25-Hydroxyvitamin D deficiency is associated with increased aortic stiffness in patients with systemic lupus erythematosus

Rheumatology (Oxford). 2012 Mar;51(3):544-51. doi: 10.1093/rheumatology/ker352. Epub 2011 Nov 24.


Objective: To determine the relationship between serum vitamin D and markers of subclinical cardiovascular disease (CVD) in patients with SLE.

Methods: We recruited SLE patients (≥ 4 ACR 1997 criteria) from outpatient clinics between January 2007 and January 2009. Vitamin D deficiency was defined as serum 25(OH)D <20 ng/ml measured by ELISA. Disease activity was measured using the SLEDAI-2K score. Aortic pulse wave velocity (aPWV) was measured using PulseTrace 3600 (Micromedical) and carotid plaque (CP) and intima-media thickness (IMT) assessed using B-mode Doppler US.

Results: Seventy-five women with SLE were recruited with a median (interquartile range) disease duration of 16 (8-27) years. Patients with vitamin D deficiency had higher BMI (P = 0.014) and insulin resistance (P = 0.023) than those with 25(OH)D >20 ng/ml. Subjects with SLEDAI-2K ≥ 4 had lower 25(OH)D than those with SLEDAI-2K <4 (median 12.9 vs 20.3 ng/ml, P = 0.031). Aortic stiffness was significantly associated with serum 25(OH)D [log(aPWV) β (95% CI) -0.0217 (-0.038, -0.005), P = 0.010] independently of BMI, CVD risk factors and serum insulin. Adjustment for disease activity reduced the strength of the association. There was no association between 25(OH)D and CP or IMT.

Conclusions: Vitamin D deficiency is associated with increased aortic stiffness in SLE, independent of CVD risk factors and insulin. Increased inflammatory disease activity may be the mechanism by which vitamin D deficiency mediates vascular stiffness in this patient group.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / physiopathology*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / physiopathology*
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Severity of Illness Index
  • Vascular Stiffness / physiology*
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / physiopathology*
  • Young Adult


  • Biomarkers
  • Vitamin D
  • 25-hydroxyvitamin D