Background/Purpose: Vitamin D insufficiency/deficiency is common in SLE. In other populations, vitamin D has been associated with cardiovascular risk factors such as blood pressure and serum cholesterol. We assessed whether there was an association between serum vitamin D and total serum cholesterol in a large SLE cohort.

Methods: Serum 25-hydroxy vitamin D [25(OH)D] was measured at quarterly clinic visits in a large SLE cohort. 1358 different patients were observed from 1 to 40 visits (the median was 11). The patients were 92% female, 50% Caucasian, 41% African American. Age ranged from 17 to 89 years. When the 25(OH)D level was below 40 mg/ml, the patient was prescribed supplemental vitamin D, usually 50,000 IU weekly. We explored the association between serum vitamin D levels and serum cholesterol using longitudinal regression models.

Results: Levels of 25(OH)D below 50 ng/ml were associated with a higher mean cholesterol. There was a significantly negative linear relationship between vitamin D and mean cholesterol when 25(OH)D was below 50 ng/ml.

Table 1: Slope of Relationship Between 25(OH) Vitamin D and Mean Cholesterol Over Different Ranges of 25(OH) Vitamin D

¹ Adjusted for age, age-squared, sex, race, proportion of time on hydroxychloroquine use, corticosteroid use, BMI and systolic blood pressure.

Conclusion: We observed a decline in total cholesterol as vitamin D increased to the normal range. Vitamin D supplementation significantly reduced cholesterol, even after adjustment for hydroxychloroquine. Vitamin D, like hydroxychloroquine, has benefit beyond immunomodulation, in that it reduces multiple cardiovascular risk factors.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/vitamin-d-deficiency-is-associated-with-increased-serum-cholesterol-among-patients-with-systemic-lupus-erythematosus/