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. Issue 1 (10th September 2014)

• Record Type: Journal Article
• Authors: Robinson, Angela Byun; Tangpricha, Vin; Yow, Eric; Gurion, Reut; Schanberg, Laura E; McComsey, Grace A
• Other Names: Ardoin Stacy collab.; Dewitt Esi Morgan collab.; Rabinovich C Egla collab.; Ellis Janet collab.; Mieszkalski Kelly collab.; Wootton Janet collab.; Chira Peter collab.; Hsu Joyce collab.; Lee Tzielan collab.; Sandborg Christy collab.; Perea Jan collab.; Gottlieb Beth collab.; Irigoyen Patricia collab.; Luftig Jennifer collab.; Siddiqi Shaz collab.; Ni Zhen collab.; Orlando Marilynn collab.; Pagano Eileen collab.; Eichenfield Andrew collab.; Imundo Lisa collab.; Levy Deborah collab.; Kahn Philip collab.; Batres Candido collab.; Cabral Digna collab.; Haines Kathleen A collab.; Kimura Yukiko collab.; Li Suzanne C collab.; Weiss Jennifer collab.; Riordan Mary Ellen collab.; Vaidya Beena collab.; von Scheven Emily collab.; Mietus-Snyder Michelle collab.; Silverman Earl collab.; Ng Lawrence collab.; Bowyer Suzanne collab.; Ballinger Susan collab.; Klausmeier Thomas collab.; Hinchman Debra collab.; Hudgins Andrea collab.; Punaro Marilynn collab.; Henry Shirley collab.; Zhang Shuzen collab.; Singer Nora G collab.; Brooks Elizabeth B collab.; Miner Stacy collab.; Szabo Nancy collab.; Scalzi Lisabeth collab.; Sherry David collab.; Dorfeld Libby collab.; Wilson Sarajane collab.; Tress Jenna collab.; McCurdy Deborah collab.; Hernandez Tatiana collab.; Vitale Jyotsna collab.; Klein-Gitelman Marisa collab.; Kress Angela collab.; Lowe Nicole collab.; Patel Falguni collab.; Wallace Carol collab.; Hamilton Stephanie collab.; Silver Richard collab.; Caldwell Katie collab.; Kamen Diane collab.; Wagner-Weiner Linda collab.; Puplava Becky collab.; Lonchev Atanas collab.; Higgins Gloria collab.; Bacani Monica collab.; Brunner Hermine collab.; Rutherford Cynthia collab.; Meyers-Eaton Jamie collab.; Nelson Shannen collab.; Grom Alexei collab.; Jung Larry collab.; Conway Teresa collab.; Frank Lacey collab.; Kuss Lori collab.; Soep Jenny collab.; Senz Hazel collab.; Reed Ann collab.; Mason Thomas collab.; Jaquith Jane collab.; Paepke-Tollefsrud Diana E collab.;
• Is Part Of: Lupus science & medicine. Volume 1:Issue 1(2014)
• Publication Date: 2014-09-10
• Subjects: Systemic Lupus Erythematosus -- Childhood/paediatric lupus -- Inflammation -- Cardiovascular Disease; Systemic lupus erythematosus -- Periodicals; 616.772005
• DOI: 10.1136/lupus-2014-000037
• Languages: English
• ISSNs: 2398-8851

Abstract

Abstract : 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.