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. 2019 Feb 22;9:2546. doi: 10.1038/s41598-019-38756-8

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© The Author(s) 2019

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Overview model of the interplay of vitamin D and lipid profiles in RA. Our results support a role for DHCR7 and genetic polymorphisms to account for the associations between vitamin D and lipid profiles in RA, in a seasonal-dependent manner. In winter/spring, environmental factors can trigger an imbalanced vitamin D/lipid profile, which can be in turn exacerbated by their mutual, complex regulation mechanisms, decreasing DHCR7 levels playing a crucial role. Due to the decreased DHCR7 levels and low sunlight exposure, the common substrate 7-DHC may be mainly shunted towards cholesterol rather than vitamin D production, hence aggravating the imbalance. Disease-specific features and genetic polymorphisms can reinforce these pathogenic loops. In summer/autumn, a more favorable effect on vitamin D by environmental factors may lead to a tighter balance among vitamin D, lipid profile and DHCR7 levels, as demonstrated by the positive associations observed in our study. (−) denotes a negative/inhibition effect, whereas (+) denotes a promoting effect. ↑: increased; ↔ : no change, normal levels; ↓: decreased.