Article Text

Download PDFPDF

S5D:4 Low vitamin d is associated with thrombosis in systemic lupus erythematosus
  1. M Petri,
  2. W Fu and
  3. D Goldman
  1. Johns Hopkins University School of Medicine, Baltimore, MD, USA


Background/purpose Low vitamin D is common in systemic lupus erythematosus (SLE). It is also found in antiphospholipid syndrome. Vitamin D has effects on tissue factor, PAI-1, thrombomodulin and platelet aggregation that suggest it has an anti-thrombotic role. We asked whether low vitamin D was associated with thrombosis in SLE, adjusting for lupus anticoagulant.

Methods A total of 1,392 SLE patients were included in the analysis. At the first visit when vitamin D was measured, 76.7% had levels of 25-hydroxyvitamin D<40 ng/mL. The SLE patients were: 92% female, mean age 42.9 years, and ethnicity 50% Caucasian, 41% African American. 27% patients had a history of thrombosis; 7% stroke, 4% MI and 14% DVT.

Results Vitamin D, measured either as a continuous variable or as ‘low’ (<40 ng/mL) vs normal, was associated with any thrombosis and with DVT.

We next looked prospectively: this analysis excluded thrombotic events before the first vitamin D measurement. It allowed for vitamin D to be a time-varying variable, as replacement therapy was given if it was low. After adjustment for race, age and sex, the adjusted hazard ratio remained significant for any thrombosis: 1.75 (1.04,2.92).

Conclusion Low vitamin D was significantly associated with any thrombosis and with DVT (even after adjustment for lupus anticoagulant). In prospective models it remained significantly associated with any thrombosis. As supplementation with vitamin D was proven to reduce thrombosis in an oncology randomised clinical trial, vitamin D replacement should become routine in SLE patients at risk for thrombosis.

Abstract S5D:4 Table 1

Associations of first vitamin D measurement with thrombosis

Abstract S5D:4 Table 2

Summary of adjusted odds ratio for low vitamin D (<40 ng/ml)

  • Vitamin D
  • Thrombosis

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.