Table 1: Relevant studies published over the last decade investigating the correlation between vitamin D levels and clinical and serological manifestations in SLE.

Reference Patients/Ethnicity/Country Main findings
Wang et al, 2017 [99] 113 premenopausal women with SLE (China) 25(OH)D3 lower level associated with increased metabolic syndrome prevalence, decreased HDL level and higher level of fasting glucose
Shahin et al, 2017 [100] 57 treatment-naïve SLE and 42 controls (Egypt) 25(OH)D3 lower levels associated with thrombocytopenia, no other clinical manifestations
Negative correlation between vitamin D and ANA titre, IL-17 and IL-23
Garcia-Carrasco et al, 2017 [101] 137 women with SLE (Mexico) No association between vitamin D and MEX-SLEDAI
Abdel-Galil et al, 2017 [102] 123 SLE and 100 controls (Egypt) Negative correlation between vitamin D and SLEDAI in the high-disease activity group and patients with lupus nephritis
Negative correlation between 25(OH)D3 and IFN-α serum level/gene expression (> in patients with lupus nephritis)
Eloi et al, 2017 [103] 199 SLE patients (Brazil) Negative correlation between vitamin D and SLEDAI
Salman-Monte et al, 2016 [104] 102 female SLE patients (Spain) Negative correlation between vitamin D insufficiency and fatigue
25(OH)D3 lower levels associated with more oral corticosteroids
Gao et al, 2016 [105] 121 SLE patients and 150 controls (China) Severe vitamin D deficiency is prevalent in moderate/high disease activity (SLEDAI), but no correlation with organ damage (SDI)
Simioni et al, 2016 [106] 153 SLE patients and 85 controls (Brazil) No correlation between vitamin D and SLEDAI
Lower levels of vitamin D associate with leukopenia
Kokic et al, 2016 [107] 22 female SLE patients and 21 controls (Croatia) Negative correlation between vitamin D levels and IFN-γ
Lin et al, 2016 [108] 35 pediatric-onset SLE (in active and inactive disease states) (Taiwan) Lower levels of vitamin D associate with lupus nephritis
Significant negative correlation between 25(OH)D3 and SLEDAI-2k
Yap et al, 2015 [109] 119 SLE patients (Australia) Negative correlation between vitamin D and SLEDAI-2K
Increase in serum 25(OH)D3 associated with reduced disease activity
Tay et al, 2015 [110] 61 SLE patients and 61 controls (Singapore) 25(OH)D3 lower levels independently predicted cognitive deficit in lupus patients.
Garf et al, 2015 [111] 70 juvenile-onset SLE patients, 40 controls (Egypt) No correlation between vitamin D deficiency and SLEDAI
Dall’Ara et al, 2015 [112] 50 SLE patients, 30 SLE patients during disease flare; 170 healthy controls (Italy) Measured 2 values, in winter and summer
Lower vitamin D associated with disease flares during winter
Sabio et al, 2015 [113] 106 non-diabetic female SLE patients and 101 controls (Spain) 25(OH)D3 lower levels associated with insulin resistance and metabolic syndrome (trend)
Negative correlation between vitamin D and insulin and C3
Sahebari et al, 2014 [114] 82 SLE patients and 49 controls (Iran) No association between vitamin D deficiency and SLEDAI
Schoindre et al, 2014 [115] 170 patients treated with HCQ for 6 months (Plaquenil LUpus Systemic study) (France) Negative correlation between 25(OH)D3 and SLEDAI score
No association with flares during the six months following the measurement
Lertratanakul et al, 2014 [116] 890 patients SLE (North America, Europe and Asia) Negative correlation between 25(OH)D3 and SELENA-SLEDAI score
25(OH)D3 lower levels associated with increased risk for hypertension and hyperlipidaemia but no correlation with other CV events
Mandal et al, 2014 [11] 129 SLE patients (79 treatment-naïve, 50 treated), 100 controls (India) Negative correlation between 25(OH)D3 and SLEDAI, anti-dsDNA titre, plasma/gene expression of IFNα
Higher levels of plasma IFN-α in treatment-naïve SLE patients compared to treated patients and controls
McGhie et al, 2014 [117] 75 patients with SLE (Jamaica) Negative correlation between vitamin D and BILAG score (trend)
De Souza et al, 2014 [118] 45 SLE patients and 24 controls (Brazil) No association between vitamin D deficiency and SLEDAI
25(OH)D3 lower levels associated with higher rate of haematuria and higher IL-6 level
Jung J et al, 2014 [119] 102 female SLE patients and 52 controls (Korea) No correlation between vitamin D levels and subclinical markers of atherosclerosis
Abou-Raya et al, 2013 [89] 267 SLE patients (Egypt) 25(OH)D3 lower levels correlated with higher SLE disease activity (SLEDAI)
Chaiamnuay et al, 2013 [51] 101 SLE patients (Thailand) Inverse correlation between 25(OH)D3 and creatinine levels and glucocorticoid doses
Attar et al, 2013 [90] 95 SLE patients (Saudi Arabia) 25(OH)D3 lower levels associated with active SLE, azathioprine treatment, low C3/C4
No correlation between vitamin D and SLEDAI-2K.
25(OH)D3: negative correlation with anti-dsDNA, positive correlation with C4
Kiani et al, 2013 [120] 200 patients followed up for 2 years
Lupus Atherosclerosis Prevention Study - Hopkins Lupus Cohort (US)
No association between 25(OH)D levels and subclinical markers of atherosclerosis
Sumethkul et al, 2012 [42] 108 SLE patients (Thailand) 25(OH)D3 lower levels associated with urinary protein/creatinine index and nephritis with proteinuria
Mok et al, 2012 [43]
Mok et al, 2012 [46]
290 Chinese patients with SLE (Hong Kong) Negative correlation between 25(OH)D3 levels and SLEDAI scores and PGA
25(OH)D3 levels significantly lower in patients who experienced disease flares
25(OH)D3 lower levels associated with higher prevalence of aPL syndrome and higher total/HDL cholesterol ratio
Negative correlation between 25(OH)D3 levels and anti-C1q/anti-dsDNA titres
No correlation with complement levels, atherosclerosis, and organ damage
Yeap et al, 2012 [121] 38 premenopausal SLE (Malaysia) Negative correlation between vitamin D levels and SLEDAI scores
Stockton et al, 2012 [41] 24 SLE 21 controls (Australia) No correlation between vitamin D levels and fatigue
Birmingham et al, 2012 [122] 46 SLE patient (82 flares) (US) 25(OH)D3 levels decreased during flares (especially in non-African American)
Bogaczewicz et al, 2012 [123] 49 SLE 49 controls (Poland) Vitamin D deficiency associated with renal disease and leukopenia
Munoz-Ortego et al, 2012 [124] 73 SLE (Spain) No correlation between vitamin D and SLEDAI and SLICC/ACR scores
Fragoso et al, 2012 [125] 78 SLE 64 controls (Brazil) No association between vitamin D and SLEDAI, fatigue and anti-dsDNA
Reynolds et al, 2012 [126] 75 SLE (United Kingdom) 25(OH)D3 lower levels associated with higher SLEDAI-2K, higher BMI and insulin resistance
Negative correlation between serum 25(OH)D3 concentration and aortic stiffness (independent of BMI, insulin and other CVD risk factors)
No association between vitamin D levels and carotid plaque area and intima media thickness.
Ravenell et al, 2012 [127] 51 SLE African-American patients Negative correlation between vitamin D and age-adjusted total plaque area
Hamza et al, 2011 [45] 60 SLE 60 controls (Egypt) Negative correlation between vitamin D levels and SLEDAI scores
25(OH)D3 lower levels associated with higher prevalence of photosensitivity
Souto et al, 2011 [44] 159 SLE patients (Brazil) No correlation between vitamin D levels and disease activity score
Bonakdar et al, 2011 [128] 40 SLE (Iran) Negative correlation between vitamin D levels and BILAG index score
25(OH)D3 lower levels associated with higher anti-dsDNA, lower Hb and albumin concentrations and higher LFTs
Szodoray et al, 2011 [129] 177 SLE (Hungary) Negative correlation between vitamin D levels and SLEDAI score
25(OH)D3: negative correlation with anti-dsDNA, anti-Sm, and IgG levels; positive correlation with complement levels
25(OH)D3 lower levels associated with higher prevalence of pericarditis, neuropsychiatric diseases and deep vein thrombosis
Kim et al, 2011 [130] 104 SLE 49 controls (Korea) No association between vitamin D levels and SLEDAI and SLICC
Positive correlation between vitamin D and Hb and serum complement
Amital et al, 2010 [131] 378 European/Israeli patients Negative correlation between vitamin D and disease activity (SLEDAI-2K/ ECLAM scales)
Ben-Zvi et al, 2010 [132] 198 SLE patients (US) Negative correlation between vitamin D and disease activity
Ruiz-Irastorza et al, 2010 [133] 80 SLE (Spain) No correlation between vitamin D levels and SLEDAI/SDI
Negative correlation between 25(OH)D3 levels and VAS-fatigue
Toloza et al, 2010 [10] 124 SLE patients (Canada) No correlation between vitamin D and disease activity
Association between vitamin D and creatinine levels
Wu et al, 2009 [134] 181 female SLE (US) Negative correlation between vitamin D levels and SLEDAI and SLICC scores.
25(OH)D3 lower levels associated with higher diastolic blood pressure, LDL cholesterol, lipoprotein-a, BMI and insulin resistance (significance lost if adjusting for BMI)
Borba et al, 2009 [135] 36 SLE, 26 controls (Brazil) Inverse correlation between vitamin D level and SLEDAI, osteocalcin and bone-specific alkaline phosphatase
Cutolo et al, 2008 [136] SLE patients from Estonia and Italy Negative correlation between 25(OH)D3 levels and ECLAM and SLEDAI (in all patients)
Thudi et al, 2008 [137] 37 female SLE (US) Vitamin D deficiency associated with lower disease global assessment scores
Higher dsDNA titres associated with vitamin D > 47.7 nmol/L
Ruiz-Irastorza et al, 2008 [48] 92 SLE patients (Spain) No association between vitamin D levels and disease duration, disease activity (SLEDAI, SLICC-ACR).
Low vitamin D levels associated with self-rated fatigue VAS score
Orbach et al, 2007 [12] 138 SLE patients No correlation between Vitamin D and ECLAM score
Kamen et al, 2006 [14] 123 recently diagnosed SLE 240 controls (US) 25(OH)D3 lowest levels (<10 ng/ml) associated with renal disease and photosensitivity