title: Vitamin D deficiency is associated with digital ulcer but not with atherosclerosis or arterial stiffness in patients with systemic sclerosis: a pilot study.
abstract: The objective of this study was to investigate the association of vitamin D deficiency with digital ulcers (DUs) that result from microvasculopathy, carotid intima-media thickness (CIMT) as surrogate markers of atherosclerosis, and brachial-ankle pulse wave velocity (baPWV) representing arterial stiffness in patients with systemic sclerosis (SSc). In this cross-sectional study, 40 female SSc patients and 80 healthy controls matched for sex, age, and blood sampling season were recruited. Vitamin D deficiency was defined as serum 25-OHD levels <30 ng/mL. "DUs ever" included active and healed DUs. CIMT and carotid plaque were examined using high-resolution ultrasonography, and baPWV was measured using an automatic waveform analyzer. Vitamin D deficiency was more prevalent in SSc patients than in controls (30 vs. 11.3%). Regarding SSc patients, 9 (22.5%) had DUs ever, and the mean CIMT and baPWV were 0.68 mm and 1561.1 cm/s, respectively; carotid plaque was detected in 13 (34.2%) patients. The frequency of DUs ever was significantly higher for SSc patients with vitamin D deficiency than those without this feature (50 vs. 10.7%, p = 0.012), but the median CIMT and baPWV and the frequency of carotid plaque did not differ according to the presence of vitamin D deficiency. Multivariable logistic regression analysis showed that vitamin D deficiency was an independent risk factor for DUs ever (OR = 7.72, p = 0.024). Vitamin D deficiency was associated with DUs, but not with atherosclerosis or arterial stiffness, potentially indicating that vitamin D may have different effects on the microvascular and macrovascular involvement in SSc pathophysiology.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 49241, South Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Eun-Kyoung
authors.initials: EK
authors.lastname: Park
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 49241, South Korea.
authors.forename: Ji-Heh
authors.initials: JH
authors.lastname: Park
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 49241, South Korea.
authors.forename: Seong-Min
authors.initials: SM
authors.lastname: Kweon
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea.
authors.forename: Geun-Tae
authors.initials: GT
authors.lastname: Kim
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 49241, South Korea. sglee@pusan.ac.kr.|Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea. sglee@pusan.ac.kr.
authors.forename: Seung-Geun
authors.initials: SG
authors.lastname: Lee
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D063177:Pulse Wave Analysis; D012595:Scleroderma, Systemic / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D012883:Skin Ulcer / Q000097:blood / Q000209:etiology*; D059289:Vascular Stiffness; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000150:complications*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Atherosclerosis; Systemic sclerosis; Ulcers; Vascular stiffness; Vitamin D