Sistemik Sklerozlu Hastalarda D Vitamini Eksikliği Sıklığının Ve Hastalık Tutulumu ile İlişkisinin Değerlendirilmesi

Year 2023, , 10 - 16, 30.04.2023

Kezban Armagan , Özgül Soysal Gündüz

https://doi.org/10.35514/mtd.2023.82

Abstract

Amaç: Sistemik skleroz (SSk), vaskülopati, visseral ve kutanöz fibrozis ile karakterize kronik otoimmün bir hastalıktır. D vitamininin immünolojik sistemde çeşitli işlevleri vardır ve farklı çalışmalar otoimmün hastalıkları tetiklemede potansiyel bir rolü olduğunu göstermiştir. SSk'lı hastalar düşük serum D vitamini seviyeleri ile başvurabilirler, ancak vitamin D düşüklüğü ile hastalık ve klinik belirti arasındaki ilişki hala belirsizdir. Amacımız, sklerodermalı hastalarda D vitamini eksikliğinin sıklığını belirlemek ve D vitamini konsantrasyonu ile sistemik sklerozun organ tutulumu ile arasındaki ilişkileri analiz etmektir.
Gereç ve Yöntemler: Bu çalışmada retrospektif olarak 54 Sistemik skleroz tanılı hastanın dosyası tarandı. Kontrol grubu olarak da metabolik kemik hastalığı ve romatolojik öyküsü bulunmayan 50 sağlıklı gönüllü alındı. D vitamini durumu, 25-hidroksivitamin D serum seviyeleri ölçülerek değerlendirildi. Skleroderma hastaları alt grupları ve organ tutulumu açısından veriler analiz edildi.
Bulgular: Elli dört SSc hastası (49 kadın, ortalama yaş 53.25 ± 10.77 yıl ve hastalık süresi 8 (1-25) yıl) ve 50 kontrol (45 kadın, ortalama yaş 51.02 ± 9.14 yıl) dahil edildi. Sistemik skleroz grubunda ortalama D vitamini düzeyi 11.35 ± 4.09 ng/dL idi. Yedi hastada (%12.9) ağır D vitamini eksikliği (<5 ng/ml) ve 46 hastada (%85.1) D vitamini eksikliği (20 - 5 ng/ml) varken optimal yeterli D vitamini düzeyi saptanmadı. Sağlıklı kontrolle kıyasla hasta grubunda anlamlı olarak D vitamini düşüklüğü saptandı (p=0.001). Sistemik skleroz alt gruplarındaki analizde pulmoner tutulum (p=0.019) ve DLCO (p=0.023) dışında anlamlı fark yoktu. 25-hidroksivitamin D konsantrasyonu ile yaş, akut faz reaktanları, otoantikor profili, cilt tutulumunun derecesi, hastalık aktivitesi ve solunum testleri ile D vitamini arasındaki korelasyon bakıldı, anlamlı korelasyon saptanmadı.
Sonuç: Sistemik skleroz hastalarının serum D vitamini konsantrasyonları sağlıklı kontrollere göre anlamlı derecede daha düşüktü. Cilt tutulumu, hastalık aktivitesi ile 25-hidroksivitamin D düzeyi arasında ise anlamlı bir korelasyon saptanmadı

Keywords

Sistemik skleroz, 25-hidroksivitamin D, cilt tutulumu, pulmoner tutulum

Supporting Institution

Funding: The authors received no financial support for the research and/or authorship of this article.

Thanks

Çalışmaya katkıda bulunan tüm yazarlara teşekkür ederiz

Evaluation Of The Frequency Of Vitamin D Deficiency And Its Relationship With Disease Involvement In Patients With Systemic Sclerosis

Abstract

Objective: Systemic sclerosis (SSc) is a chronic autoimmune disease characterized by vasculopathy, visceral and cutaneous fibrosis. Vitamin D has various functions in the immunological system and different studies have shown a potential role in triggering autoimmune diseases. Patients with SSc may present with low serum vitamin D levels, but the relationship between low vitamin D levels and disease and clinical manifestations is still unclear. Our aim is to determine the frequency of vitamin D deficiency in patients with scleroderma and to analyze the relationship between vitamin D concentration and organ involvement of systemic sclerosis.
Material and Methods: This study retrospectively scanned the files of 54 patients with systemic sclerosis and compared them with the control group. Serum levels of 25-hydroxyvitamin D were measured and the two groups and Systemic sclerosis subgroups were compared. Systemic sclerosis subgroups were also analyzed for organ involvement.
Results: Fifty-four SSc patients ( 49 females, mean age 53.25 ± 10.77 years, and the median disease duration 8 (1-25) years) and 50 controls (45 females, mean age 51.02 ± 9.14 years) were included. In the Systemic sclerosis group, 7 patients (12.9%) had severe vitamin D deficiency (<5 ng/ml) and 46 patients (85.1%) had vitamin D deficiency (20 - 5 ng/ml), while optimal vitamin D level was not found. There was a significant decrease in vitamin D in the patient group compared to the healthy control (p=0.001). There was no significant difference in the analysis of Systemic sclerosis subgroups except for pulmonary involvement (p=0.019) and DLCO (p=0.023).The correlation between 25-hydroxyvitamin D concentration and age, acute phase reactants, autoantibody profile, degree of skin involvement, disease activity and respiratory tests and vitamin D was not found.
Conclusion: Serum vitamin D concentrations of patients with SSc were significantly lower than healthy controls. There was no significant correlation between skin involvement, disease activity and 25-hydroxyvitamin D level.

Keywords

Systemic sclerosis, 25-hydroxyvitamin D, skin involvement, pulmonary involvement

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