Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Lower vitamin D is associated with metabolic syndrome and insulin resistance in systemic lupus : Data from an international inception cohort

Chew, Christine ; Reynolds, John A. ; Lertratanakul, Apinya ; Wu, Peggy ; Urowitz, Murray ; Gladman, Dafna D. ; Fortin, Paul R. ; Bae, Sang Cheol ; Gordon, Caroline and Clarke, Ann E. , et al. (2021) In Rheumatology (United Kingdom) 60(10). p.4737-4747
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... (More)

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.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiovascular disease, Epidemiology, Systemic lupus erythematosus, Vitamin D
in
Rheumatology (United Kingdom)
volume
60
issue
10
pages
11 pages
publisher
Oxford University Press
external identifiers
  • pmid:33555325
  • scopus:85117191243
ISSN
1462-0324
DOI
10.1093/rheumatology/keab090
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021 The Author(s) 2021.
id
5704255a-f4f7-4e5a-9de3-67b0ea21b627
date added to LUP
2021-12-15 14:53:51
date last changed
2024-04-20 17:51:12
@article{5704255a-f4f7-4e5a-9de3-67b0ea21b627,
  abstract     = {{<p>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 (&lt;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. </p>}},
  author       = {{Chew, Christine and Reynolds, John A. and Lertratanakul, Apinya and Wu, Peggy and Urowitz, Murray and Gladman, Dafna D. and Fortin, Paul R. and Bae, Sang Cheol and Gordon, Caroline and Clarke, Ann E. and Bernatsky, Sasha and Hanly, John G. and Isenberg, David and Rahman, Anisur and Sanchez-Guerrero, Jorge and Romero-Diaz, Juanita and Merrill, Joan and Wallace, Daniel and Ginzler, Ellen and Khamashta, Munther and Nived, Ola and Jönsen, Andreas and Steinsson, Kristjan and Manzi, Susan and Kalunian, Ken and Dooley, Mary Anne and Petri, Michelle and Aranow, Cynthia and Van Vollenhoven, Ronald and Stoll, Thomas and Alarcón, Graciela S. and Lim, S. Sam and Ruiz-Irastorza, Guillermo and Peschken, Christine A. and Askanase, Anca D. and Kamen, Diane L. and Inanç, Murat and Ramsey-Goldman, Rosalind and Bruce, Ian N.}},
  issn         = {{1462-0324}},
  keywords     = {{Cardiovascular disease; Epidemiology; Systemic lupus erythematosus; Vitamin D}},
  language     = {{eng}},
  month        = {{10}},
  number       = {{10}},
  pages        = {{4737--4747}},
  publisher    = {{Oxford University Press}},
  series       = {{Rheumatology (United Kingdom)}},
  title        = {{Lower vitamin D is associated with metabolic syndrome and insulin resistance in systemic lupus : Data from an international inception cohort}},
  url          = {{http://dx.doi.org/10.1093/rheumatology/keab090}},
  doi          = {{10.1093/rheumatology/keab090}},
  volume       = {{60}},
  year         = {{2021}},
}