Lower vitamin D is associated with metabolic syndrome and insulin resistance in systemic lupus: data from an international inception cohort
- Authors
- Chew, Christine; Reynolds, John A.; Lertratanakul, Apinya; Wu, Peggy; Urowitz, Murray; Gladman, Dafna D.; Fortin, Paul R.; Bae, Sang-Cheol; Gordon, Caroline; Clarke, Ann E.; Bernatsky, Sasha; Hanly, John G.; Isenberg, David; Rahman, Anisur; Sanchez-Guerrero, Jorge; Romero-Diaz, Juanita; Merrill, Joan; Wallace, Daniel; Ginzler, Ellen; Khamashta, Munther; Nived, Ola; Jonsen, Andreas; Steinsson, Kristjan; Manzi, Susan; Kalunian, Ken; Dooley, Mary Anne; Petri, Michelle; Aranow, Cynthia; van Vollenhoven, Ronald; Stoll, Thomas; Alarcon, Graciela S.; Lim, S. Sam; Ruiz-Irastorza, Guillermo; Peschken, Christine A.; Askanase, Anca D.; Kamen, Diane L.; Inanc, Murat; Ramsey-Goldman, Rosalind; Bruce, Ian N.
- Issue Date
- Oct-2021
- Publisher
- OXFORD UNIV PRESS
- Keywords
- systemic lupus erythematosus; vitamin D; cardiovascular disease; epidemiology
- Citation
- RHEUMATOLOGY, v.60, no.10, pp.4737 - 4747
- Indexed
- SCIE
SCOPUS
- Journal Title
- RHEUMATOLOGY
- Volume
- 60
- Number
- 10
- Start Page
- 4737
- End Page
- 4747
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/140769
- DOI
- 10.1093/rheumatology/keab090
- ISSN
- 1462-0324
- Abstract
- Objectives. Vitamin D (25(OH)D) deficiency and metabolic syndrome (MetS) may both contribute to increased cardiovascular risk in SLE. We aimed to examine the association of demographic factors, SLE phenotype, therapy and vitamin D levels with MetS and insulin resistance. Methods. The Systemic Lupus International Collaborating Clinics (SLICC) enrolled patients recently diagnosed with SLE (<15 months) from 33 centres across 11 countries from 2000. Clinical, laboratory and therapeutic data were collected. Vitamin D level was defined according to tertiles based on distribution across this cohort, which were set at T1 (10-36 nmol/l), T2 (37-60 nmol/l) and T3 (61-174 nmol/l). MetS was defined according to the 2009 consensus statement from the International Diabetes Federation. Insulin resistance was determined using the HOMA-IR model. Linear and logistic regressions were used to assess the association of variables with vitamin D levels. Results. Of the 1847 patients, 1163 (63%) had vitamin D measured and 398 (34.2%) subjects were in the lowest 25(OH)D tertile. MetS was present in 286 of 860 (33%) patients whose status could be determined. Patients with lower 25(OH)D were more likely to have MetS and higher HOMA-IR. The MetS components, hypertension, hypertriglyceridemia and decreased high-density lipoprotein (HDL) were all significantly associated with lower 25(OH)D. Increased average glucocorticoid exposure was associated with higher insulin resistance. Conclusions. MetS and insulin resistance are associated with lower vitamin D in patients with SLE. Further studies could determine whether vitamin D repletion confers better control of these cardiovascular risk factors and improve long-term outcomes in SLE.
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