الفهرس 
S YSTEMIC S CLEROSISOnly 14 pages are availabe for public view
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Abstract
Background: Systemic sclerosis (SSc) is a connective tissue disease characterized by different degrees of skin fibrosis and visceral organ involvement. The etiology of SSc remains obscure; the disease appears to be the result of a multistep and multifactorial process, including immune system alterations, under the influence of genetic and exogenous factors. The aim of this work is to study levels of vitamin D in relation to the femoral cartilage thickness (FCT) in patients with SSc and to analyze the associations between the (FCT), vitamin D levels, SSc- disease severity score.
Patients and methods: This is a cross sectional study which included 40 adult systemic sclerosis patients diagnosed according to ACR/EULAR (2013) classification criteria of systemic sclerosis. Patients were categorized into two groups according to vitamin D sufficiency; group I: n=14, sufficient vitamin D (level > 30 ng/ml), group II: n=26, insufficient vitamin D (level < 30 ng/ml). Serum levels of 25-hydroxyvitamin D (25[OH] D) were assessed by (ELISA). The thickness of femoral articular cartilage was measured by muscloskeletal ultrasound. Three measurements were taken from each knee: lateral femoral condyle (LFC), femoral intercondylar area (ICA) and medial femoral condyle (MFC).
Results: The majority of patients (60%) had thin femoral cartilage of knee joint, we found that (35%) of patients had sufficient vitamin D level while (65%) of patients had insufficient vitamin D level. We compared the insufficient vitamin D level group with sufficient vitamin D level group according to femoral cartilage thickness, and concluded that vitamin D level related to femoral cartilage thickness at left medial condylar area and left lateral condyle, meanwhile we found no relation between disease severity and cartilage thickness or vitamin D level. There was significant relation between vitamin D sufficiency and sex of studied patients more in females, also showed significant inverse correlation between parity in females and femoral cartilage thickness at Rt intercondylar area and Rt medial condyle. There was highly significant statistical relation between disease severity grades and proximal muscle weakness among studied patients.
Conclusion: Vitamin D level has significant relation with femoral cartilage thickness in SSc patients in two of six of measured cartilage areas and proximal muscle weakness was associated with vitamin D insufficiency and disease severity.