Correlation between cognitive dysfunction and 25-hydroxyvitamin D in patients with systemiclupus erythematosus

Objective To explore the correlation between cognitive dysfunction (CD) and the level of 25-hydroxyvitamin D 25(OH)D in patients with systemic lupus erythematosus (SLE).

Methods A total of 283 SLE patients were selected as the research subjects. According to the scores of the Montreal Cognitive Assessment Scale (MoCA), they were divided into cognitive-normal group (MoCA score≥26 points, 145 cases) and cognitive-impairment group (MoCA score < 26 points, 138 cases). Differences in demographic data, psychophysiological characteristics, disease activity, hormone treatment dosage, and 25(OH)D levels between the two groups were compared. Spearman correlation analysis was used to determine the correlation between MoCA scores and 25(OH)D levels, and multivariate logistic regression analysis was employed to investigate the association between 25(OH)D levels and the risk of CD.

Results There were significant differences in age, Self-rating Depression Scale (SDS) scores, Fatigue Severity Scale (FSS) scores, dosage of hormone use, occupational status, educational level, and 25(OH)D levels between the two groups (P < 0.05). The distribution differences in total MoCA scores and scores in each dimension between the two groups of SLE patients were also statistically significant (P < 0.05). Spearman correlation analysis showed that the 25(OH)D levels of CD patients were positively correlated with the abstract thinking ability scores (r=0.134, P=0.024), delayed recall scores (r=0.167, P=0.005), and total scores (r=0.167, P=0.005) in the MoCA. After adjusting for demographic data, psychophysiological characteristics, disease activity, and hormone use, multivariate logistic regression analysis revealed that 25(OH)D level for every 1 ng/mL increase, the risk of CD in patients decreased by 3%(OR=0.97, 95%CI, 0.95 to 0.99, P=0.015).

Conclusion The risk of CD in SLE patients is correlated with 25(OH)D levels. Maintaining a high level of 25(OH)D may have a protective effect. Clinically, its dynamic changes should be regularly monitored and timely interventions should be provided.