Article ; Online: Lower vitamin D is associated with metabolic syndrome and insulin resistance in systemic lupus: data from an international inception cohort.
Rheumatology (Oxford, England)
2021 Volume 60, Issue 10, Page(s) 4737–4747
Abstract: Objectives: Vitamin D (25(OH)D) deficiency and metabolic syndrome (MetS) may both contribute ... phenotype, therapy and vitamin D levels with MetS and insulin resistance.: Methods: The Systemic Lupus ... centres across 11 countries from 2000. Clinical, laboratory and therapeutic data were collected. Vitamin D ...
| 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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| MeSH term(s) | Adult ; Cohort Studies ; Cross-Sectional Studies ; Female ; Global Health/statistics & numerical data ; Humans ; Insulin Resistance ; Lupus Erythematosus, Systemic/blood ; Lupus Erythematosus, Systemic/complications ; Male ; Metabolic Syndrome/epidemiology ; Metabolic Syndrome/etiology ; Vitamin D/analogs & derivatives ; Vitamin D/blood ; Vitamin D Deficiency/blood ; Vitamin D Deficiency/complications ; Vitamin D Deficiency/epidemiology ; Young Adult |
| Chemical Substances | Vitamin D (1406-16-2) ; 25-hydroxyvitamin D (A288AR3C9H) |
| Language | English |
| Publishing date | 2021-04-05 |
| Publishing country | England |
| Document type | Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 1464822-2 |
| ISSN | 1462-0332 ; 1462-0324 |
| ISSN (online) | 1462-0332 |
| ISSN | 1462-0324 |
| DOI | 10.1093/rheumatology/keab090 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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