eprintid: 10122084 rev_number: 17 eprint_status: archive userid: 608 dir: disk0/10/12/20/84 datestamp: 2021-02-22 13:22:43 lastmod: 2022-04-25 13:32:10 status_changed: 2021-02-22 13:22:43 type: article metadata_visibility: show creators_name: Chew, C creators_name: Reynolds, JA creators_name: Lertratanakul, A creators_name: Wu, P creators_name: Urowitz, M creators_name: Gladman, DD creators_name: Fortin, PR creators_name: Bae, S-C creators_name: Gordon, C creators_name: Clarke, AE creators_name: Bernatsky, S creators_name: Hanly, JG creators_name: Isenberg, D creators_name: Rahman, A creators_name: Sanchez-Guerrero, J creators_name: Romero-Diaz, J creators_name: Merrill, J creators_name: Wallace, D creators_name: Ginzler, E creators_name: Khamashta, M creators_name: Nived, O creators_name: Jönsen, A creators_name: Steinsson, K creators_name: Manzi, S creators_name: Kalunian, K creators_name: Dooley, MA creators_name: Petri, M creators_name: Aranow, C creators_name: van Vollenhoven, R creators_name: Stoll, T creators_name: Alarcón, GS creators_name: Lim, SS creators_name: Ruiz-Irastorza, G creators_name: Peschken, CA creators_name: Askanase, AD creators_name: Kamen, DL creators_name: İnanç, M creators_name: Ramsey-Goldman, R creators_name: Bruce, IN title: Lower vitamin D is associated with metabolic syndrome and insulin resistance in systemic lupus: data from an international inception cohort ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D17 divisions: G90 keywords: Systemic lupus erythematosus, cardiovascular disease, epidemiology, vitamin D note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: OBJECTIVES: Vitamin D (25(OH)D) deficiency and metabolic syndrome (MetS) may both contribute to increased cardiovascular risk in systemic lupus erythematosus (SLE). We aimed to examine the association of demographic factors, SLE phenotype, therapy and vitamin D levels with MetS and insulin resistance. METHODS: The Systemic Lupus International Collaborating Clinics (SLICC) enrolled patients recently diagnosed with SLE (<15 months) from 33 centres across 11 countries from 2000. Clinical, laboratory and therapeutic data were collected. Vitamin D level was defined according to tertiles based on distribution across this cohort, which were set at T1 (10-36 nmol/l), T2 (37-60 nmol/l) and T3 (61-174 nmol/l). MetS was defined according to the 2009 consensus statement from the International Diabetes Federation. Insulin resistance was determined using the HOMA-IR model. Linear and logistic regressions were used to assess the association of variables with vitamin D levels. RESULTS: Of the 1847 patients, 1163 (63%) had vitamin D measured and 398 (34.2%) subjects were in the lowest 25(OH)D tertile. MetS was present in 286 of 860 (33%) patients whose status could be determined. Patients with lower 25(OH)D were more likely to have MetS and higher HOMA-IR. The MetS components, hypertension, hypertriglyceridemia and decreased HDL were all significantly associated with lower 25(OH)D. Increased average glucocorticoid exposure was associated with higher insulin resistance. CONCLUSIONS: MetS and insulin resistance are associated with lower vitamin D in patients with SLE. Further studies could determine whether vitamin D repletion confers better control of these cardiovascular risk factors and improve long-term outcomes in SLE. date: 2021-10 date_type: published official_url: https://doi.org/10.1093/rheumatology/keab090 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1846665 doi: 10.1093/rheumatology/keab090 pii: 6130830 lyricists_name: Isenberg, David lyricists_name: Rahman, Mohammed lyricists_id: DAISE40 lyricists_id: ARAHM26 actors_name: Bracey, Alan actors_id: ABBRA90 actors_role: owner full_text_status: public publication: Rheumatology volume: 60 number: 10 pagerange: 4737-4747 event_location: England citation: Chew, C; Reynolds, JA; Lertratanakul, A; Wu, P; Urowitz, M; Gladman, DD; Fortin, PR; ... Bruce, IN; + view all <#> Chew, C; Reynolds, JA; Lertratanakul, A; Wu, P; Urowitz, M; Gladman, DD; Fortin, PR; Bae, S-C; Gordon, C; Clarke, AE; Bernatsky, S; Hanly, JG; Isenberg, D; Rahman, A; Sanchez-Guerrero, J; Romero-Diaz, J; Merrill, J; Wallace, D; Ginzler, E; Khamashta, M; Nived, O; Jönsen, A; Steinsson, K; Manzi, S; Kalunian, K; Dooley, MA; Petri, M; Aranow, C; van Vollenhoven, R; Stoll, T; Alarcón, GS; Lim, SS; Ruiz-Irastorza, G; Peschken, CA; Askanase, AD; Kamen, DL; İnanç, M; Ramsey-Goldman, R; Bruce, IN; - view fewer <#> (2021) Lower vitamin D is associated with metabolic syndrome and insulin resistance in systemic lupus: data from an international inception cohort. Rheumatology , 60 (10) pp. 4737-4747. 10.1093/rheumatology/keab090 <https://doi.org/10.1093/rheumatology%2Fkeab090>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10122084/1/keab090.pdf