Vitamin D deficiency is common and associated with increased C-reactive protein in children and young adults with lupus: An Atherosclerosis Prevention in Pediatric Lupus Erythematosus substudy
Objective: Epidemiological associations suggest vitamin D may play a role in inflammation and atherosclerosis. Using frozen serum and data from the Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) trial, we assessed associations between 25-hydroxyvitamin D [25(OH)D] and measures of systemic lupus erythematosus (SLE) disease activity and cardiovascular risk. Methods: Baseline APPLE serum samples were used to measure 25(OH)D levels. Logistic regression models for vitamin D deficiency [25(OH)D levels <20 ng/mL] were constructed using baseline variables collected as part of the trial, including race, season, latitude, disease duration, disease activity, high-sensitivity C-reactive protein (hsCRP), proteinuria, fasting lipids and carotid intima medial thickness (CIMT). Results: Samples were available from 201 of 221 APPLE subjects; 61/201 (30%) had vitamin D deficiency at baseline. In univariable analysis, baseline vitamin D deficiency was associated with season (p<0.01), minority status ( p<0.01), body mass index (p=0.04), duration of SLE ( p<0.01), SLICC damage index ( p=0.04), hsCRP ( p<0.01), mean-max CIMT (p=0.01), LDL-cholesterol ( p=0.03) and timed urine protein ( p=0.03). In multivariable modelling, vitamin D deficiency was associated with age, latitude, season, minority status, proteinuria and hsCRP. Conclusions: Vitamin D deficiency is common in paediatric lupus and is independently associated with elevated hsCRP, a marker of inflammation that predicts cardiovascular disease risk. Although association is not proof of causation, this association is novel in the paediatric SLE population and suggests that vitamin D deficiency may contribute to heightened inflammation and cardiovascular risk in this population.
Duke Scholars
Altmetric Attention Stats
Dimensions Citation Stats
Published In
DOI
EISSN
Publication Date
Volume
Issue
Related Subject Headings
- 3204 Immunology
- 3202 Clinical sciences
Citation
Published In
DOI
EISSN
Publication Date
Volume
Issue
Related Subject Headings
- 3204 Immunology
- 3202 Clinical sciences