Vitamin D Levels and Associations in Indian Patients with Primary Sjögren’s Syndrome
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 9
Abstract
Introduction: Vitamin D is a steroid hormone belonging to the class of secosteroids with myriad immune functions and has been implicated in aetiopathogenesis of various autoimmune diseases. Although, there have been various studies showing the association of vitamin D in rheumatoid arthritis and lupus in different populations, there have been limited studies on vitamin D and primary Sjögren's Syndrome (pSS). There are no studies on association of vitamin D and pSS from any tropical country including Indian subcontinent. Aim: The purpose of the study was to look for any association between 25-hydroxyvitamin D (25(OH)D) levels and disease manifestations in Indian patients with pSS. Materials and Methods: This is a retrospective cross-sectional study done at a tertiary teaching hospital in southern India in 235 patients with pSS. Patients satisfying the American European Consensus Group (AECG) or American College of Rheumatology (ACR) 2012 for pSS between 2008 and 2015 were included if baseline 25(OH)D levels using electrochemiluminescence were available in hospital’s laboratory record, 25(OH)D <20 ng/ml,20-30 ng/ml and >30 ng/ml was defined as deficiency, insufficiency and normal, respectively. Clinical laboratory data and disease activity scoring by EULAR Sjögren's syndrome disease activity index (ESSDAI) were retrieved retrospectively. Latitude corresponding to residence of each patient and the season of performing the assay were recorded. Chi-square statistics was done to find associations between categorized 25(OH)D and outcomes and was reported as odds ratio(95% confidence interval). Results: Mean 25(OH)D for 235 patients with pSS was 19.98(12.55)ng/ml. A vitamin D deficiency, insufficiency and sufficiency was seen in 141(60%), 60(25.5%) and 34.0(14.5%), respectively. No association was noted between latitude or season of performing assay and the levels. pSS with 25(OH)D ≤30ng/ml had more than two fold risk of higher grading on lip biopsy as well as Rheumatoid Factor (RF) positivity. However, low 25(OH)D seemed to be associated with lower ESSDAI and less pulmonary involvement. Conclusion: Prevalence of 25(OH)D deficiency in Indian patients with pSS was comparable to that of general Indian population. Low 25(OH)D level ≤30ng/ml was associated with higher odds for RF positivity and positive grading on lip biopsy. Surprisingly, low 25(OH)D was associated with lower ESSDAI score.
Authors and Affiliations
Pulukool Sandhya, Gowri Mahasampath, Puneet Mashru, Joseph Dian Bondu, Victoria Job, Debashish Danda
Keywords
Related Articles
- EP ID EP363010
- DOI 10.7860/JCDR/2017/28493.10697
- Views 83
- Downloads 0
Large Multicystic Dysplastic Kidney Mimicking a Large Cystic Renal Neoplasm
ticystic Dysplastic Kidney (MCDK) is one of the most common renal conditions seen in paediatric population. The natural history typically involves involution and many of the patients with unilateral disease may actually...
Platelet Count Estimation using Unstained and Stained Peripheral Blood Smears: A Comparative Study
Introduction: The manual count of platelets using stained smears is the most commonly employed method, although this method has its own limitations. Hence, we planned to use unstained peripheral blood smear for platelet...
Pattern of Usage of TB Diagnostic Procedures in Private Sector across Three Cities of a Central Indian State
Introduction: Despite the preference of Revised National Tuberculosis Control Program (RNTCP) for sputum microscopy, a variety of Tuberclosis (TB) diagnostic procedures are being used in private sector for the diagnosis...
Comparative Study for Detection of Carbapenemase Producers among Non-fermenting Gram Negative Uropathogens with Special Reference to Risk Factors and Fosfomycin Susceptibility
ABSTRACT Introduction: Urinary Tract Infections (UTIs) are among the commonest type of bacterial infections. Non-Fermenting Gram-Negative Bacilli (NFGNB) are now emerging as important uropathogens. Accurate detection of...
Role of Synovial Fluid Examination in Diagnosis of Joint Diseases
Introduction: Joint effusion is a common clinical problem resulting from various inflammatory and non-inflammatory conditions. Synovial fluid analysis is one of the most important diagnostic tests to classify the type of...