Maintaining optimal levels of vitamin D in the blood may protect against the risk of a cardiovascular disease often seen in patients with systemic lupus erythematosus (SLE), according to a large literature review on the subject.
The review, “Vitamin D and cardiovascular disease in patients with systemic lupus erythematosus,” was written by Dr. Mario García-Carrasco at Universidad Autónoma de Puebla and Dr. Jose Luis Romero-Galvez from Hospital Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado in Puebla, Mexico, and published in the scientific journal Reumatología Clínica.
The overall recommendation is that it may be reasonable to give vitamin D supplements to any SLE patients who are deficient in vitamin D, and to those at high risk of developing cardiovascular disease.
SLE is a complex autoimmune disease with many unexplained aspects, such as the clinical observation that patients have a higher risk of developing cardiovascular disease. Previous research was unable to attribute this risk to co-conditions, like diabetes, or to lifestyle choices, such as smoking.
In an attempt to identify less obvious factors that might contribute to the increased risk of cardiovascular disease in SLE patients, the authors reviewed the medical literature on the topic.
A possible clue came from previous work by García-Carrasco and colleagues, who had shown that these patients very often had vitamin D insufficiency or deficiency. This is likely related to the absence of exposure to sunlight, and to the use of sunscreens as part of the treatment for photosensitivity in this group of people. The authors hypothesized that vitamin D deficiency could be a risk factor.
Several studies were identified suggesting that vitamin D may have a protective role against the development of autoimmune disorders. Some studies have shown that vitamin D is able to influence the maturation of the immune system; others found that it is able to reduce the abundance of molecules that trigger inflammation. Some studies also suggested that vitamin D is able to alter the relative composition of immune cells, increasing the number of protective ones while reducing the number of toxic cells that may attack the body’s tissues.
Overall, the studies suggested that vitamin D may have a beneficial general effect that could be extended to the cardiovascular system. However, published articles differed as to whether vitamin D can actually contribute to a reduction in atherosclerosis, the main cardiovascular condition seen in SLE patients. This controversy also extended to the optimal dose of vitamin that is required to achieve a beneficial effect.
Researchers concluded that, although there is no certainty that deficiency in vitamin D contributes to cardiovascular disease in SLE per se, there is evidence that it worsens the manifestations of SLE. They suggest that maintaining optimal levels of vitamin D through supplements could reduce the risk of cardiovascular disease in SLE patients.