Systemic Autoimmune Diseases Unit, Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda, Joaquin Rodrigo 2, 28222, Majadahonda, Madrid, Spain.
Biochemistry Service, Hospital Universitario Puerta de Hierro Majadahonda, Joaquin Rodrigo 2, 28222, Majadahonda, Madrid, Spain.
Clin Rheumatol. 2019 Apr;38(4):1177-1186. doi: 10.1007/s10067-018-04416-x. Epub 2019 Jan 9.
Low serum levels of 25-hydroxyvitamin D (25(OH)D) have been associated with a higher frequency of risk factors and cardiovascular disease. The aim of this study is to evaluate the association of 25(OH)D, cardiovascular risk factors, and subclinical atherosclerosis in systemic lupus erythematosus (SLE) patients.
Forty-seven female SLE patients were studied. Data collected included demographics, SLE activity, disease damage, cardiovascular risk factors, and markers of subclinical atherosclerosis. Patient treatments and vitamin D and calcium supplementation (VitD-Ca) were recorded. Vitamin D deficiency was defined as serum 25(OH)D < 50 nmol/l measured by ultra-high-performance liquid chromatography. Atherosclerosis was assessed by measuring the carotid-femoral pulse wave velocity (PWV) by Doppler velocimetry and intima-media thickness (IMT) by B-mode ultrasound scanning.
61.7% of patients were vitamin D deficient with a mean level of 31.91 ± 10.21 nmol/l. Serum vitamin D concentration was significantly higher in the 23 patients taking VitD-Ca supplements than that in patients not supplemented (p = 0.004). No significant association was found between 25(OH)D serum levels and cardiovascular risk factors, disease activity, or different treatments for SLE. A significant positive correlation was found between 25(OH)D levels, PWV (p = 0.02), and IMT (p = 0.01); moreover, patients taking VitD-Ca supplements presented an increased arterial stiffness.
Patients with arterial stiffness showed higher levels of serum vitamin D and most of them were on VitD-Ca supplements. Although prospective studies with a larger number of patients and follow-up are needed, our findings suggest that VitD-Ca supplementation may have effects on SLE patients' arterial stiffness.
血清 25-羟维生素 D（25（OH）D）水平较低与心血管疾病风险因素的发生频率较高有关。本研究旨在评估系统性红斑狼疮（SLE）患者中 25（OH）D、心血管风险因素和亚临床动脉粥样硬化之间的关系。
研究了 47 名女性 SLE 患者。收集的数据包括人口统计学、SLE 活动、疾病损害、心血管风险因素和亚临床动脉粥样硬化标志物。记录了患者的治疗方法和维生素 D 和钙补充剂（VitD-Ca）的使用情况。维生素 D 缺乏症的定义为采用超高效液相色谱法检测血清 25（OH）D < 50 nmol/L。通过多普勒速度测量法测量颈动脉-股动脉脉搏波速度（PWV）和 B 型超声扫描测量内膜-中层厚度（IMT）来评估动脉粥样硬化。
61.7%的患者维生素 D 缺乏，平均水平为 31.91 ± 10.21 nmol/L。正在服用 VitD-Ca 补充剂的 23 名患者的血清维生素 D 浓度显著高于未补充的患者（p = 0.004）。25（OH）D 血清水平与心血管风险因素、疾病活动或不同的 SLE 治疗方法之间无显著相关性。25（OH）D 水平与 PWV（p = 0.02）和 IMT（p = 0.01）之间呈显著正相关；此外，服用 VitD-Ca 补充剂的患者动脉僵硬度增加。
动脉僵硬度患者的血清维生素 D 水平较高，其中大多数患者正在服用 VitD-Ca 补充剂。尽管需要进行更多患者和随访的前瞻性研究，但我们的研究结果表明，VitD-Ca 补充剂可能对 SLE 患者的动脉僵硬度有影响。
