Wu Peggy W, Rhew Elisa Y, Dyer Alan R, Dunlop Dorothy D, Langman Craig B, Price Heather, Sutton-Tyrrell Kim, McPherson David D, Edmundowicz Daniel, Kondos George T, Ramsey-Goldman Rosalind
Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Arthritis Rheum. 2009 Oct 15;61(10):1387-95. doi: 10.1002/art.24785.
Low serum levels of 25-hydroxyvitamin D (25[OH]D; vitamin D) are associated with a higher frequency of cardiovascular disease and risk factors in the general population. Vitamin D deficiency has also been noted in systemic lupus erythematosus (SLE). The objective of this study was to evaluate the associations of serum 25(OH)D levels with cardiovascular risk factors in women with SLE.
Data collected in 181 women with SLE included demographics, SLE activity and damage assessments, cardiovascular risk factors, medications, and laboratory assessments of inflammatory markers and 25(OH)D levels. Multiple linear and logistic regressions were used to estimate the association of 25(OH)D levels with cardiovascular risk factors.
The mean age and disease duration were 43.2 and 11.9 years, respectively. The mean 25(OH)D level was 27.1 ng/ml and 62.2% had 25(OH)D levels <30 ng/ml. In unadjusted analyses, lower 25(OH)D levels were significantly associated with higher diastolic blood pressure, low-density lipoprotein cholesterol, lipoprotein(a), body mass index (BMI), and fibrinogen levels, as well as self-reported hypertension and diabetes mellitus. Lower 25(OH)D levels were also significantly associated with higher SLE disease activity and damage scores. After adjustment for age, seasonal variation, and race/ethnicity, lower 25(OH)D levels were also significantly related to higher fasting serum glucose. With further adjustment for BMI, associations between 25(OH)D and cardiovascular risk factors were no longer significant.
This study demonstrates that vitamin D levels are low in women with SLE and significant associations exist with selected cardiovascular risk factors, although most of these associations can be explained by BMI.
在普通人群中,血清25-羟维生素D(25[OH]D;维生素D)水平较低与心血管疾病及危险因素的较高发生率相关。系统性红斑狼疮(SLE)患者中也存在维生素D缺乏的情况。本研究的目的是评估SLE女性患者血清25(OH)D水平与心血管危险因素之间的关联。
收集了181例SLE女性患者的数据,包括人口统计学信息、SLE活动度和损伤评估、心血管危险因素、用药情况以及炎症标志物和25(OH)D水平的实验室评估。采用多元线性回归和逻辑回归来估计25(OH)D水平与心血管危险因素之间的关联。
平均年龄和病程分别为43.2岁和11.9年。平均25(OH)D水平为27.1 ng/ml,62.2%的患者25(OH)D水平<30 ng/ml。在未调整的分析中,较低的25(OH)D水平与较高的舒张压、低密度脂蛋白胆固醇、脂蛋白(a)、体重指数(BMI)和纤维蛋白原水平显著相关,同时也与自我报告的高血压和糖尿病相关。较低的25(OH)D水平还与较高的SLE疾病活动度和损伤评分显著相关。在调整年龄、季节变化和种族/民族后,较低的25(OH)D水平也与较高的空腹血糖显著相关。进一步调整BMI后,25(OH)D与心血管危险因素之间的关联不再显著。
本研究表明,SLE女性患者的维生素D水平较低,且与某些心血管危险因素存在显著关联,尽管这些关联大多可由BMI解释。