et al. Screening to prevent osteoporotic fractures in Egypt: a position statement of the Egyptian Academy of Bone Health. Egypt Rheumatol Rehabil. 2024;51:8. https://doi.org/10.1186/s43166-024-00240-1

2. Fanouriakis A, Tziolos N, Bertsias G, Boumpas DT. Update οn the diagnosis and management of systemic lupus erythematosus. Ann Rheum Dis. 2021;80:14-25. https://doi.org/10.1136/annrheumdis-2020-218272

3. Pan L, Lu M-p, Wang J-H, Xu M, Yang S-R. Immunological pathogenesis and treatment of systemic lupus erythematosus. World J Clin Pediatr. 2020;16:19-30. https://doi.org/10.1007/s12519-019-00229-3

4. Zharkova O, Celhar T, Cravens PD, Satterthwaite AB, Fairhurst A-M, Davis LS. Pathways leading to an immunological disease: systemic lupus erythematosus. Rheumatology. 2017;56:55-66. https://doi.org/10.1093/rheumatology/kew427

5. Fava A, Petri M. Systemic lupus erythematosus: diagnosis and clinical management. J Autoimmun. 2019;96:1-13. https://doi.org/10.1016/j.jaut.2018.11.001

6. AlOmair M, AlMalki H, AlShahrani M, Mushait H, Al Qout M, Alshehri T, et al. Clinical manifestations of systemic lupus erythematosus in a tertiary center in Saudi Arabia. Cureus. 2023;15:12-23. https://doi.org/10.7759/cureus.41215

7. Gergianaki I, Fanouriakis A, Repa A, Tzanakakis M, Adamichou C, Pompieri A, et al. Epidemiology and burden of systemic lupus erythematosus in a southern european population: Data from the community-based lupus registry of Crete, Greece. Ann Rheum Dis. 2017;76:1992-2000. https://doi.org/10.1136/annrheumdis-2017-211206

8. Yeoh S-A, Dias SS, Isenberg DA. Advances in systemic lupus erythematosus. Medicine. 2018;46:84-92. https://doi.org/10.1016/j.mpmed.2017.11.010

9. Siegel CH, Sammaritano LR. Systemic lupus erythematosus: a review. JAMA. 2024;331:1480-91. https://doi.org/10.1001/jama.2024.2315

10. Elkon K, Casali p. Nature and functions of autoantibodies. Nat Clin Pract Rheumatol. 2008;4:491-8. https://doi.org/10.1038/ncprheum0895

11. Ludwig RJ, Vanhoorelbeke K, Leypoldt F, Kaya Z, Bieber K, McLachlan SM, et al. Mechanisms of autoantibody-induced pathology. Front Immunol. 2017;8:603-21. https://doi.org/10.3389/fimmu.2017.00603

12. Mackern-Oberti JP, Vega F, Llanos C, Bueno SM, Kalergis AM. Targeting dendritic cell function during systemic autoimmunity to restore tolerance. Int J Mol Sci. 2014;15:16381-417. https://doi.org/10.3390/ijms150916381

13. Sakthiswary R, Raymond AA. The clinical significance of vitamin D in systemic lupus erythematosus: a systematic review. PLoS One. 2013;8:552-75. https://doi.org/10.1371/journal.pone.0055275

14. Wimalawansa SJ. Infections and autoimmunity-the immune system and vitamin D: a systematic review. Nutrients. 2023;15:3842-56. https://doi.org/10.3390/nu15173842

15. Charoenngam N, Holick MF. Immunologic effects of vitamin D on human health and disease. Nutrients. 2020;12:20-97. https://doi.org/10.3390/nu12072097

16. Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997;40:1725. https://doi.org/10.1002/art.1780400928

17. Al-Alyani H, Al-Turki HA, Al-Essa ON, Alani FM, Sadat-Ali M. Vitamin D deficiency in Saudi Arabians: a reality or simply hype. A meta-analysis (2008-2015). J Family Community Med. 2018;25:1-4. https://doi.org/10.4103/jfcm.JFCM_73_17

18. Gladman DD, Ibañez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002;29:288-91.

19. Bikle DD. Vitamin D regulation of immune function. Curr Osteoporos Rep. 2022;20:186-93. https://doi.org/10.1007/s11914-022-00732-z

20. Wimalawansa SJ. Physiology of vitamin D-focusing on disease prevention. Nutrients. 2024;16:1666-92. https://doi.org/10.3390/nu16111666

21. Wu H, Chang C, Lu Q. The epigenetics of lupus erythematosus. In: Chang C, Lu Q, editors. Epigenetics in allergy and autoimmunity: advances in experimental medicine and biology. Vol. 1253. Singapore: Springer; 2020. https://doi.org/10.1007/978-981-15-3449-2_7

22. Nerviani A, Mauro D, Gilio M, Grembiale RD, Lewis MJ. To supplement or not to supplement? The rationale of vitamin D supplementation in systemic lupus erythematosus. Open Rheumatol J. 2018;12:226-47. https://doi.org/10.2174/1874312901812010226

23. Hassanalilou T, Khalili L, Ghavamzadeh S, Shokri A, Payahoo L, Bishak YK. Role of vitamin D deficiency in systemic lupus erythematosus incidence and aggravation. Auto Immun Highlights. 2017;9:1-5. https://doi.org/10.1007/s13317-017-0101-x

24. Skrobot A, Demkow U, Wachowska M. Immunomodulatory role of vitamin D: a review. In: Pokorski M, editor. Current trends in immunity and respiratory infections. Vol. 1108. Cham: Springer; 2018. p. 13-23. https://doi.org/10.1007/5584_2018_246

25. Yamamoto E, Jørgensen TN. Immunological effects of vitamin D and their relations to autoimmunity. J Autoimmun. 2019;100:7-16. https://doi.org/10.1016/j.jaut.2019.03.002

26. Bscheider M, Butcher EC. Vitamin D immunoregulation through dendritic cells. Immunology. 2016;148:227-36. https://doi.org/10.1111/imm.12610

27. Dutta C, Kakati S, Barman B, Bora K. Vitamin D status and its relationship with systemic lupus erythematosus as a determinant and outcome of disease activity. Horm Mol Biol Clin Investig. 2019;38:20-64. https://doi.org/10.1515/hmbci-2018-0064

28. Battesti G, Felten R, Piga M, Sarmiento-Monroy JC, Ziade N, El Kibbi L, et al. Prevalence and characteristics of, and knowledge related to, photosensitivity in patients with lupus erythematosus: the international PHOTOLUP study. Rheumatology. 2023;1:5-48.

29. Colotta F, Jansson B, Bonelli F. Modulation of inflammatory and immune responses by vitamin D. J Autoimmun. 2017;85:78-97. https://doi.org/10.1016/j.jaut.2017.07.007

30. Utami AT. Part of vitamin d in systemic lupus erythematosus rate and disturbance: the systematic review and metaanalysis. Biomed J Sci Tech Res. 2022;42:33939-46. https://doi.org/10.26717/BJSTR.2022.42.006801

31. Kamen DL. Vitamin D in lupus: new kid on the block? Bull Hosp Jt Dis. 2010;68:218-35.

32. Borba V, Vieira J, Kasamatsu T, Radominski S, Sato E, Lazaretti-Castro M. Vitamin D deficiency in patients with active systemic lupus erythematosus. Osteoporos Int. 2009;20:427-33. https://doi.org/10.1007/s00198-008-0676-1

33. Bonakdar Z, Jahanshahifar L, Jahanshahifar F, Gholamrezaei A. Vitamin D deficiency and its association with disease activity in new cases of systemic lupus erythematosus. Lupus. 2011;20:1155-60. https://doi.org/10.1177/0961203311405703

34. Islam MA, Khandker SS, Alam SS, Kotyla p, Hassan R. Vitamin D status in patients with systemic lupus erythematosus (SLE): a systematic review and meta-analysis. Autoimmun Rev. 2019;18:102-392. https://doi.org/10.1016/j.autrev.2019.102392

35. Mahmoud HM, Elhendy YA, Amr GE, Elzwawy RAE, Kamal NM. Vitamin D pattern in patients with systemic lupus erythematosus with and without nephritis. Egypt J Hosp Med. 2021;85:2695-26700. https://doi.org/10.21608/ejhm.2021.189618

36. Acosta-Colman I, Morel Z, Paats A, Ortíz N, Román L, Vázquez M, et al. Association between vitamin D deficiency and disease activity in Paraguayan patients with systemic lupus erythematosus. Rev Colomb Reumatol. 2022;29:19-25. https://doi.org/10.1016/j.rcreue.2020.12.001

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2025 Doaa Ismail, Ebtisam Bakhsh, Khaled Qushmaq , Nourah Alfraijy , Hedaya Alhabardi , Rawan Alhazmi , Danah Alghamdi