Document Detail


Evidence that abnormally large seasonal declines in vitamin D status may trigger SLE flare in non-African Americans.
MedLine Citation:
PMID:  22433915     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cross-sectional studies have shown that low vitamin D (25-hydroxyvitamin D (25(OH)D)) is associated with increased systemic lupus erythematosus (SLE) activity. This study is the first to assess the temporal relationship between 25(OH)D levels and onset of SLE flare. This assessment was made possible because of the specimen bank and database of the Ohio SLE Study (OSS), a longitudinal study of frequently relapsing SLE that involved regular bimonthly patient follow-up. We identified for this study 82 flares from 46 patients that were separated by at least 8 months from previous flares. Serum 25(OH)D levels were measured at 4 and 2 months before flare, and at the time of flare (a flare interval). We found that for flares occurring during low daylight months (LDM, Oct-Mar), 25(OH)D levels were decreased at the time of flare, but only in non-African American (non-AA) patients (32% decrease at flare, compared to 4 months prior, p < 0.001). To control for seasonal effects, we also measured 25(OH)D levels in the LDM "no-flare" intervals, which were intervals that matched to the same calendar months of the patients' LDM flare intervals, but that didn't end in flare (n = 24). For these matches, a significant decrease occurred in 25(OH)D levels during the flare intervals (18.1% decrease, p < 0.001), but not during the matching no-flare intervals (6.2% decrease, p = 0.411). For flares occurring during high daylight months (HDM), 25(OH)D levels changed only in non-AA patients, increasing slightly (5.6%, p = 0.010). Analysis of flare rates for the entire OSS cohort (n = 201 flares) revealed a tendency for higher flare rates during LDM compared to HDM, but again only in non-AA patients (p = 0.060). Flare rates were lower during HDM for non-AA patients compared to AA patients (p = 0.028). In conclusion, in non-AA SLE patients, unusually large declines in 25(OH)D during LDM may be mechanistically related to SLE flare, whereas relatively high 25(OH)D levels during HDM may protect against flare.
Authors:
D J Birmingham; L A Hebert; H Song; W T Noonan; B H Rovin; H N Nagaraja; C Y Yu
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-03-20
Journal Detail:
Title:  Lupus     Volume:  21     ISSN:  1477-0962     ISO Abbreviation:  Lupus     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-01     Completed Date:  2012-11-26     Revised Date:  2013-12-08    
Medline Journal Info:
Nlm Unique ID:  9204265     Medline TA:  Lupus     Country:  England    
Other Details:
Languages:  eng     Pagination:  855-64     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
African Americans
Asian Continental Ancestry Group
European Continental Ancestry Group
Female
Humans
Longitudinal Studies
Lupus Erythematosus, Systemic / blood*,  ethnology,  physiopathology
Male
Seasons
Severity of Illness Index*
Sunlight
Time Factors
Vitamin D / analogs & derivatives*,  blood
Grant Support
ID/Acronym/Agency:
P01 DK055546/DK/NIDDK NIH HHS; P01 DK55546/DK/NIDDK NIH HHS; UL1 RR025755/RR/NCRR NIH HHS; UL1 TR000090/TR/NCATS NIH HHS; UO1 DK48621/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
1406-16-2/Vitamin D; 64719-49-9/25-hydroxyvitamin D
Comments/Corrections

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