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

被引：7

作者：

Chew, Christine ^{[1
]}

Reynolds, John A. ^{[2
,3
]}

Lertratanakul, Apinya ^{[4
]}

Wu, Peggy ^{[4
]}

Urowitz, Murray ^{[5
]}

Gladman, Dafna D. ^{[5
]}

Fortin, Paul R. ^{[6
]}

Bae, Sang-Cheol ^{[7
]}

Gordon, Caroline ^{[3
]}

Clarke, Ann E. ^{[8
,9
]}

Bernatsky, Sasha ^{[10
]}

Hanly, John G. ^{[11
,12
]}

Isenberg, David ^{[13
]}

Rahman, Anisur ^{[13
]}

Sanchez-Guerrero, Jorge ^{[5
]}

Romero-Diaz, Juanita ^{[14
]}

Merrill, Joan ^{[15
]}

Wallace, Daniel ^{[16
]}

Ginzler, Ellen ^{[17
]}

Khamashta, Munther ^{[18
]}

Nived, Ola ^{[19
]}

Jonsen, Andreas ^{[19
]}

Steinsson, Kristjan ^{[20
]}

Manzi, Susan ^{[21
]}

Kalunian, Ken ^{[22
]}

Dooley, Mary Anne ^{[23
]}

Petri, Michelle ^{[24
]}

Aranow, Cynthia ^{[25
]}

van Vollenhoven, Ronald ^{[26
]}

Stoll, Thomas ^{[27
]}

Alarcon, Graciela S. ^{[28
]}

Lim, S. Sam ^{[29
]}

Ruiz-Irastorza, Guillermo ^{[30
]}

Peschken, Christine A. ^{[31
]}

Askanase, Anca D. ^{[32
]}

Kamen, Diane L. ^{[33
]}

Inanc, Murat ^{[34
]}

Ramsey-Goldman, Rosalind ^{[4
]}

Bruce, Ian N. ^{[35
,36
]}

机构：

[1] Univ Manchester, Manchester Acad Hlth Sci Ctr, Fac Biol Med & Hlth,Lydia Becker Inst Immunol & I, Manchester Collaborat Ctr Inflammat Res, Manchester, Lancs, England

[2] Sandwell & West Birmingham NHS Trust, Dept Rheumatol, Birmingham, W Midlands, England

[3] Univ Birmingham, Inst Inflammat & Ageing, Rheumatol Res Grp, Birmingham, W Midlands, England

[4] Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA

[5] Toronto Western Hosp, Ctr Prognosis Studies Rheumat Dis, Toronto, ON, Canada

[6] Univ Laval, Dept Rheumatol, Fac Med, Quebec City, PQ, Canada

[7] Hanyang Univ, Dept Rheumatol, Hosp Rheumat Dis, Seoul, South Korea

[8] Univ Calgary, Div Clin Immunol Allergy, Cumming Sch Med, Calgary, AB, Canada

[9] Univ Calgary, Div Clin Epidemiol, Cumming Sch Med, Calgary, AB, Canada

[10] McGill Univ, Fac Med, Div Rheumatol, Montreal, PQ, Canada

[11] Queen Elizabeth 2 Hlth Sci Ctr, Dept Med, Div Rheumatol, Halifax, NS, Canada

[12] Queen Elizabeth 2 Hlth Sci Ctr, Dept Pathol Halifax, Halifax, NS, Canada

[13] UCL, Fac Med Sci, Div Med, London, England

[14] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Immunol & Rheumatol Tlalpan, Mexico City, DF, Mexico

[15] Oklahoma Med Res Fdn, Dept Clin Pharmacol, Arthrit & Clin Immunol Res Program, Oklahoma City, OK USA

[16] Univ Calif Los Angeles, David Geffen Sch Med, Cedars Sinai, Cedars Sinai Med Ctr, Los Angeles, CA 90095 USA

[17] SUNY Downstate Med Ctr Coll Med, Dept Med, Brooklyn, NY USA

[18] Kings Coll London, Rayne Inst, St Thomas Hosp, Sch Med, London, England

[19] Lund Univ, Fac Med, Dept Clin Sci Lund, Sect Rheumatol, Lund, Sweden

[20] Natl Univ Hosp Iceland, Dept Rheumatol, Reykjavik, Iceland

[21] Lupus Ctr Excellence, Allegheny Hlth Network, Pittsburgh, PA USA

[22] Univ Calif San Diego, Sch Med, La Jolla, CA 92093 USA

[23] Univ N Carolina, Div Rheumatol & Immunol, Dept Med, Chapel Hill, NC USA

[24] Johns Hopkins Univ, Sch Med, Ctr Musculoskeletal Res, Dept Rheumatol, Baltimore, MD USA

[25] Northwell Hlth Feinstein Inst Med Res, Manhasset, NY USA

[26] Amsterdam Univ Med Ctr, Duivendrecht, Noord Holland, Netherlands

[27] Kantonsspital Schaffhausen, Dept Rheumatol, Schaffhausen, Schaffhausen, Switzerland

[28] Univ Alabama Birmingham, Sch Med, Dept Med, Div Clin Immunol & Rheumatol, Birmingham, AL USA

[29] Emory Univ, Div Rheumatol, Sch Med, Atlanta, GA USA

[30] Hosp Univ Cruces, Biocruces Bizkaia Hlth Res Inst, Autoimmune Dis Units, Baracaldo, Pais Vasco, Spain

[31] Univ Manitoba, Winnipeg, MB, Canada

[32] Columbia Univ, Irving Med Ctr, New York, NY USA

[33] Med Univ South Carolina, Charleston, SC 29425 USA

[34] Istanbul Univ Istanbul, Fac Med, Dept Internal Med, Div Rheumatol, Istanbul, Turkey

[35] Manchester Univ NHS Fdn Trust, Manchester Acad Hlth Sci Ctr, Kellgren Ctr Rheumatol, NIHR Manchester Biomed Res Ctr, Manchester, Lancs, England

[36] Univ Manchester, Fac Biol Med & Hlth, Versus Arthrit Ctr Epidemiol, Div Musculoskeletal & Dermatol Sci, Oxford Rd, Manchester M13 9PT, Lancs, England

来源：

RHEUMATOLOGY | 2021年 / 60卷 / 10期

基金：

加拿大健康研究院;

关键词：

systemic lupus erythematosus; vitamin D; cardiovascular disease; epidemiology; 25-HYDROXYVITAMIN D DEFICIENCY; CARDIOVASCULAR RISK-FACTORS; LOW-DENSITY-LIPOPROTEIN; 3RD NATIONAL-HEALTH; ERYTHEMATOSUS DATA; DISEASE-ACTIVITY; INDEPENDENT ASSOCIATION; WOMEN; PREVALENCE; 1,25-DIHYDROXYVITAMIN-D;

D O I：

10.1093/rheumatology/keab090

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：4737 / 4747

页数：11

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