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Ann Rheum Dis. 2017 Jan;76(1):153-158. doi: 10.1136/annrheumdis-2016-209157. Epub 2016 Jun 9.

Combined role of vitamin D status and CYP24A1 in the transition to systemic lupus erythematosus.

Author information

1
Colorado School of Public Health, Aurora, Colorado, USA.
2
Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA.
3
Medical University of South Carolina, Charleston, South Carolina, USA.
4
Mayo Clinic, Rochester, Minnesota, USA.
5
Cedars-Sinai Medical Center, Los Angeles, California, USA.
6
Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma, USA.
7
University of Texas Southwestern Medical Center, Dallas, Texas, USA.
8
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
9
US Department of Veterans Affairs Medical Center, Cincinnati, Ohio, USA.

Abstract

OBJECTIVE:

We examined whether measures of vitamin D were associated with transitioning to systemic lupus erythematosus (SLE) in individuals at risk for SLE.

METHODS:

436 individuals who reported having a relative with SLE but who did not have SLE themselves were evaluated at baseline and again an average of 6.3 (±3.9) years later. Fifty-six individuals transitioned to SLE (≥4 cumulative American College of Rheumatology criteria). 25-Hydroxyvitamin D (25[OH]D) levels were measured by ELISA. Six single-nucleotide polymorphisms in four vitamin D genes were genotyped. Generalised estimating equations, adjusting for correlation within families, were used to test associations between the vitamin D variables and the outcome of transitioning to SLE.

RESULTS:

Mean baseline 25[OH]D levels (p=0.42) and vitamin D supplementation (p=0.65) were not different between those who did and did not transition to SLE. Vitamin D deficiency (25[OH]D <20 ng/mL) was greater in those who transitioned compared with those who did not transition to SLE (46% vs 33%, p=0.05). The association between 25[OH]D and SLE was modified by CYP24A1 rs4809959, where for each additional minor allele increased 25[OH]D was associated with decreased SLE risk: zero minor alleles (adjusted OR: 1.03, CI 0.98 to 1.09), one minor allele (adjusted OR: 1.01, CI 0.97 to 1.05) and two minor alleles (adjusted OR: 0.91, CI 0.84 to 0.98). Similarly, vitamin D deficiency significantly increased the risk of transitioning to SLE in those with two minor alleles at rs4809959 (adjusted OR: 4.90, CI 1.33 to 18.04).

CONCLUSIONS:

Vitamin D status and CYP24A1 may have a combined role in the transition to SLE in individuals at increased genetic risk for SLE.

KEYWORDS:

Epidemiology; Gene Polymorphism; Systemic Lupus Erythematosus

PMID:
27283331
PMCID:
PMC5360632
DOI:
10.1136/annrheumdis-2016-209157
[Indexed for MEDLINE]
Free PMC Article

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