Background/Purpose:
Vitamin D deficiency is common in SLE. Vitamin D deficiency is also associated with activation of Tissue Factor. In cross-sectional studies, vitamin D deficiency is more common with APS and thrombosis. We determined whether vitamin D deficiency was associated with thrombosis in SLE.
Methods: 1131 SLE patients had a measure of 25-OH vitamin D. Twenty-seven% had a history of any thrombosis, 15% arterial thrombosis (defined as stroke, myocardial infarction, digital gangrene or other arterial thrombosis), and 17% venous thrombosis (defined as DVT or PE, or other venous thrombosis).
Results:
Table 1 shows that low 25-OH vitamin D (<32 ng/ml) was associated with all thrombosis and with venous thrombosis, but not with arterial thrombosis.
Table 1. Association of 25-OH vitamin D level with thrombosis.
|
Variable |
Number (%) with the characteristic Vitamin D <32 (n=667) Vitamin D ≥32 (n=464) |
Adjusted p-value |
|
|
All thrombosis |
199 (30%) |
105 (23%) |
0.0017* |
|
Arterial thrombosis |
107 (16%) |
63 (14%) |
0.43** |
|
Venous thrombosis |
130 (19%) |
59 (13%) |
0.0004* |
|
Same-day lupus anticoagulant |
111 (17%) |
62 (14%) |
0.089§ |
*Adjusted for age at last assessment, ethnicity, gender, and history of lupus anticoagulant (LAC).
**Adjusted for age at last assessment, ethnicity, gender, history of LAC, history of hypertension, and history of hypercholesterolemia.
§Adjusted for age at last assessment, ethnicity, and gender.
Vitamin D deficiency was not associated with any gene signature (interferon, BAFF, neutrophil, or plasma cell).
Conclusion: Vitamin D deficiency in SLE is associated with venous (but not arterial thrombosis) in adjusted analyses that controlled for other risk factors, including lupus anticoagulant. Vitamin D deficiency is not associated with the interferon gene signature. Given that vitamin D deficiency is associated with Tissue Factor expression and that it is already known to be associated with thrombosis in antiphospholipid patients, this is another rationale for vitamin D measurement and supplementation in SLE. Clinical trials, already underway, in the general population may shed further light on the anti-thrombotic potential of vitamin D.
Disclosure:
M. Petri,
None;
H. Fang,
None.
ACR Meeting Abstracts - https://acrabstracts.org/abstract/low-vitamin-d-is-associated-with-increased-risk-of-venous-thrombosis-in-systemic-lupus-erythematosus-regardless-of-lupus-anticoagulant-status/