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Role of vitamin D, transition to SLE by high risk patients unclear
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Investigators found no association between baseline levels of vitamin D in patients who had a relative with systemic lupus erythematosus and later transitioned to clinical systemic lupus erythematosus compared with patients who had a similar ancestry and did not transition to the condition.
Researchers studied 436 participants without systemic lupus erythematosus (SLE) who reported a relative who had the disease. The investigators followed individuals for a mean of 6.3 years and evaluated them at baseline and at one follow-up. Researchers collected demographic, environmental, clinical, genetic and therapeutic data at both visits.
At follow-up, 56 individuals were diagnosed with SLE as verified by medical records. Antinuclear antibodies were present in 77% of participants. Overall, 77% of participants were Americans of European descent and 88% were women. Investigators found no significant differences between vitamin D levels of supplement use at baseline between patients who transitioned to SLE and participants who did not. Researchers also found no associations with vitamin D levels and transition to positive SLE status after adjusting for age, sex, race or season of blood analysis.
Single nucleotide polymorphisms in CYP27A1, GC, DHCR7/NADSYN1, CYP2R1, VDR, CYP27B1 and CYP24A1 were not associated with transition to SLE. However, in participants who did not supplement with vitamin D, investigators discovered a significant effect modification. In these patients, investigators found a decreased risk for the development of SLE with each additional minor allele variation in rs12794717 in CYP2R1 with an adjusted odds ratio (OR) of 0.71. The presence of each additional allele was associated with an adjusted OR of 5.76 in participants who supplemented with vitamin D.
The researchers wrote that, “the large effect size of vitamin D deficiency and the interaction between supplement use and CYP2R1 on SLE risk suggests that vitamin D may play a role that is not adequately marked by 25[OH]D levels.” - by Shirley Pulawski
Reference:
Young KA, et al. Paper #24. Presented at: American College of Rheumatology Annual Meeting; Nov. 7-11, 2015; San Francisco.
Disclosures: The researchers report no relevant financial disclosures.