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APS (associated with miscarriage, stillbirth. preterm delivery and stroke) is 3X more likely if low vitamin D – meta-analysis Oct 2017

Vitamin D and antiphospholipid syndrome: A retrospective cohort study and meta-analysis

Seminars in Arthritis and Rheumatism, online 12 October 2017, https://doi.org/10.1016/j.semarthrit.2017.10.007
Leyre Riancho-Zarrabeitiaa, 1, Maite Cuberíaa, Pedro Muñoze, Marcos López-Hoyosb, Silvia García-Canalea, Mayte García-Unzuetac, José L. Hernándezd, Víctor M. Martínez-Taboadaa, ,

Objectives

  • a) To determine serum 25-OH vitamin D (vitD) levels in primary antiphospholipid syndrome (APS) and to compare them with patients with positive antiphospholipid serology who do not meet clinical criteria for APS, and with healthy controls.
  • b) To analyze the association of vitD levels with both the clinical manifestations and the immunological profile of patients with primary APS.
  • c) To perform a meta-analysis evaluating potential differences in serum vitD levels between APS and controls as well as the frequency of vit D deficiency in APS patients.

Methods
Retrospective study including 74 patients with primary APS, 54 with positive antiphospholipid (aPL) serology not meeting clinical criteria for APS and 215 healthy controls. We considered 30 ng/ml and 10 ng/ml as the thresholds for vitamin D insufficiency and deficiency, respectively. Meta-analysis included 4 case-control studies (325 primary APS patients and 507 controls) and was conducted by fitting random effects models and checked for heterogeneity.

Results
Median serum vitD levels were similar in the three groups: 21 ng/ml in primary APS, 25 ng/ml in the aPL-positive group, and 21 ng/ml in controls (p=0.115). However, we found differences in the PTH levels, being 40.4 ± 24.9 pg/ml in APS, 34.1 ± 18.2 pg/ml in aPL serology and 23.4 ±12.6 pg/ml in healthy controls (p<0.001). Regarding vitamin D deficiency, we found significant differences across the groups: 16.2% in APS, 11.1% in patients with positive serology and 3.7% in controls (p=0.001). There was a trend for the presence of thrombotic events in patients with vitamin D deficiency (38.9% vs 19.1%, p=0.071).
The meta-analysis confirmed that the combined mean difference in serum vitD levels between APS and controls was −3.605 (p <0.001) and that APS patients had an increased frequency of vitD deficiency, with an OR 3.06 (95% CI 2.12 − 4.43, p<0.001).

Conclusions
APS patients show higher frequency of vitD deficiency than the healthy individuals. The meta-analysis study, including three cohorts and ours, suggests that APS patients have significantly lower serum vitD levels and higher frequency of vitD deficiency than controls.

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Autoimmune category starts with

See also web: consensus that ~50 diseases are autoimmune, ~50 more are suspected:

  • Wikipedia long list with details and accepted/suspected labels
  • American Autoimmune Association very long list, click for details
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See also web: antiphospholipid syndrome

Rare autoimmune disease: prevalence 40-50 cases per 100, 000 persons
antiphospholipid syndrome Wikipedia

  • “Antiphospholipid syndrome or antiphospholipid antibody syndrome (APS or APLS), is an autoimmune, hypercoagulable state caused by antiphospholipid antibodies.’
  • “APS provokes blood clots (thrombosis) in both arteries and veins as well as pregnancy-related complications such as miscarriage, stillbirth, preterm delivery, and severe preeclampsia.”
  • “In APS patients, the most common venous event is deep vein thrombosis of the lower extremities, and the most common arterial event is stroke.”

Vitamin D deficiency in antiphospholipid syndrome Oct 2016

Created by admin. Last Modification: Monday November 13, 2017 20:55:33 UTC by admin. (Version 7)

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8541 Vitamin D deficiency in antiphospholipid syndrome - Oct 2016.pdf PDF 2016 admin 13 Oct, 2017 20:33 190.23 Kb 21
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