SAT0141 Vitamin D Deficiency is A Risk Factor for Carotid Atherosclerosis in Women with Rheumatoid Arthritis

Abstract

Background Although there is increasing evidence that low serum 25-hydroxy vitamin D (25-OHD) is associated with a higher frequency of cardiovascular diseases (CVDs) in the general population, little attention has been given to the relationship between vitamin D deficiency and atherosclerosis in patients with rheumatoid arthritis (RA). Objectives The present study aimed to investigate whether vitamin D deficiency is a potential risk factor for carotid atherosclerosis in patients with (RA). Methods With a cross-sectional design, we recruited 60 consecutive female RA patients without previous CVDs between September 2013 and December 2013 at the outpatient rheumatology clinic of a tertiary referral centre in South Korea. Carotid intima media thickness (CIMT) was measured using high-resolution ultrasonography (Philips HD15, Bothwell, WA, USA) and QLAB's IMT-quantification software plug-in (Philips Healthcare, DA Best, The Netherlands) was used to enhance the consistency and reliability of CIMT measurement. Serum 25-OHD levels were assessed by radioimmunoassay. Stepwise multivariable linear regression models were used to evaluate the association between serum 25-OHD levels and CIMT. Results Mean (SD) age and disease duration were 56.0 (11.2) and 5.9 (4.9) years, respectively. Median 25-OHD levels (IQR) was 14.0 (11.0-20.7) ng/mL and 74% of patients had vitamin D deficiency (<20ng/mL). Mean (SD) CIMT was 0.58 (0.08) mm and 24 (48%) RA patients had abnormal CIMT (≥6 mm). Compared to RA patients with normal CIMT (<6mm), those with abnormal CIMT (≥6 mm) were older and had longer disease duration, lower serum 25-OHD levels and high density lipoprotein (HDL) and higher disease activity score (DAS) 28 and Korean version of health assessment questionnaire (K-HAQ) score. In univariable analyses, lower serum 25-OHD levels and HDL, older age, and higher DAS28 and K-HAQ scores were associated with increased CIMT (Table 1), while disease duration, blood pressure, triglyceride, low density lipoprotein and Homeostatic model assessment - insulin resistance showed no association with CIMT. Serum 25-OHD levels remains statistically significant in multivariable regression models after adjusting confounding factors (Table 1). Table 1. Linear regression models evaluating the association between serum vitamin D levels and carotid intima media thickness Univariable analysis Model 1* Model 2** β (SE) P β (SE) P β (SE) P Serum 25-OHD, ng/mL −0.001 (4.8–4) 0.044 −0.001 (3.7–4) 0.010 −0.001 (3.7–4) 0.043 Age, years 0.003 (7.2–4) <0.001 0.003 (7.2–4) <0.001 0.003 (7.1–4) <0.001 BMI, kg/m2 0.005 (0.003) 0.106 0.007 (0.002) 0.008 0.006 (0.002) 0.011 HDL, mg/dL −0.001 (5.2–4) 0.054 DAS28-ESR 0.021 (0.010) 0.034 0.015 (0.008) 0.076 K-HAQ 0.0511 (0.015) 0.002 0.041 (0.064) 0.011 Adjusted R2 0.448 0.489 25-OHD, 25-hydroxy vitamin D; BMI, body mass index; HDL, high density lipoprotein; DAS28-ESR, disease activity score 28 – erythrocyte sedimentation rate; K-HAQ, Korean version of health assessment questionna...