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. Issue 1 (1st May 2014)

• Record Type: Journal Article
• Authors: Robinson, Angela Byun; Tangpricha, Vin; Yow, Eric; Gurion, Reut; McComsey, Grace A; Schanberg, Laura E
• 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: 2014-05-01
• Subjects: Systemic lupus erythematosus -- Periodicals; 616.772005
• DOI: 10.1136/lupus-2014-000011
• Languages: English
• ISSNs: 2398-8851

Abstract

Abstract : 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. Trial register number: NCT00065806.