Vitamin D Is Associated With Susceptibility and Disease Severity in Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis.
Level 4 - case-series / case-control
Systematic review and meta-analysis of case-control studies
PubMed 40745895 · doi:10.1111/1756-185x.70379
What was done
A systematic review and meta-analysis evaluated case-control studies assessing serum vitamin D, disease activity indices (SLEDAI), complement levels (C3, C4), and anti-dsDNA antibodies in patients with systemic lupus erythematosus (SLE) versus healthy controls. Searches were conducted across PubMed, Scopus, ScienceDirect, Web of Science, and Embase through April 6, 2024. Methodological quality was evaluated using the Newcastle-Ottawa Scale, publication bias was assessed via Begg's funnel plot and Egger's test, and meta-analyses were performed using CMAv4.
What was found
Across 43 studies with 2,940 SLE patients and 2,458 healthy controls, SLE patients had significantly lower vitamin D levels than controls (mean difference: -10.070 ng/mL; 95% CI: -12.85 to -7.28; p < 0.001). Lower vitamin D levels significantly correlated with worse disease activity and serological markers: SLEDAI score (correlation: -0.427; 95% CI: -0.541 to -0.298; p < 0.001), anti-dsDNA antibodies (correlation: -0.397; 95% CI: -0.611 to -0.130; p = 0.004), C3 levels (correlation: 0.268; 95% CI: 0.077 to 0.440; p = 0.006), and C4 levels (correlation: 0.299; 95% CI: 0.192 to 0.400; p < 0.001).
Why it matters
These findings synthesize evidence that vitamin D deficiency is closely linked with both the presence of SLE and higher clinical and serological disease activity, highlighting vitamin D status as a relevant clinical marker in disease monitoring.
Limits
The analysis relied entirely on observational case-control studies, precluding causal inference or determination of whether hypovitaminosis D drives disease activity or results from sun avoidance and medication use. The authors noted heterogeneity across studies, small-study bias, and possible language restrictions during study retrieval.
Cited by
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