Association between low 25-hydroxyvitamin D, insulin resistance and arterial stiffness in nondiabetic women with systemic lupus erythematosus

Sabio, José Mario; Vargas‐Hitos, José Antonio; Martínez-Bordonado, Josefa; Navarrete‐Navarrete, Nuria; Díaz-Chamorro, Antonio; Porcel, María del Carmen Olvera; Zamora, Margarita; Jiménez-Alonso, J

doi:10.1177/0961203314551811

Cited by 53 publications

(55 citation statements)

References 41 publications

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“…In our previous analysis we found an independent inverse association between 25-OH-D 3 and increased arterial stiffness in the general population [14], and this finding was confirmed by several other studies in various settings of subjects [30][31][32][33]. The potential physiological role of vitamin D in regulating vascular calcification is multifactorial, but the pivotal role of matrix metalloproteinases (MMPs), a group of connective-tissue enzymes, is generally accepted.…”

Section: Accepted Manuscriptmentioning

confidence: 63%

Synergistic effect of low K and D vitamin status on arterial stiffness in a general population

Mayer

Seidlerová

Wohlfahrt

et al. 2017

The Journal of Nutritional Biochemistry

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Section: Accepted Manuscriptmentioning

confidence: 63%

Synergistic effect of low K and D vitamin status on arterial stiffness in a general population

Mayer

Seidlerová

Wohlfahrt

et al. 2017

The Journal of Nutritional Biochemistry

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“…Evidence exists of a more severe IR in SLE patients when compared with age-and sex-matched healthy controls, as identified by higher fasting insulin levels and the Homeostasis Model Assessment Index (HOMA IR) (2,4,(7)(8)(9), a surrogate marker of IR (10). Notably, this is observed despite normal levels of fasting glucose (7,8), which suggests that SLE patients may be able to maintain normal glycemia due to a higher secretion of insulin by pancreatic beta cells, which could predispose to beta cell dysfunction and type 2 DM in the long term (11).…”

Section: Introductionmentioning

confidence: 99%

Increased Insulin Resistance and Glucagon Levels in Mild/Inactive Systemic Lupus Erythematosus Patients Despite Normal Glucose Tolerance

Miyake

Gualano

Dantas

et al. 2017

Arthritis Care & Research

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Objective. To assess insulin sensitivity in patients with systemic lupus erythematosus (SLE) in response to a meal tolerance test (MTT). Methods. In this cross-sectional study, 33 adult females with mild/inactive SLE (SLE group) and 16 age-and body mass index-matched female healthy controls (CTRL group) underwent an MTT and were assessed for insulin sensitivity and beta cell function. Skeletal muscle protein expressions of total and membrane insulin-dependent glucose transporter 4 (GLUT-4) were also evaluated (SLE group: n = 10, CTRL group: n = 5); muscle biopsies were performed after MTT. Further measurements included inflammatory cytokines, adipocytokines, physical activity level, body composition, and food intake. Results. SLE and CTRL groups showed similar fasting glucose, glucose response, and skeletal muscle GLUT-4 translocation after MTT. However, the SLE group demonstrated higher fasting insulin levels (P = 0.01; effect size [ES] 1.2), homeostatic model assessment insulin resistance (IR) (P = 0.03; ES 1.1), insulin-to-glucose ratio response to MTT (P = 0.02; ES 1.2), fasting glucagon levels (P = 0.002; ES 2.7), glucagon response to MTT (P = 0.0001; ES 2.6), and a tendency toward lower Matsuda index of whole-body insulin sensitivity (P = 0.06; ES À0.5) when compared with the CTRL group. Fasting proinsulin-to-insulin ratio and proinsulin-to-insulin ratio response to MTT were similar between groups (P > 0.05), while the SLE group showed a higher insulinogenic index when compared with the CTRL group (P = 0.02; ES = 0.9). Conclusion. We have identified that SLE patients had a bi-hormone metabolic abnormality characterized by increased IR and hyperglucagonemia despite normal glucose tolerance and preserved beta cell function and skeletal muscle GLUT-4 translocation. Strategies capable of ameliorating insulin sensitivity to reduce the risk of type 2 diabetes mellitus and cardiovascular disease in SLE may require more than targeting IR alone.

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“…Ultimately, 19 studies were included in our meta‐analysis (Figure ). Sixteen studies compared circulating 25(OH)D levels between SLE patients and healthy controls (Table ); seven Studies provided the information about the deficiency, insufficiency, sufficiency of vitamin D in both SLE patients and healthy controls (Table ); 6 studies explored the correlations between disease activity of SLE and 25(OH)D levels (Table ). The NOS scores of included studies ranged from 6 to 8 stars, indicating each of the studies had high methodological quality (Table ).…”

Section: Resultsmentioning

confidence: 99%

Association between circulating 25‐hydroxyvitamin D and systemic lupus erythematosus: A systematic review and meta‐analysis

et al. 2019

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Aim The indicators for measuring vitamin D are various, and 25‐hydroxyvitamin D (25(OH)D) is considered as the optimal indicator of total vitamin D levels. In this study, we aim to deeply explore the 25(OH)D status in systemic lupus erythematosus (SLE) patients, and evaluate its relation to SLE risk and disease severity. Methods Literature about 25(OH)D status and its associations with SLE were searched in Pubmed, Embase and Cochrane Library databases. Standardized mean difference (SMD), odds ratio (OR) and corresponding 95% confidence interval (95% CI) were illustrated by forest plots, and correlation coefficients (r) were combined by generic inverse variance method. Heterogeneity and publication bias were quantified by I‐squared (I2) test, funnel plot and Egger's test, respectively. Sensitivity analyses were further examined by leave‐one‐out method. Results Nineteen articles were included into our meta‐analysis. The overall results showed that compared with the healthy controls, the circulating 25(OH)D levels were significantly lower in SLE patients (pooled SMD = −1.63, 95% CI: −2.51 to −0.76). Subgroup analysis revealed that compared with the healthy controls, SLE patients of Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) ≥ 10, Arab and European ethnicity, all 4 seasons, no vitamin D supplement, had significantly lower circulating 25(OH)D levels; no significant differences were observed in SLE patients of SLEDAI < 10, mixed ethnicity, spring, summer, vitamin D supplement, respectively; no matter the changes of age, disease duration, and the therapy of corticosteroid or immunosuppressive or neither, circulating 25(OH)D levels were significantly reduced in SLE patients. The deficiency, insufficiency and sufficiency of vitamin D could significantly elevate, slightly decrease (not significantly), significantly decrease SLE risk, respectively (pooled OR = 4.37, 95% CI: 1.49 to 12.84; pooled OR = 0.52, 95% CI: 0.22 to 1.26; pooled OR = 0.31, 95% CI: 0.15 to 0.63). Circulating 25(OH)D levels were inversely associated with SLEDAI (pooled correlation coefficient = −0.50, 95% CI: −0.8278 to −0.1689). Conclusions Compared with healthy controls, 25(OH)D levels are significantly lower in SLE patients, which is influenced by disease activity, ethnicity, seasons and vitamin D supplement; no matter the change of age, diseases duration and therapy of corticosteroid or immunosuppressive or neither, 25(OH)D levels are significantly decreased in SLE patients; the deficiency, insufficiency and sufficiency of vitamin D could significantly elevate, slightly decrease, and significantly decrease SLE risk, respectively; and 25(OH)D levels inversely correlate with SLEDAI.

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Association between low 25-hydroxyvitamin D, insulin resistance and arterial stiffness in nondiabetic women with systemic lupus erythematosus

Abstract: Low 25(OH)D levels were found to be associated with increased IR in nondiabetic women with SLE independently of BMI. Low 25(OH)D levels, but not IR, could be associated with increased arterial stiffness in these patients.

Cited by 53 publications

References 41 publications

Synergistic effect of low K and D vitamin status on arterial stiffness in a general population

Synergistic effect of low K and D vitamin status on arterial stiffness in a general population

Increased Insulin Resistance and Glucagon Levels in Mild/Inactive Systemic Lupus Erythematosus Patients Despite Normal Glucose Tolerance

Association between circulating 25‐hydroxyvitamin D and systemic lupus erythematosus: A systematic review and meta‐analysis

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