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Vitamin D status is a determinant of atorvastatin effect on carotid intima medial thickening progression rate in children with lupus: an Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) substudy.

Publication ,  Journal Article
Robinson, AB; Tangpricha, V; Yow, E; Gurion, R; Schanberg, LE; McComsey, GA; APPLE Investigators,
Published in: Lupus Sci Med
2014

OBJECTIVE: Epidemiological associations suggest that vitamin D status may play a role in inflammation and progression of atherosclerosis. Using frozen serum, carotid intima medial thickness (CIMT) measurements and other existing data from the Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) trial, we assessed interactions between serum 25-hydroxyvitamin D (25(OH)D), atorvastatin randomisation and CIMT progression rate. METHODS: Participants in the 3-year APPLE trial were randomised to placebo or atorvastatin and CIMT progression rate was measured. Baseline frozen serum was used to measure 25(OH)D concentrations. Mixed effect longitudinal models for CIMT progression at 3 years were used to evaluate interaction between vitamin D deficiency (serum 25(OH)D <20 ng/mL) at baseline and atorvastatin or placebo treatment, adjusting for key systemic lupus erythematosus disease variables and cardiovascular risk factors. RESULTS: 201/221 APPLE participants had available samples and were included in this analysis; 61/201 (30%) had vitamin D deficiency at baseline. In adjusted longitudinal modelling, there was significant interaction between baseline vitamin D deficiency and atorvastatin randomisation in 3-year progression of mean-max CIMT. In four out of six carotid segments, there was a greater decrease in mean-max CIMT progression rate in subjects who were treated with atorvastatin compared with placebo if they had baseline serum 25(OH)D levels ≥20 ng/mL. CONCLUSIONS: Subjects with serum 25(OH)D ≥20 ng/mL had less mean-max CIMT progression following 3 years of atorvastatin treatment. Results from secondary analyses must be interpreted cautiously, but findings suggest that underlying vitamin D deficiency may be involved in response to atorvastatin in atherosclerosis prevention. TRIAL REGISTRATION NUMBER: NCT00065806.

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Published In

Lupus Sci Med

DOI

ISSN

2053-8790

Publication Date

2014

Volume

1

Issue

1

Start / End Page

e000037

Location

England

Related Subject Headings

  • 3204 Immunology
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Robinson, A. B., Tangpricha, V., Yow, E., Gurion, R., Schanberg, L. E., McComsey, G. A., & APPLE Investigators, . (2014). Vitamin D status is a determinant of atorvastatin effect on carotid intima medial thickening progression rate in children with lupus: an Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) substudy. Lupus Sci Med, 1(1), e000037. https://doi.org/10.1136/lupus-2014-000037
Robinson, Angela Byun, Vin Tangpricha, Eric Yow, Reut Gurion, Laura E. Schanberg, Grace A. McComsey, and Grace A. APPLE Investigators. “Vitamin D status is a determinant of atorvastatin effect on carotid intima medial thickening progression rate in children with lupus: an Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) substudy.Lupus Sci Med 1, no. 1 (2014): e000037. https://doi.org/10.1136/lupus-2014-000037.

Published In

Lupus Sci Med

DOI

ISSN

2053-8790

Publication Date

2014

Volume

1

Issue

1

Start / End Page

e000037

Location

England

Related Subject Headings

  • 3204 Immunology
  • 3202 Clinical sciences