Background Atherosclerosis in patients with systemic lupus erythematosus (SLE) develops earlier and is one of the important causes in mortality. Vitamin D was revealed to affect many systems including cardiovascular and immune system, and several data suggested vitamin D deficiency contributed cardiovascular disease and immune dysregulation in SLE.
Objectives We planned to analyze correlations between vitamin D levels and carotid subclinical atherosclerosis in patients with SLE.
Methods One-hundred-two female patients with SLE and 52 female normal controls were recruited. The carotid artery intima-media thickness (cIMT) and plague were assessed by B-mode ultrasound at the carotid artery level. Vitamin 25(OH)D levels were checked by immunoradiometric assay using the Bio-Line 25(OH)D3-Ria CT kit (Bio-Line S.A., Belgium). Disease activity markers were checked at the time of enrollment.
Results The cIMT of SLE is 0.41 ± 0.08 mm, which is higher than normal control (0.32 ± 0.08, p < 0.001). The carotid plague was detected in 26 patients of SLE (25.4%), and the mean of plaque index (PI) was 1.45 ± 0.14. The cIMT was correlated with age (r2 = 0.458, p < 0.001), SLEDAI (r2 = 0.272, p = 0.028), taking aspirin or not (r2 = 0.237, p = 0.033) in patients with SLE. The complement 3 (r2 = 0.400, p = 0.010) and complement 4 (r2 = -0.359, p = 0.020) were correlated with PI. The 25(OH)D levels in patients with SLE were 12.06 ± 7.56 ng/mL and 46 patients of SLE (45%) had vitamin D deficiency. The 25(OH)D levels of SLE patients were not correlated with cIMT or PI. When the patients were divided at 12 ng/mL of 25(OH)D level, only complement 4 was different significantly (18.95 ± 7.34 vs 22.27 ± 9.09, p = 0.047), and there was no difference in cIMT or PI between two groups.
Conclusions In patients with SLE, the risk of cardiovascular disease estimated by cIMT and carotid artery plaque was higher than normal control, which was correlated with disease activity. However, vitamin D levels were not showed significant correlations with carotid subclinical atherosclerosis. To our disappointment, vitamin D level was considered inappropriate to assess predisposition to cardiovascular disease in SLE.
References Wu PW, Rhew EY, Dyer AR, et al. 25-hydroxyvitamin D and cardiovascular risk factors in women with systemic lupus erythematosus. Arthritis Rheum. 2009;61:1387-95.
Disclosure of Interest None Declared
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