Vitamin D deficiency is a potential risk factor for cardiometabolic disease. We investigated the associations between vitamin D and dyslipidemia and the metabolic syndrome in patients with rheumatoid arthritis,a group at high risk for cardiovascular disease.
Serum 25(OH)vitamin D and lipoprotein levels were measured at baseline in a random sample of 499 participants,ages 18-85 years,enrolled in a randomized trial of golimumab (GOlimumab Before Employing methotrexate as the First-line Option in the treatment of Rheumatoid arthritis of Early onset or GO-BEFORE Trial). Participants had rheumatoid arthritis with active disease,and were naïve to methotrexate and biologic therapies. Multivariable linear regression was performed to assess associations between vitamin D levels and lipoprotein fractions. Multivariable logistic regression was performed to determine the odds of hyperlipidemia and the metabolic syndrome in participants with vitamin D deficiency (<20 ng/mL).
In multivariable linear regression,vitamin D levels (per 10 ng/mL) were associated inversely with low-density lipoprotein (β:−0.029 [−0.049,−0.0091],P=.004) and triglyceride (β:−0.094 [−0.15,−0.039] P=.001) levels,adjusted for demographic,cardiovascular,and disease-specific variables. Vitamin D and high-density lipoprotein levels were not associated in univariate or multivariate analyses. Vitamin D deficiency was associated independently with an increased odds of hyperlipidemia (odds ratio 1.72;95% confidence interval,1.10-2.45;P=.014) and metabolic syndrome (odds ratio 3.45;95% confidence interval,1.75-6.80;P <.001) in adjusted models.
In conclusion,vitamin D deficiency was associated with the metabolic syndrome and dyslipidemia in rheumatoid arthritis,suggesting a potential role in cardiovascular disease risk. Large-scale,prospective studies are needed to determine if vitamin D supplementation improves lipoprotein levels and reduces cardiovascular risk in rheumatoid arthritis.