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. 2008;10(5):R123.
doi: 10.1186/ar2533. Epub 2008 Oct 18.

Vitamin D deficiency in undifferentiated connective tissue disease

Eva Zold  1 , Peter Szodoray, Janos Gaal, János Kappelmayer, Laszlo Csathy, Edit Gyimesi, Margit Zeher, Gyula Szegedi, Edit Bodolay
Affiliations

Vitamin D deficiency in undifferentiated connective tissue disease

Eva Zold et al. Arthritis Res Ther. 2008.

Abstract

Introduction: Both experimental and clinical data provide evidence that vitamin D is one of those important environmental factors that can increase the prevalence of certain autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, insulin-dependent diabetes mellitus, and inflammatory bowel disease. The aim of the present study was to investigate the prevalence of vitamin D insufficiency in patients with undifferentiated connective tissue disease (UCTD).

Methods: Plasma 25(OH)D3 levels in 161 UCTD patients were measured in both summer and winter periods. Autoantibody profiles (antinuclear antibody, anti-U1-ribonucleoprotein, anti-SSA, anti-SSB, anti-Jo1, anti-Scl70, anti-double-stranded DNA, anti-centromere, anti-cardiolipin, rheumatoid factor, and anti-cyclic citrullinated peptide) and clinical symptoms of the patients were assessed.

Results: Plasma levels of 25(OH)D3 in UCTD patients were significantly lower compared with controls in both summer and winter periods (UCTD summer: 33 +/- 13.4 ng/mL versus control: 39.9 +/- 11.7 ng/mL, P = 0.01; UCTD winter: 27.8 +/- 12.48 ng/mL versus control: 37.8 +/- 12.3 ng/mL, P = 0.0001). The presence of dermatological symptoms (photosensitivity, erythema, and chronic discoid rash) and pleuritis was associated with low levels of vitamin D. During the average follow-up period of 2.3 years, 35 out of 161 patients (21.7%) with UCTD further developed into well-established connective tissue disease (CTD). Patients who progressed into CTDs had lower vitamin D levels than those who remained in the UCTD stage (vitamin D levels: CTD: 14.7 +/- 6.45 ng/mL versus UCTD: 33.0 +/- 13.4 ng/mL, P = 0.0001).

Conclusions: In patients with UCTD, a seasonal variance in levels of 25(OH)D3 was identified and showed that these levels were significantly lower than in controls during the corresponding seasons. Our results suggest that vitamin D deficiency in UCTD patients may play a role in the subsequent progression into well-defined CTDs.

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Figures

Figure 1
Figure 1
Comparison of vitamin D of undifferentiated connective tissue disease (UCTD) patients with healthy controls during the summer and winter months. NS, not significant.
Figure 2
Figure 2
Evolution of undifferentiated connective disease to defined connective tissue diseases. MCTD, mixed connective tissue disease; RA, rheumatoid arthritis; SLE, systemic lupus erythematosus; UCTD, undifferentiated connective tissue disease.
See this image and copyright information in PMC

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