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Koç Yıldırım S, Najafova T, Ersoy Evans S, Lay İ, Karaduman A. Serum vitamin D levels and vitamin D receptor gene ApaI and TaqI polymorphisms in patients with morphea: a case-control study. Arch Dermatol Res 2023; 315:2119-2127. [PMID: 36964246 DOI: 10.1007/s00403-023-02612-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 02/11/2023] [Accepted: 03/14/2023] [Indexed: 03/26/2023]
Abstract
A uncommon inflammatory condition called morphea causes fibrosis in the skin and subcutaneous tissue. The key stages in the pathophysiology are vascular damage, immunological response, and fibrosis. Numerous research have examined the relationships between the immune system, fibrosis, and vitamin D, but the exact pathogenetic pathways of morphea remain poorly understood. The purpose of this study was to investigate serum 25(OH)D levels and the ApaI (rs7975232) and TaqI (rs731236) polymorphisms of the vitamin D receptor (VDR) in morphea patients. There were 48 age- and sex-matched controls and 41 morphea patients total. VDR polymorphisms were found using PCR tests and gel electrophoresis, and serum 25(OH)D levels were determined using liquid chromatography combined with tandem mass spectrometry (LC-MS/MS). The patient group consisted of 37 females (90.2%) and 4 males (9.8%). The patients' mean age was 38.68 ± 17.54 years. In terms of VDR ApaI and TaqI polymorphisms, there was no discernible difference between the patient and control groups. TaqI polymorphism heterozygosity was discovered in all patients with progressive disease, and this finding was statistically significant (p = 0.012). Patients' mean serum 25(OH)D levels were 16.98 ± 11.55 ng/mL, while those in the control group were 18.02 ± 14.30 ng/mL. VDR polymorphisms, vitamin D levels, disease subtype, age of onset, and responsiveness to treatment did not significantly correlate. In our research, we discovered that TaqI polymorphism may be related to the severity of the disease and that the polymorphisms of the VDR ApaI and TaqI were not associated with morphea susceptibility.
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Affiliation(s)
- Sema Koç Yıldırım
- Department of Dermatology and Venereology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
- Department of Dermatology and Venereology, Uşak University Faculty of Medicine, Uşak, Turkey.
| | - Tahmina Najafova
- Department of Medical Biochemistry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sibel Ersoy Evans
- Department of Dermatology and Venereology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - İncilay Lay
- Department of Medical Biochemistry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ayşen Karaduman
- Department of Dermatology and Venereology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Calderon LM, Domsic RT, Shah AA, Pope JE. Preventative Care in Scleroderma: What Is the Best Approach to Bone Health and Cancer Screening? Rheum Dis Clin North Am 2023; 49:411-423. [PMID: 37028844 PMCID: PMC10845237 DOI: 10.1016/j.rdc.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Abstract
Systemic sclerosis (SSc) is a rare multisystem autoimmune disease characterized by fibrosis, vasculopathy, and autoimmunity. Lesser known complications inherent to SSc, such as malignancies and osteoporosis, can lead to decreased quality of life and increased morbidity and mortality. Patients with SSc have a greater risk of developing malignancies than the general population. In addition, they are more likely to be vitamin D deficient and are at great risk of osteoporosis-related fractures. However, these complications can be addressed through preventative measures. The purpose of this review is to provide clinicians with an approach to bone health and cancer screening in SSc.
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Affiliation(s)
- Leonardo Martin Calderon
- Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Robyn T Domsic
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ami A Shah
- Johns Hopkins Scleroderma Center, Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason F. Lord Building Center Tower, Suite 4100, Baltimore, MD 21224, USA.
| | - Janet E Pope
- Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Division of Rheumatology, University of Western Ontario, St. Joseph's Health Care, 268 Grosvenor Street, London, Ontario N6A 4V2, Canada.
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Dal-Bekar NE, İşlekel GH, Köken-Avşar A, Yarkan-Tuğsal H, Tuna G, Zengin B, Birlik AM. Vitamin D attenuates elevated oxidative DNA damage in scleroderma patients with organ involvement: A prospective study. J Steroid Biochem Mol Biol 2023; 229:106273. [PMID: 36813139 DOI: 10.1016/j.jsbmb.2023.106273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 02/23/2023]
Abstract
Scleroderma is a rare autoimmune disease characterized by progressive fibrosis of the skin and internal organs. Oxidative damage to macromolecules has been reported to occur in scleroderma. Among the macromolecular damages, oxidative DNA damage is a sensitive and cumulative marker of oxidative stress and is of particular interest because of its cytotoxic and mutagenic effects. Vitamin D supplementation is an important part of treatment, as vitamin D deficiency is a common problem in scleroderma. Furthermore, the antioxidant role of vitamin D has been demonstrated in recent studies. In light of this information, the present study aimed to comprehensively investigate oxidative DNA damage in scleroderma at baseline and to evaluate the contribution of vitamin D supplementation to the attenuation of DNA damage in a prospectively designed study. In accordance with these objectives, oxidative DNA damage in scleroderma was evaluated by measurement of stable damage products (8-oxo-dG, S-cdA, and R-cdA) in urine by liquid chromatography-tandem mass spectrometry (LC-MS/MS); serum vitamin D levels were determined by high-resolution mass spectrometry (HR-MS); VDR gene expression and four polymorphisms in the VDR gene (rs2228570, rs1544410, rs7975232, and rs731236) were analyzed by RT-PCR and compared with healthy subjects. In the prospective part, the DNA damage and the VDR expression of the patients who received vitamin D were re-evaluated after the replacement. As a result of this study, we demonstrated that all DNA damage products were increased in scleroderma patients compared to healthy controls, whereas vitamin D levels and VDR expression were significantly lower (p < 0.05). After supplementation, statistical significance (p < 0.05) was reached for the decrease in 8-oxo-dG and the increase in VDR expression. Attenuated 8-oxo-dG after replacement in patients with lung, joint, and gastrointestinal system involvement demonstrated the efficacy of vitamin D in scleroderma patients with organ involvement. To the best of our knowledge, this is the first study to examine oxidative DNA damage in scleroderma comprehensively and to evaluate the effects of vitamin D on DNA damage using a prospective design.
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Affiliation(s)
- Nazlı Ecem Dal-Bekar
- Dokuz Eylül University, Institute of Health Sciences, Department of Molecular Medicine, Izmir, Turkey; Izmir University of Economics, Faculty of Medicine, Department of Medical Biochemistry, Izmir, Turkey.
| | - Gül Hüray İşlekel
- Dokuz Eylül University, Institute of Health Sciences, Department of Molecular Medicine, Izmir, Turkey; Dokuz Eylül University, Faculty of Medicine, Department of Medical Biochemistry, Izmir, Turkey
| | - Aydan Köken-Avşar
- Dokuz Eylül University, Faculty of Medicine, Department of Immunology and Rheumatology, Izmir, Turkey; Kocaeli State Hospital, Department of Rheumatology, Izmit, Turkey
| | - Handan Yarkan-Tuğsal
- Ankara Training and Research Hospital, Department of Rheumatology, Ankara, Turkey
| | - Gamze Tuna
- Dokuz Eylül University, Institute of Health Sciences, Department of Molecular Medicine, Izmir, Turkey
| | - Berrin Zengin
- Dokuz Eylül University, Faculty of Medicine, Department of Immunology and Rheumatology, Izmir, Turkey; Izmir Bozyaka Training and Research Hospital, Department of Rheumatology, Izmir, Turkey
| | - Ahmet Merih Birlik
- Dokuz Eylül University, Institute of Health Sciences, Department of Molecular Medicine, Izmir, Turkey; Dokuz Eylül University, Faculty of Medicine, Department of Immunology and Rheumatology, Izmir, Turkey
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Athanassiou L, Kostoglou-Athanassiou I, Koutsilieris M, Shoenfeld Y. Vitamin D and Autoimmune Rheumatic Diseases. Biomolecules 2023; 13:709. [PMID: 37189455 PMCID: PMC10135889 DOI: 10.3390/biom13040709] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/12/2023] [Accepted: 04/19/2023] [Indexed: 05/17/2023] Open
Abstract
Vitamin D is a steroid hormone with potent immune-modulating properties. It has been shown to stimulate innate immunity and induce immune tolerance. Extensive research efforts have shown that vitamin D deficiency may be related to the development of autoimmune diseases. Vitamin D deficiency has been observed in patients with rheumatoid arthritis (RA) and has been shown to be inversely related to disease activity. Moreover, vitamin D deficiency may be implicated in the pathogenesis of the disease. Vitamin D deficiency has also been observed in patients with systemic lupus erythematosus (SLE). It has been found to be inversely related to disease activity and renal involvement. In addition, vitamin D receptor polymorphisms have been studied in SLE. Vitamin D levels have been studied in patients with Sjogren's syndrome, and vitamin D deficiency may be related to neuropathy and the development of lymphoma in the context of Sjogren's syndrome. Vitamin D deficiency has been observed in ankylosing spondylitis, psoriatic arthritis (PsA), and idiopathic inflammatory myopathies. Vitamin D deficiency has also been observed in systemic sclerosis. Vitamin D deficiency may be implicated in the pathogenesis of autoimmunity, and it may be administered to prevent autoimmune disease and reduce pain in the context of autoimmune rheumatic disorders.
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Affiliation(s)
- Lambros Athanassiou
- Department of Rheumatology, Asclepeion Hospital, Voula, GR16673 Athens, Greece
- Department of Physiology, Medical School, University of Athens, GR11527 Athens, Greece
| | | | - Michael Koutsilieris
- Department of Physiology, Medical School, University of Athens, GR11527 Athens, Greece
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Aviv University, Tel Aviv 69978, Israel
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Nguyen AD, McMahan ZH, Volkmann ER. Micronutrient Deficiencies in Systemic Sclerosis: A Scoping Review. Open Access Rheumatol 2022; 14:309-327. [PMID: 36571105 PMCID: PMC9769137 DOI: 10.2147/oarrr.s354736] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/15/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose The primary aim is to identify the micronutrient deficiencies commonly reported in SSc. The exploratory aim is to evaluate associations between micronutrient deficiencies and SSc clinical manifestations. Patient and Methods We conducted a scoping review of all published reports on SSc and nutrition in PubMed from its inception to August 2020. Clinical trials, observational studies, meta-analyses, and case series (with ≥20 cases) containing data on nutritional deficiency and SSc were included. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for reporting our findings. Two reviewers (ADN and ERV) studied the titles and abstracts of all search results with pre-specified inclusion and exclusion criteria. Results Among 790 retrieved publications, 35 full-length articles and 3 abstracts met the inclusion/exclusion criteria. Included studies took place across multiple geographic locations and included patients with both diffuse and limited cutaneous SSc. Vitamin D deficiency was the most commonly reported deficiency described in SSc, followed by vitamin B12, vitamin B9, selenium, zinc, and iron. In addition, some small studies found deficiencies in vitamins B1, B6, C, E, and A. While some studies reported associations between specific micronutrient deficiencies and SSc disease features (eg, interstitial lung disease was commonly associated with vitamin D deficiency and elevated homocysteine [Hcy]), the evidence to support these associations was not robust. Conclusion Micronutrient deficiencies are common in SSc and are associated with specific SSc features. Routine screening for micronutrient deficiencies may lead to early detection of malnutrition. Future studies are needed to understand how interventions to replete micronutrient deficiencies affect patient outcomes in SSc.
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Affiliation(s)
- Audrey D Nguyen
- Division of Rheumatology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Zsuzsanna H McMahan
- Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elizabeth R Volkmann
- Division of Rheumatology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Perazzi M, Gallina E, Manfredi GF, Patrucco F, Acquaviva A, Colangelo D, Pirisi M, Bellan M. Vitamin D in Systemic Sclerosis: A Review. Nutrients 2022; 14:nu14193908. [PMID: 36235561 PMCID: PMC9573213 DOI: 10.3390/nu14193908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/10/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: In the present paper we aimed to review the evidence about the potential implication of vitamin D in the pathogenesis and management of systemic sclerosis (SSc); (2) Methods: we performed a review of the literature looking for studies evaluating the potential role of vitamin D and its analogs in SSc. We searched the PubMed, Medline, Embase, and Cochrane libraries using the following strings: (vitamin D OR cholecalciferol) AND (systemic sclerosis OR scleroderma). We included cohort studies, case-control studies, randomized controlled trials, and observational studies. (3) Results: we identified nine pre-clinical and 21 clinical studies. Pre-clinical data suggest that vitamin D and its analogs may suppress fibrogenesis. Clinical data are concordant in reporting a high prevalence of hypovitaminosis D and osteoporosis in SSc patients; data about the association with clinical manifestations and phenotypes of SSc are, conversely, far less consistent; (4) Conclusions: in vitro data suggest that vitamin D may play an antifibrotic role in SSc, but clinical data confirming this finding are currently lacking. Hypovitaminosis D is common among SSc patients and should be treated to reduce the risk of osteoporosis.
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Affiliation(s)
- Mattia Perazzi
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale UPO, Via Solaroli 17, 28100 Novara, Italy
- Department of Internal Medicine, Rheumatology Unit, “AOU Maggiore della Carità”, 28100 Novara, Italy
| | - Enrico Gallina
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale UPO, Via Solaroli 17, 28100 Novara, Italy
- Department of Internal Medicine, Rheumatology Unit, “AOU Maggiore della Carità”, 28100 Novara, Italy
| | - Giulia Francesca Manfredi
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale UPO, Via Solaroli 17, 28100 Novara, Italy
- Department of Internal Medicine, Rheumatology Unit, “AOU Maggiore della Carità”, 28100 Novara, Italy
| | - Filippo Patrucco
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale UPO, Via Solaroli 17, 28100 Novara, Italy
- Department of Internal Medicine, Rheumatology Unit, “AOU Maggiore della Carità”, 28100 Novara, Italy
| | - Antonio Acquaviva
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale UPO, Via Solaroli 17, 28100 Novara, Italy
- Department of Internal Medicine, Rheumatology Unit, “AOU Maggiore della Carità”, 28100 Novara, Italy
| | - Donato Colangelo
- Department of Health Sciences (DSS), Università del Piemonte Orientale UPO, 28100 Novara, Italy
| | - Mario Pirisi
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale UPO, Via Solaroli 17, 28100 Novara, Italy
- Department of Internal Medicine, Rheumatology Unit, “AOU Maggiore della Carità”, 28100 Novara, Italy
- Center for Translational Research on Autoimmune and Allergic Disease (CAAD), Università del Piemonte Orientale UPO, 28100 Novara, Italy
| | - Mattia Bellan
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale UPO, Via Solaroli 17, 28100 Novara, Italy
- Department of Internal Medicine, Rheumatology Unit, “AOU Maggiore della Carità”, 28100 Novara, Italy
- Center for Translational Research on Autoimmune and Allergic Disease (CAAD), Università del Piemonte Orientale UPO, 28100 Novara, Italy
- Correspondence: ; Tel.: +39-0321-3737512
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Role of Vitamin D in Systemic Sclerosis: A Systematic Literature Review. J Immunol Res 2021; 2021:9782994. [PMID: 34881335 PMCID: PMC8648450 DOI: 10.1155/2021/9782994] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/29/2021] [Indexed: 01/11/2023] Open
Abstract
Background Systemic sclerosis (SSc) is a chronic multisystem autoimmune condition defined by a complex pathobiology, comprising excessive fibrosis of skin and internal organs, peripheral vasculopathy with endothelial cell dysfunction, inadequate vascular repair and neovascularization, and aberrant immunity. Vitamin D is a steroid hormone with pleiotropic effects beyond its traditional role in calcium and bone homeostasis. Since vitamin D has immunomodulatory, cardioprotective, and antifibrotic properties, it could potentially interfere with SSc pathogenesis. Suboptimal vitamin D levels are classically recognized in scleroderma, irrespective of clinical and serological phenotype. Aim This systematic review is aimed at investigating and clarifying the role of vitamin D in SSc and emphasizing the association of vitamin D status with different clinical settings. Methods and Results A systematic online search was performed, using PubMed databases to collect articles on the topic of vitamin D in SSc. The final analysis included 40 eligible articles. Conclusions Hypovitaminosis D is common in SSc patients and could be associated with clinical and serologic patterns of the disease. Intervention for low serum vitamin D levels in SSc pathogenesis remains controversial, as well as the significance of vitamin D supplementation in such patients.
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ERTUĞRUL G, AKTAŞ H. Serum 25-hydroxy vitamin D level does not reflect the severity of warts: a cross-sectional study. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2021. [DOI: 10.17517/ksutfd.987056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Abstract
Despite an incomplete overall understanding, nutrition plays an important role in connective tissue disease. Assessment of patients with connective tissue disease for nutritional status and metabolic disturbances may significantly contribute to patient outcomes. Several studies have indicated the multifactorial role of macronutrients, micronutrients, and supplements in the setting of connective tissue disease. There is additional evidence regarding the roles of weight, obesity, and malnutrition. This contribution reviews a growing body of data regarding nutrition in the development and treatment of various connective tissue diseases, including systemic lupus erythematosus, dermatomyositis, and systemic sclerosis.
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Affiliation(s)
- Alexa Lisevick
- Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, Connecticut, USA
| | - Jette Hooper
- Department of Dermatology, University of Connecticut Medical Center, Farmington, Connecticut, USA
| | - Neda Shahriari
- Department of Dermatology, University of Connecticut Medical Center, Farmington, Connecticut, USA
| | - Jun Lu
- Department of Dermatology, University of Connecticut Medical Center, Farmington, Connecticut, USA.
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Vitamin D supply in patients with rheumatic diseases in Poland - a pilot study. Reumatologia 2021; 59:146-152. [PMID: 34538941 PMCID: PMC8436800 DOI: 10.5114/reum.2021.107430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/08/2021] [Indexed: 12/30/2022] Open
Abstract
Objectives In rheumatic diseases, vitamin D supply is recommended as part of the prophylaxis and treatment of osteoporosis, especially in patients undergoing glucocorticoid therapy, but also due to its immunoregulatory and anti-inflammatory properties. We aimed to evaluate serum 25-hydroxyvitamin D [25(OH)D3] levels in Polish patients with systemic sclerosis (SSc), systemic lupus erythematosus (SLE) and granulomatosis with polyangiitis (GPA), in relation to various clinical parameters, and to assess the initial range of doses for the purpose of further research. Material and methods 112 patients (39 with SLE, 44 with SSc and 29 with GPA), referred to the Department of Rheumatology and Internal Medicine in Poznan, Poland, were enrolled in this retrospective study. Demographic and clinical data were collected, including 25(OH)D3 serum levels, vitamin D supplementation doses and season of blood sampling. Results Mean (SD) serum 25(OH)D3 concentrations were 31 (19.4) ng/ml for SLE, 28.8 (12.5) ng/ml for SSc and 28 (15.2) ng/ml for GPA, and they did not significantly differ between the groups. Vitamin D levels below the optimal range were found in 43.8% of SLE, 65.9% of SSc and 72.4% of GPA patients. 80% of patients reported vitamin D intake, with a mean daily dose of 1398 IU for SLE, 1345 IU for SSc and 1689 IU for GPA. Vitamin D insufficiency and deficiency were frequent among patients with rheumatic diseases, independently of the diagnosis and season. Conclusions Patients with rheumatic diseases seem to require higher doses of vitamin D than recommended for the general population. The present results indicate the necessity to use higher initial doses of vitamin D in this group of patients (2000 to 4000 UI) and to maintain the dose of vitamin D regardless of the change of seasons.
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Abstract
INTRODUCTION Hypovitaminosis D has been frequently described in systemic sclerosis (SSc). Cytokines are important mediators of tissue damage and clinical dysfunction in SSc and may be influenced by vitamin D levels. OBJECTIVE To evaluate the serum levels of vitamin D and its correlation with the clinical features and cytokine profiles in SSc patients. METHODS Case-control study, including 50 SSc patients and 35 healthy non matched controls. Serum levels of 25(OH) vitamin D were measured by chemiluminescence assay, and serum concentrations of interleukin 2 (IL-2), IL-4, IL-6, IL-10, tumor necrosis factor, and interferon γ were determined by flow cytometry. RESULTS Fourteen patients (28%) had diffuse cutaneous SSc, 94% were female, 80% European derived, with a mean age of 57.2 ± 12.8 years. The serum vitamin D levels in SSc patients were 23.9 ± 8.5 ng/mL and 30.2 ± 6.2 ng/mL in the control group (standardized mean difference -6.19; 95% confidence interval, -9.9 to -2.3; p = 0.002), despite the more frequent supplementation of vitamin D in SSc patients (p = 0.014). No significant associations were found among vitamin D concentrations and cytokine levels. Serum levels of IL-6 were significantly elevated in SSc patients (p = 0.024) and were positively correlated with the modified Rodnan skin score (rs = 0.291, p =0.041). CONCLUSIONS Despite lower vitamin D levels in SSc patients, there was no clear association with any cytokine. Serum levels of IL-6 were significantly elevated and positively correlated with the extent of skin involvement in SSc patients.
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Schneider L, Hax V, Monticielo O, Macedo TF, Barreto RKM, Marcondes NA, Chakr R. Dualities of the vitamin D in systemic sclerosis: a systematic literature review. Adv Rheumatol 2021; 61:34. [PMID: 34108054 DOI: 10.1186/s42358-021-00192-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Systemic sclerosis (SSc) is a chronic disease characterized by autoimmunity, vasculopathy, and visceral and cutaneous fibrosis. Vitamin D has several functions in the immunological system, and different studies have suggested a potential role in triggering autoimmune diseases. Patients with SSc may present with low serum levels of vitamin D, but the association between hypovitaminosis D and disease onset or any clinical manifestation is still obscure. Our goal was to verify the causal relationship between hypovitaminosis D and SSc onset or any particular clinical manifestation in the literature. METHODS A systematic literature review was performed through February 24th, 2021 on Pubmed, Lilacs/BIREME, and Cochrane databases. The eligible studies were read in full text, and, in the absence of exclusion criteria, were included in this review after consensus between two reviewers. RESULTS Forty articles met the eligibility criteria and the main results of each study are described. In most studies, SSc patients showed a higher prevalence of vitamin D deficiency and insufficiency compared to controls. Additionally, in some reports serum levels of vitamin D were inversely correlated with the severity of SSc. Oral supplementation did not seem to affect serum levels of vitamin D. Four of the included studies were with experimental models. CONCLUSION In conclusion, vitamin D deficiency seems to have a role in susceptibility to SSc, as well as in the clinical manifestations of the disease.
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Affiliation(s)
- Laiana Schneider
- Programa de Pós-Graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. .,Serviço de Reumatologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, 2350 Ramiro Barcelos St, Room 645, Porto Alegre, RS, 90035-903, Brazil.
| | - Vanessa Hax
- Serviço de Reumatologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, 2350 Ramiro Barcelos St, Room 645, Porto Alegre, RS, 90035-903, Brazil
| | - Odirlei Monticielo
- Serviço de Reumatologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, 2350 Ramiro Barcelos St, Room 645, Porto Alegre, RS, 90035-903, Brazil.,Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Tamires Ferri Macedo
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Rafael Chakr
- Serviço de Reumatologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, 2350 Ramiro Barcelos St, Room 645, Porto Alegre, RS, 90035-903, Brazil.,Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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13
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Zhao J, Sheng Y, Dai C, Qi S, Hu R, Rui W, Miao Y, Xu F, Zhang Y, Yang Q. Serum 25 hydroxyvitamin D levels in alopecia areata, female pattern hair loss, and male androgenetic alopecia in a Chinese population. J Cosmet Dermatol 2020; 19:3115-3121. [PMID: 32275116 DOI: 10.1111/jocd.13396] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/29/2020] [Accepted: 03/13/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND It has been suggested that low vitamin D levels may affect the development of hair loss. AIMS Our aim was to evaluate the serum 25-hydroxy vitamin D [25(OH)D] status in Chinese patients with alopecia areata (AA), female pattern hair loss (FPHL), and male androgenetic alopecia (MAGA) compared with healthy individuals. METHODS We performed a case-control study including 443 AA patients, 657 FPHL patients, 777 MAGA patients, and 2070 normal controls (1064 male and 1006 female healthy individuals) from 2015 to 2017 to analyze the correlation of serum 25(OH)D levels and hair loss in a Chinese population. RESULTS Serum 25(OH)D levels stratified by age, sex, and season were compared between patients and healthy individuals. AA patients' serum 25(OH)D levels were statistically lower than that of controls (P < .0001, α = .05). Serum 25(OH)D levels of FPHL patients (P < .0001, α = .05) and MAGA patients (P = .0005, α = .05) were also significantly lower than counterpart control subjects. CONCLUSION Our findings suggest an association between serum 25(OH)D levels and alopecia areata, female pattern hair loss, or male androgenetic alopecia in a Chinese population.
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Affiliation(s)
- Jun Zhao
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Youyu Sheng
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chunyang Dai
- Department of Dermatology, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Sisi Qi
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ruiming Hu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenlong Rui
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ying Miao
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Feng Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yao Zhang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qinping Yang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
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14
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Berardi S, Giardullo L, Corrado A, Cantatore FP. Vitamin D and connective tissue diseases. Inflamm Res 2020; 69:453-462. [PMID: 32172354 DOI: 10.1007/s00011-020-01337-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/04/2020] [Accepted: 03/09/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE AND DESIGN Recently, many studies have shown that the biologically active form of vitamin D-1,25(OH)2 D-is involved in many biological processes, including immune system modulation, and patients affected by various autoimmune diseases, such as connective tissue diseases (CTD), showed low levels of vitamin D. It is not clear if vitamin D deficiency is involved in the pathogenesis of autoimmune diseases or it is a consequence. MATERIAL We carried out a review of literature to summarize the existing connections between 25-OH vitamin D and CTD. METHODS We searched for articles on PubMed by keywords: vitamin D, connective tissue diseases, systemic lupus erythematosus, Sjogren's syndrome, systemic sclerosis, undifferentiated connective tissue disease. RESULTS The relationship between vitamin D and CTD is still not very clear, despite many studies having been performed and some data suggest a connection between these diseases and 25-OH vitamin D levels. CONCLUSIONS The limitations of the study, such as the heterogeneity of patients, methods used to measure vitamin D serum concentration and other biases, do not lead to unequivocal results to demonstrate a direct link between low vitamin D serum levels and autoimmune diseases. Further studies are needed to resolve conflicting results.
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Affiliation(s)
- Stefano Berardi
- Department of Medical and Surgical Sciences, Rheumatology Clinic, Ospedali Riuniti Foggia, University of Foggia, Viale Pinto 1, 71121, Foggia, Italy.
| | - Liberato Giardullo
- Department of Medical and Surgical Sciences, Rheumatology Clinic, Ospedali Riuniti Foggia, University of Foggia, Viale Pinto 1, 71121, Foggia, Italy
| | - Addolorata Corrado
- Department of Medical and Surgical Sciences, Rheumatology Clinic, Ospedali Riuniti Foggia, University of Foggia, Viale Pinto 1, 71121, Foggia, Italy
| | - Francesco Paolo Cantatore
- Department of Medical and Surgical Sciences, Rheumatology Clinic, Ospedali Riuniti Foggia, University of Foggia, Viale Pinto 1, 71121, Foggia, Italy
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15
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Abstract
Although first discovered in 1931, vitamin D has seen an increased interest in the scientific community over the past decades, including the dermatology field. Vitamin D promotes calcium and phosphorus absorption; however, the actions of vitamin D are not confined to bone. Indeed, there is now overwhelming and compelling scientific data that vitamin D plays a crucial role in a plethora of cellular function and in extra-skeletal health. Except for fatty fish livers, very few foods naturally contain vitamin D; and the major source of vitamin D comes from skin exposure to sunlight via ultraviolet B. Keratinocytes are unique in the body as not only do they provide the primary source of vitamin D for the body, but they also possess both the enzymatic machinery to metabolize the vitamin D produced to active metabolites. This has been referred to as the photoendocrine vitamin D system. Vitamin D regulates keratinocytes proliferation and differentiation; and plays a role in the defense against opportunistic infections. Multiple factors are linked to vitamin D status; and a growing number of dermatologic diseases has been linked to vitamin D status such as atopic dermatitis, psoriasis, vitiligo, and cutaneous cancers. In this article, we reviewed the potential determinants of vitamin D status, as its implications in dermatologic diseases.
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Affiliation(s)
- Christina Bergqvist
- Department of Dermatology, AP-HP, Henri Mondor University Hospital, Université Paris-Est Créteil, Créteil, France
| | - Khaled Ezzedine
- Department of Dermatology, AP-HP, Henri Mondor University Hospital, Université Paris-Est Créteil, Créteil, France - .,EA 7379 EpidermE, Université Paris-Est Créteil, Créteil, France
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16
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Spinella A, Coppi F, Mattioli AV, Lumetti F, Rossi R, Cocchiara E, Colaci M, Boriani G, Ferri C, Salvarani C, Giuggioli D. Management of cardiopulmonary disease in patients with systemic sclerosis: cardiorheumatology clinic and patient care standardization proposal. J Cardiovasc Med (Hagerstown) 2019; 19:513-515. [PMID: 30004950 DOI: 10.2459/jcm.0000000000000693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - Francesca Coppi
- Department of Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena
| | - Anna Vittoria Mattioli
- Department of Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena
| | | | - Rosario Rossi
- Department of Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena
| | | | - Michele Colaci
- Internal Medicine Unit, Cannizzaro Hospital, University of Catania, Catania
| | - Giuseppe Boriani
- Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
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17
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Tuchinda P, Kulthanan K, Chularojanamontri L, Arunkajohnsak S, Sriussadaporn S. Relationship between vitamin D and chronic spontaneous urticaria: a systematic review. Clin Transl Allergy 2018; 8:51. [PMID: 30534360 PMCID: PMC6278169 DOI: 10.1186/s13601-018-0234-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 11/16/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Vitamin D has been reported to be associated with many allergic diseases. There are a limited number of the studies of vitamin D supplementation in patients with chronic spontaneous urticaria (CSU). This study aims to study the relationship between vitamin D and CSU in terms of serum vitamin D levels, and the outcomes of vitamin D supplementation. METHODS A literature search of electronic databases for all relevant articles published between 1966 and 2018 was performed. The systematic literature review was done following Preferred Reporting Items for Systematic Reviews and Meta-analysis recommendations. RESULTS Seventeen eligible studies were included. Fourteen (1321 CSU cases and 6100 controls) were concerned with serum vitamin D levels in CSU patients. Twelve studies showed statistically significant lower serum vitamin D levels in CSU patients than the controls. Vitamin D deficiency was reported more commonly for CSU patients (34.3-89.7%) than controls (0.0-68.9%) in 6 studies. Seven studies concerned with vitamin D supplementation in CSU patients showed disease improvement after high-dosages of vitamin D supplementation. CONCLUSION CSU patients had significantly lower serum vitamin D levels than the controls in most studies. However, the results did not prove causation, and the mechanisms were not clearly explained. Despite the scarcity of available studies, this systematic review showed that a high dosage of vitamin D supplementation for 4-12 weeks might help to decrease the disease activity in some CSU patients. Well-designed randomized placebo-controlled studies are needed to determine the cut-off levels of vitamin D for supplementation and treatment outcomes.
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Affiliation(s)
- Papapit Tuchinda
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700 Thailand
| | - Kanokvalai Kulthanan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700 Thailand
| | - Leena Chularojanamontri
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700 Thailand
| | - Sittiroj Arunkajohnsak
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700 Thailand
| | - Sutin Sriussadaporn
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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18
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Role of Vitamin D Beyond the Skeletal Function: A Review of the Molecular and Clinical Studies. Int J Mol Sci 2018; 19:ijms19061618. [PMID: 29849001 PMCID: PMC6032242 DOI: 10.3390/ijms19061618] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 12/11/2022] Open
Abstract
The classical function of Vitamin D, which involves mineral balance and skeletal maintenance, has been known for many years. With the discovery of vitamin D receptors in various tissues, several other biological functions of vitamin D are increasingly recognized and its role in many human diseases like cancer, diabetes, hypertension, cardiovascular, and autoimmune and dermatological diseases is being extensively explored. The non-classical function of vitamin D involves regulation of cellular proliferation, differentiation, apoptosis, and innate and adaptive immunity. In this review, we discuss and summarize the latest findings on the non-classical functions of vitamin D at the cellular/molecular level and its role in complex human diseases.
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19
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Abstract
Vitamin D plays a key role in skeletal and cardiovascular disorders, cancers, central nervous system diseases, reproductive diseases, infections, and autoimmune and dermatological disorders. The two main sources of vitamin D are sun exposure and oral intake, including vitamin D supplementation and dietary intake. Multiple factors are linked to vitamin D status, such as Fitzpatrick skin type, sex, body mass index, physical activity, alcohol intake, and vitamin D receptor polymorphisms. Patients with photosensitive disorders tend to avoid sun exposure, and this practice, along with photoprotection, can put this category of patients at risk for vitamin D deficiency. Maintaining a vitamin D serum concentration within normal levels is warranted in atopic dermatitis, psoriasis, vitiligo, polymorphous light eruption, mycosis fungoides, alopecia areata, systemic lupus erythematosus, and melanoma patients. The potential determinants of vitamin D status, as well as the benefits and risks of vitamin D (with a special focus on the skin), will be discussed in this article.
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20
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Gupta S, Mahajan VK, Yadav RS, Mehta KS, Bhushan S, Chauhan PS, Rawat R, Sharma V. Evaluation of Serum Vitamin D Levels in Patients with Systemic Sclerosis and Healthy Controls: Results of a Pilot Study. Indian Dermatol Online J 2018; 9:250-255. [PMID: 30050814 PMCID: PMC6042194 DOI: 10.4103/idoj.idoj_328_17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background The anti-inflammatory, immunomodulatory, and anti-proliferative effects of vitamin D in pathogenesis of autoimmune diseases have been highlighted in recent years but implications of vitamin D deficiency in systemic sclerosis (SSc) remain understudied. Objectives To evaluate serum vitamin D levels in SSc patients and matched controls. Materials and Methods Serum vitamin D levels were estimated in 38 (M:F 5:33) patients aged 23-70 years of untreated SSc and age and gender matched healthy controls. Clinical and investigative evaluation for skin sclerosis by modified Rodnan skin score (mRSS), presence of digital ulcers, Raynaud's phenomenon, type of auto-antibodies, systemic involvement, and serum vitamin D levels were performed. Serum vitamin D levels were defined as normal (30-100 ng/ml), insufficient (10-30 ng/ml), and deficient (<10 ng/ml). Results Serum vitamin D levels (median ± IQR) were 19.5 ± 77.8 ng/ml in 38 patients and 100 ± 31.3 ng/ml in controls each. Vitamin D deficiency in 13 (34.2%) and insufficiency in 10 (26.3%) patients were identified. Only 2 (5.3%) controls had vitamin D insufficiency and the difference was statistically significant (P = 0.001). An inverse relationship was observed between mRSS and serum vitamin D levels. Conclusions Patients with SSc have significantly lower serum vitamin D levels than healthy controls. Serum vitamin D levels do not correlate well with age, gender, disease duration or its variants, type of auto antibodies, presence of digital ulceration, or systemic involvement but has inverse correlation with skin sclerosis. Better-designed studies will perhaps resolve issues of potential benefits of vitamin D supplementation in modification of disease activity or severity in SSc.
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Affiliation(s)
- Sarita Gupta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Rajinder S Yadav
- Department of Biochemistry, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Satya Bhushan
- Department of Biochemistry, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Ritu Rawat
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
| | - Vikas Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India
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21
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Malnutrition and sarcopenia in a large cohort of patients with systemic sclerosis. Clin Rheumatol 2017; 37:987-997. [PMID: 29196890 DOI: 10.1007/s10067-017-3932-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/20/2017] [Accepted: 11/24/2017] [Indexed: 12/13/2022]
Abstract
Systemic sclerosis (SSc) is an autoimmune disease which may lead to malnutrition. Previous studies have defined it with different criteria. No thorough evaluations of sarcopenia in SSc are available. The aim of the present study was to assess the prevalence and the potential association of malnutrition and sarcopenia in a large cohort of SSc cases. A total of 141 SSc consecutive outpatients were enrolled. Body composition was analyzed by densitometry. Malnutrition was defined according to recently published ESPEN criteria, whereas sarcopenia was diagnosed in patients with reduced skeletal muscle index. Malnutrition was diagnosed in 9.2% of patients (95% CI, 4.4-14.0%). Malnourished patients had worse gastrointestinal symptoms according to UCLA SCTC GIT 2.0 questionnaire (p = 0.007), lower physical activity (p = 0.028), longer disease duration (p = 0.019), worse predicted DLCO/VA and FVC (p = 0.009, respectively), worse disease severity according to Medsger severity score (p < 0.001), lower hemoglobin (p = 0.023), and fat-free mass (p < 0.001) and were more often sarcopenic (p < 0.001). In multivariate analysis, only FVC (p = 0.006) and disease severity (p = 0.003), in particular for the lungs (p = 0.013), were confirmed to be worse in malnourished patients. Sarcopenia was diagnosed in 29\140 patients (20.7%; 95% CI, 14.0-27.4%); 11\29 were also malnourished. In multivariate analysis, sarcopenic patients had longer disease duration (p = 0.049), worse DLCO/VA (p = 0.002), and lung (p = 0.006) and skin (p = 0.014) involvement. In SSc, malnutrition defined with ESPEN criteria was found to be lower than previously reported. Sarcopenia was found to be somewhat common. Lung involvement was significantly associated with nutritional status and may not be explained only by muscle weakness.
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22
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Abstract
PURPOSE This study aimed to investigate the association between vitamin D and systemic sclerosis (SSc) by meta-analysis. METHODS A comprehensive search was performed through June 12, 2017. Pooled standardized mean difference (SMD) was used to estimate the mean vitamin D difference between case and control groups (or between diffused- and limited-type SSc). Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were used to assess the impact of vitamin D level on clinical characteristics of SSc patients. All statistical analyses were performed using Revman 5.0 software. RESULTS The search yielded six studies with a total of 554 SSc patients and 321 healthy controls. The meta-analysis showed that SSc patients suffered from decreased vitamin D levels (SMD =-8.72 ng/mL; 95% CI: -10.11 to -7.32) compared with healthy controls. The meta-analysis results of three studies with 240 SSc patients (93 diffused-type and 147 limited-type SSc patients) showed that diffused-type SSc patients exhibited lower vitamin D levels (SMD =-4.71 ng/mL; 95% CI: -8.98 to -0.44) compared with limited-type SSc patients. However, vitamin D level was not found to be associated with Rodnan score (SMD =-2.29 ng/mL, 95% CI: -8.49 to 3.91, P=0.47), systolic pulmonary pressure (SMD =-1.68 ng/mL, 95% CI: -10.79 to 7.43, P=0.72), gastrointestinal ulcer (RR =1.01, 95% CI: 0.53-1.93, P=0.98), or pulmonary involvement (RR =1.01, 95% CI: 0.36-2.86, P=0.99) in SSc patients. CONCLUSION SSc patients exhibited lower vitamin D levels compared with healthy controls. Vitamin D levels in diffused-type SSc patients were significantly lower than those in limited-type SSc patients. The severity of clinical features was not associated with the extent of vitamin D deficit. Therefore, we hypothesize that SSc patients, especially diffused type, have lower vitamin D levels, and that the decrease of vitamin D levels might not be an accelerating factor of SSc severity.
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Affiliation(s)
- Lin An
- Department of Dermatology, China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China
| | - Ming-hui Sun
- Department of Dermatology, China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China
| | - Feng Chen
- Department of Dermatology, China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China
| | - Jin-ran Li
- Department of Dermatology, China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China
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23
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Ursini F, D’Angelo S, Padula A, Leccese P, Abignano G, Mennillo GA, Ammerata G, De Sarro G, Olivieri I. Vitamin D deficiency in systemic sclerosis: a possible role of subclinical liver fibrosis? Retrospective analysis from an Italian cohort. Clin Rheumatol 2017; 36:2871-2872. [DOI: 10.1007/s10067-017-3709-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 05/26/2017] [Indexed: 11/25/2022]
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24
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Vitamin D deficiency is associated with digital ulcer but not with atherosclerosis or arterial stiffness in patients with systemic sclerosis: a pilot study. Clin Rheumatol 2017; 36:1325-1333. [DOI: 10.1007/s10067-017-3622-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 03/22/2017] [Accepted: 03/28/2017] [Indexed: 12/12/2022]
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25
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Fallahi P, Ruffilli I, Giuggioli D, Colaci M, Ferrari SM, Antonelli A, Ferri C. Associations between Systemic Sclerosis and Thyroid Diseases. Front Endocrinol (Lausanne) 2017; 8:266. [PMID: 29042859 PMCID: PMC5632355 DOI: 10.3389/fendo.2017.00266] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 09/21/2017] [Indexed: 12/31/2022] Open
Abstract
We have reviewed scientific literature about the association of systemic sclerosis (SSc) and thyroid disorders. A high incidence, and prevalence, of new cases of autoimmune thyroiditis (AT) and/or hypothyroidism have been shown in sclerodermic patients (overall in the female gender). An association among a Th1 immune-predominance, low vitamin D levels, and AT have been also shown in SSc patients. Cases of Graves' disease (GD) have been described in SSc patients, too, according with the higher prevalence of thyroid autoimmunity. It has been also shown a higher prevalence of papillary thyroid cancer (PTC), in association with AT, in SSc patients. However, in order to confirm results about GD and thyroid cancer, studies in larger number of patients with SSc are needed. During the follow-up of SSc patients it would be appropriate to monitor carefully their thyroid status. The abovementioned data strongly suggest a periodic thyroid function follow-up in female SSc patients [showing a borderline high (although in the normal range) thyroid-stimulating hormone level, antithyroid peroxidase antibody positivity, and a small thyroid with a hypoechoic pattern], and, when necessary, appropriate treatments. In conclusion, most of the studies show an association among SSc, AT, and hypothyroidism, such as an increased prevalence of TC overall in SSc patients with AT. Only few cases of GD have been also described in SSc.
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Affiliation(s)
- Poupak Fallahi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- *Correspondence: Poupak Fallahi,
| | - Ilaria Ruffilli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Dilia Giuggioli
- Department of Medical, Surgical, Maternal, Pediatric and Adult Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Michele Colaci
- Department of Medical, Surgical, Maternal, Pediatric and Adult Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Alessandro Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Clodoveo Ferri
- Department of Medical, Surgical, Maternal, Pediatric and Adult Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Zimmermann A, Neves F, Medeiros C, Abreu I. AUSÊNCIA DE ASSOCIAÇÃO ENTRE CALCINOSE, PARÂMETROS BIOQUÍMICOS DO METABOLISMO ÓSSEO E DENSIDADE MINERAL ÓSSEA NA ESCLEROSE SISTÊMICA. REVISTA BRASILEIRA DE REUMATOLOGIA 2017. [DOI: 10.1016/j.rbr.2017.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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