الفهرس 
IntroductionOnly 14 pages are availabe for public view
Abstract
Our study included 50 SLE female patients who were classified into 2 groups according to their level of 25 hydroxy-vitamin D as follows:
- group I: 22 patients with vitamin D deficiency (25 hydroxy-vitamin D level < 30 ng/ml).
- group II: 28 patients with vitamin D sufficiency (25 hydroxy-vitamin D level > 30 ng/ml).
All patients were subjected to the following: full history taking and thorough clinical examination, body mass index and waist/hip ratio measurements, assessment of disease activity and disease damage by SLAM score and (SLICC/ACR) damage index respectively, routine laboratory investigations, ESR, lipid profile, urine analysis, protein creatinine ratio, ANA and Anti-ds DNA, high sensitivity CRP (hs-CRP), and 25-Hydroxy-vitamin D serum level. Also investigations for CVS assessment were done in the form of ECG, echocardiography, and carotid artery B-mode ultrasound.
Low levels of vitamin D were found to be frequent in our lupus patients (44% had levels <30 ng/ml). Treatment with oral calcium and vitamin D offers an incomplete protection against vitamin D deficiency (96% of patients were on regular calcium supplements and 90% of patients were on regular vitamin D
Summary
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supplements). This indicates that the amount of vitamin D supplementation currently used at our clinics was not adequate enough to maintain normal circulating 25(OH)D levels.
An association was found between low levels of vitamin D and more frequent Raynaud’s phenomenon and hypertension in our patients, supporting the relationship between CV risk factors and 25(OH)D in SLE patients.
The lower levels of vitamin D were associated with higher BMI and waist/hip ratio which are well known traditional risk factors for development of CVD, moreover increased BMI is one of the known risk factors for decrease vitamin D levels as it is fat soluble and so, has less bioavailability in overweight individuals as a result of its sequestration in body fat.
Hypertension–one of the most important CV risk factors– was strongly associated with low levels of vitamin D in our SLE patients.
Total cholesterol, TGs, and LDL levels were significantly higher in vitamin D insufficient SLE patients, while HDL was significantly lower in vitamin D insufficient SLE patients.
After studying the individual risk factors of metabolic syndrome and their relation to level of vitamin D, we concluded that; a relationship was found between low levels of vitamin D and traditional cardiovascular risk factors.
Summary
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We found no significant relationship between cerebro-vascular events and 25(OH)D levels in this study, which may be attributed to the small number of the events which was few to consider this an accurate assessment.
In our study we found a significant association between low level of 25(OH)D and the increased intima media thickness of both left and right carotid arteries, however the number of carotid plaques in our patients was few to found a significant relationship between it and vitamin D.
Lower levels of vitamin D in our patients were associated with increased SLE disease activity measured by SLAM score as well as disease damage measured by SLICC/ACR damage index.
Low vitamin D level is an important risk factor for severe disease activity and damage in our SLE patients.
Strong relationship between vitamin D level and hs-CRP was found, as higher levels of high sensitivity CRP–a known marker for atherosclerosis and predictor for CVD–were significantly associated with lower levels of 25-hydroxyvitamin D.
In this study, we found an association between lower 25(OH)D levels and increased CVD risk factors, markers of subclinical atherosclerosis, as well as increased SLE disease activity and damage indices, in women with SLE.
Conclusion
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Modification in the level of vitamin D could be considered as a modification in cardiovascular risk factors in SLE patients