{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T07:49:45Z","timestamp":1790322585318,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T00:00:00Z","timestamp":1640908800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Immunology Research"],"published-print":{"date-parts":[[2021,12,31]]},"abstract":"<jats:p>Vitamin D (calcidiol) deficiency in systemic lupus erythematosus (SLE) is more frequent than in healthy subjects (HS); it is associated with clinical activity and damage in SLE. Although calcidiol is considered the best indicator of the vitamin D serum status, its deficiency could not reflect its hydroxylation efficiency ratio and calcitriol serum status. This study was aimed at assessing the association of calcidiol and calcitriol serum levels and its hydroxylation efficiency ratio with the risk to clinical and renal disease activities in SLE patients. A cross-sectional study was conducted in 308 SLE and HS women; calcidiol and calcitriol serum levels were evaluated by immunoassays. SLE patients showed lower calcidiol serum levels vs. HS (21.2 vs. 24.2\u2009ng\/mL; <jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>p<\/a:mi>\n                        <a:mo>&lt;<\/a:mo>\n                        <a:mn>0.001<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>). Active SLE patients presented higher calcidiol\/calcitriol ratio scores vs. inactive SLE patients (2.78 vs. 1.92\u2009pg\/ng; <jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>p<\/c:mi>\n                        <c:mo>=<\/c:mo>\n                        <c:mn>0.02<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>), and SLE patients with renal disease activity showed a pattern of calcidiol-deficient levels (19.5 vs. 25.3\u2009ng\/mL; <jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>p<\/e:mi>\n                        <e:mo>&lt;<\/e:mo>\n                        <e:mn>0.04<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>) with higher calcitriol levels (47\u2009pg\/mL vs. 41.5\u2009pg\/mL; <jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>p<\/g:mi>\n                        <g:mo>=<\/g:mo>\n                        <g:mn>0.02<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>) and calcidiol\/calcitriol ratio scores (2.13 vs. 1.54\u2009pg\/ng; <jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mi>p<\/i:mi>\n                        <i:mo>&lt;<\/i:mo>\n                        <i:mn>0.02<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula>) compared to SLE patients without renal disease activity. Calcidiol levels were negatively correlated with calcitriol levels (<jats:inline-formula>\n                     <k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                        <k:mi>r<\/k:mi>\n                        <k:mo>=<\/k:mo>\n                        <k:mo>\u2212<\/k:mo>\n                        <k:mn>0.26<\/k:mn>\n                     <\/k:math>\n                  <\/jats:inline-formula>; <jats:inline-formula>\n                     <m:math xmlns:m=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\">\n                        <m:mi>p<\/m:mi>\n                        <m:mo>=<\/m:mo>\n                        <m:mn>0.001<\/m:mn>\n                     <\/m:math>\n                  <\/jats:inline-formula>) and urine proteins (mg\/dL) (<jats:inline-formula>\n                     <o:math xmlns:o=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\">\n                        <o:mi>r<\/o:mi>\n                        <o:mo>=<\/o:mo>\n                        <o:mo>\u2212<\/o:mo>\n                        <o:mn>0.39<\/o:mn>\n                     <\/o:math>\n                  <\/jats:inline-formula>; <jats:inline-formula>\n                     <q:math xmlns:q=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\">\n                        <q:mi>p<\/q:mi>\n                        <q:mo>&lt;<\/q:mo>\n                        <q:mn>0.01<\/q:mn>\n                     <\/q:math>\n                  <\/jats:inline-formula>). Regarding calcitriol levels, it was positively correlated with the blood lymphocyte count (<jats:inline-formula>\n                     <s:math xmlns:s=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M10\">\n                        <s:mi>r<\/s:mi>\n                        <s:mo>=<\/s:mo>\n                        <s:mn>0.30<\/s:mn>\n                     <\/s:math>\n                  <\/jats:inline-formula>; <jats:inline-formula>\n                     <u:math xmlns:u=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M11\">\n                        <u:mi>p<\/u:mi>\n                        <u:mo>&lt;<\/u:mo>\n                        <u:mn>0.001<\/u:mn>\n                     <\/u:math>\n                  <\/jats:inline-formula>) and negatively correlated with the glomerular filtration rate (<jats:inline-formula>\n                     <w:math xmlns:w=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M12\">\n                        <w:mi>r<\/w:mi>\n                        <w:mo>=<\/w:mo>\n                        <w:mo>\u2212<\/w:mo>\n                        <w:mn>0.28<\/w:mn>\n                     <\/w:math>\n                  <\/jats:inline-formula>; <jats:inline-formula>\n                     <y:math xmlns:y=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M13\">\n                        <y:mi>p<\/y:mi>\n                        <y:mo>=<\/y:mo>\n                        <y:mn>0.001<\/y:mn>\n                     <\/y:math>\n                  <\/jats:inline-formula>). Moreover, the calcitriol\/calcidiol ratio was positively correlated with urine proteins (<jats:inline-formula>\n                     <ab:math xmlns:ab=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M14\">\n                        <ab:mi>r<\/ab:mi>\n                        <ab:mo>=<\/ab:mo>\n                        <ab:mn>0.38<\/ab:mn>\n                     <\/ab:math>\n                  <\/jats:inline-formula>; <jats:inline-formula>\n                     <cb:math xmlns:cb=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M15\">\n                        <cb:mi>p<\/cb:mi>\n                        <cb:mo>&lt;<\/cb:mo>\n                        <cb:mn>0.01<\/cb:mn>\n                     <\/cb:math>\n                  <\/jats:inline-formula>). The calcidiol deficiency (<jats:inline-formula>\n                     <eb:math xmlns:eb=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M16\">\n                        <eb:mtext>OR<\/eb:mtext>\n                        <eb:mo>=<\/eb:mo>\n                        <eb:mn>2.27<\/eb:mn>\n                     <\/eb:math>\n                  <\/jats:inline-formula>; 95% <jats:inline-formula>\n                     <gb:math xmlns:gb=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M17\">\n                        <gb:mtext>CI<\/gb:mtext>\n                        <gb:mo>=<\/gb:mo>\n                        <gb:mn>1.15<\/gb:mn>\n                     <\/gb:math>\n                  <\/jats:inline-formula>-4.49; <jats:inline-formula>\n                     <ib:math xmlns:ib=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M18\">\n                        <ib:mi>p<\/ib:mi>\n                        <ib:mo>&lt;<\/ib:mo>\n                        <ib:mn>0.01<\/ib:mn>\n                     <\/ib:math>\n                  <\/jats:inline-formula>), high calcitriol levels (<jats:inline-formula>\n                     <kb:math xmlns:kb=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M19\">\n                        <kb:mi>T<\/kb:mi>\n                        <kb:msup>\n                           <kb:mrow>\n                              <kb:mn>3<\/kb:mn>\n                           <\/kb:mrow>\n                           <kb:mrow>\n                              <kb:mtext>rd<\/kb:mtext>\n                           <\/kb:mrow>\n                        <\/kb:msup>\n                     <\/kb:math>\n                  <\/jats:inline-formula>, <jats:inline-formula>\n                     <mb:math xmlns:mb=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M20\">\n                        <mb:mtext>OR<\/mb:mtext>\n                        <mb:mo>=<\/mb:mo>\n                        <mb:mn>4.19<\/mb:mn>\n                     <\/mb:math>\n                  <\/jats:inline-formula>, 95% <jats:inline-formula>\n                     <ob:math xmlns:ob=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M21\">\n                        <ob:mtext>CI<\/ob:mtext>\n                        <ob:mo>=<\/ob:mo>\n                        <ob:mn>2.23<\/ob:mn>\n                     <\/ob:math>\n                  <\/jats:inline-formula>-7.90; <jats:inline-formula>\n                     <qb:math xmlns:qb=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M22\">\n                        <qb:mi>p<\/qb:mi>\n                        <qb:mo>&lt;<\/qb:mo>\n                        <qb:mn>0.001<\/qb:mn>\n                     <\/qb:math>\n                  <\/jats:inline-formula>), and a high calcitriol\/calcidiol ratio score (<jats:inline-formula>\n                     <sb:math xmlns:sb=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M23\">\n                        <sb:mi>T<\/sb:mi>\n                        <sb:msup>\n                           <sb:mrow>\n                              <sb:mn>3<\/sb:mn>\n                           <\/sb:mrow>\n                           <sb:mrow>\n                              <sb:mtext>rd<\/sb:mtext>\n                           <\/sb:mrow>\n                        <\/sb:msup>\n                     <\/sb:math>\n                  <\/jats:inline-formula>, <jats:inline-formula>\n                     <ub:math xmlns:ub=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M24\">\n                        <ub:mtext>OR<\/ub:mtext>\n                        <ub:mo>=<\/ub:mo>\n                        <ub:mn>5.93<\/ub:mn>\n                     <\/ub:math>\n                  <\/jats:inline-formula>, 95% CI: 3.08-11.5; <jats:inline-formula>\n                     <wb:math xmlns:wb=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M25\">\n                        <wb:mi>p<\/wb:mi>\n                        <wb:mo>&lt;<\/wb:mo>\n                        <wb:mn>0.001<\/wb:mn>\n                     <\/wb:math>\n                  <\/jats:inline-formula>) were associated with the risk for SLE. In conclusion, a pattern of calcidiol deficiency with high calcitriol serum levels and a high vitamin D hydroxylation efficiency ratio was associated with disease risk in SLE patients.<\/jats:p>","DOI":"10.1155\/2021\/2808613","type":"journal-article","created":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T03:26:35Z","timestamp":1641007595000},"page":"1-16","source":"Crossref","is-referenced-by-count":9,"title":["Association of High Calcitriol Serum Levels and Its Hydroxylation Efficiency Ratio with Disease Risk in SLE Patients with Vitamin D Deficiency"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4991-4965","authenticated-orcid":true,"given":"M\u00f3nica R.","family":"Meza-Meza","sequence":"first","affiliation":[{"name":"Proyecto Inmunonutrici\u00f3n y Gen\u00f3mica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco 44340, Mexico"},{"name":"Instituto de Nutrigen\u00e9tica y Nutrigen\u00f3mica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco 44340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2272-9260","authenticated-orcid":true,"given":"Jos\u00e9 Francisco","family":"Mu\u00f1oz-Valle","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n en Ciencias Biom\u00e9dicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco 44340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8993-6312","authenticated-orcid":true,"given":"Adolfo I.","family":"Ruiz-Ballesteros","sequence":"additional","affiliation":[{"name":"Proyecto Inmunonutrici\u00f3n y Gen\u00f3mica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco 44340, Mexico"},{"name":"Instituto de Nutrigen\u00e9tica y Nutrigen\u00f3mica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco 44340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0680-0802","authenticated-orcid":true,"given":"Barbara","family":"Vizmanos-Lamotte","sequence":"additional","affiliation":[{"name":"Proyecto Inmunonutrici\u00f3n y Gen\u00f3mica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco 44340, Mexico"},{"name":"Instituto de Nutrigen\u00e9tica y Nutrigen\u00f3mica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco 44340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9213-8263","authenticated-orcid":true,"given":"Isela","family":"Parra-Rojas","sequence":"additional","affiliation":[{"name":"Proyecto Inmunonutrici\u00f3n y Gen\u00f3mica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco 44340, Mexico"},{"name":"Laboratorio de Investigaci\u00f3n en Obesidad y Diabetes, Facultad de Ciencias Qu\u00edmico-Biol\u00f3gicas, Universidad Aut\u00f3noma de Guerrero, Chilpancingo de los Bravo, Guerrero 39087, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2005-9512","authenticated-orcid":true,"given":"Erika","family":"Mart\u00ednez-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Instituto de Nutrigen\u00e9tica y Nutrigen\u00f3mica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco 44340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6010-0837","authenticated-orcid":true,"given":"Edith","family":"Oregon-Romero","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n en Ciencias Biom\u00e9dicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco 44340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4530-3940","authenticated-orcid":true,"given":"Yolanda Fabiola","family":"M\u00e1rquez-Sandoval","sequence":"additional","affiliation":[{"name":"Instituto de Nutrigen\u00e9tica y Nutrigen\u00f3mica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco 44340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0755-0289","authenticated-orcid":true,"given":"Sergio","family":"Cerpa-Cruz","sequence":"additional","affiliation":[{"name":"Departamento de Reumatolog\u00eda, O.P.D. Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco 44280, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4579-2294","authenticated-orcid":true,"given":"Ulises","family":"de la Cruz-Mosso","sequence":"additional","affiliation":[{"name":"Proyecto Inmunonutrici\u00f3n y Gen\u00f3mica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco 44340, Mexico"},{"name":"Instituto de Nutrigen\u00e9tica y Nutrigen\u00f3mica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco 44340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2014-000064"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1038\/nm.2752"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2016.186"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0224707"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1080\/08916934.2019.1693545"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/980286"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.3889\/oamjms.2015.052"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.3390\/ijms19082355"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1080\/10408398.2020.1862753"},{"issue":"3","key":"10","first-page":"48","article-title":"High prevalence of hypovitaminosis D of patients with autoimmune rheumatic diseases in China","volume":"5","author":"Z. 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