Vitamin D, metabolic dyslipidemia, and metabolic syndrome in rheumatoid arthritis.

Abstract

PURPOSE:

Vitamin D deficiency is a potential risk factor for cardiometabolic disease. We investigated the associations between vitamin D and dyslipidemia and the metabolic syndrome in patients with rheumatoid arthritis, a group at high risk for cardiovascular disease.

METHODS:

Serum 25(OH)vitamin D and lipoprotein levels were measured at baseline in a random sample of 499 participants, ages 18-85 years, enrolled in a randomized trial of golimumab (GOlimumab Before Employing methotrexate as the First-line Option in the treatment of Rheumatoid arthritis of Early onset or GO-BEFORE Trial). Participants had rheumatoid arthritis with active disease, and were naïve to methotrexate and biologic therapies. Multivariable linear regression was performed to assess associations between vitamin D levels and lipoprotein fractions. Multivariable logistic regression was performed to determine the odds of hyperlipidemia and the metabolic syndrome in participants with vitamin D deficiency (<20 ng/mL).

RESULTS:

In multivariable linear regression, vitamin D levels (per 10 ng/mL) were associated inversely with low-density lipoprotein (β: -0.029 [-0.049, -0.0091], P=.004) and triglyceride (β: -0.094 [-0.15, -0.039] P=.001) levels, adjusted for demographic, cardiovascular, and disease-specific variables. Vitamin D and high-density lipoprotein levels were not associated in univariate or multivariate analyses. Vitamin D deficiency was associated independently with an increased odds of hyperlipidemia (odds ratio 1.72; 95% confidence interval, 1.10-2.45; P=.014) and metabolic syndrome (odds ratio 3.45; 95% confidence interval, 1.75-6.80; P <.001) in adjusted models.

CONCLUSIONS:

In conclusion, vitamin D deficiency was associated with the metabolic syndrome and dyslipidemia in rheumatoid arthritis, suggesting a potential role in cardiovascular disease risk. Large-scale, prospective studies are needed to determine if vitamin D supplementation improves lipoprotein levels and reduces cardiovascular risk in rheumatoid arthritis.

• Authors: Joshua F Baker, Nehal N Mehta, Daniel G Baker, Gary Toedter, Justine Shults, Joan Marie Von Feldt, Mary B Leonard
• Journal: The American journal of medicine (Am J Med) Vol. 125 Issue 10 Pg. 1036.e9-1036.e15 (Oct 2012) ISSN: 1555-7162 [Electronic] United States
• PMID: 22800875 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers
• Lipoproteins, HDL
• Lipoproteins, LDL
• Triglycerides
• Vitamin D
• 25-hydroxyvitamin D

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Arthritis, Rheumatoid (blood, complications)
• Biomarkers (blood)
• Female
• Humans
• Hyperlipidemias (blood, etiology)
• Hyperlipoproteinemias (etiology)
• Hypertriglyceridemia (etiology)
• Linear Models
• Lipoproteins, HDL (blood)
• Lipoproteins, LDL (blood)
• Logistic Models
• Male
• Metabolic Syndrome (blood, etiology)
• Middle Aged
• Multivariate Analysis
• Odds Ratio
• Triglycerides (blood)
• Vitamin D (analogs & derivatives, blood)
• Vitamin D Deficiency (blood, complications)
• Young Adult