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Randall Simpson JA, Miller N, Hartwig T, Leach J, Purdy M, Roth E, Mok Siu V, Soulliere C, Tam J, Watt A. Vitamin D, Folate, Vitamin B 12, and Iron Status in Pregnant/Postpartum Old Order Anabaptist Women in Southwestern Ontario. CAN J DIET PRACT RES 2024:1-8. [PMID: 39133050 DOI: 10.3148/cjdpr-2024-003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Purpose: To assess vitamin D, folate, vitamin B12, and iron status in Old Order Anabaptist (OOA) pregnant/postpartum women.Methods: Blood was analyzed for plasma 25 hydroxy vitamin D (25(OH)D), red blood cell (RBC) folate, serum vitamin B12, and iron status indicators. Dietary intakes (food and supplements) from 3-day estimated records were compared to Dietary Reference Intakes and Canada's Food Guide (2007).Results: Fifty women participated in this descriptive cross-sectional study. Concentrations of 25(OH)D were low (<50 nmol/L for 20% and < 75 nmol/L for 63%); 42% had total vitamin D intakes < estimated average requirement (EAR). All women had RBC folate above the 1360 mmol/L cut-off. Nineteen percent had folate intakes upper limit. One woman had low serum vitamin B12 (<148 pmol/L); serum vitamin B12 was high (>652 pmol/L) for 24%. None had vitamin B12 intakes
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Affiliation(s)
| | | | - Taylor Hartwig
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON
| | - Jane Leach
- Huron Perth Public Health, Stratford, ON
| | | | - Emily Roth
- Countryside Midwifery Services, Milverton, ON
| | | | | | - Jacqui Tam
- Huron Perth Public Health, Stratford, ON
| | - Ann Watt
- Huron Perth Public Health, Stratford, ON
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Laird E, O'Halloran AM, Molloy AM, Healy M, Bourke N, Kenny RA. Vitamin D status & associations with inflammation in older adults. PLoS One 2023; 18:e0287169. [PMID: 37379302 DOI: 10.1371/journal.pone.0287169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/30/2023] [Indexed: 06/30/2023] Open
Abstract
Research studies have observed associations of vitamin D with inflammation but data in representative older adult studies is lacking. We aimed to investigate the association of C-reactive protein (CRP) with vitamin D status in a representative sample of the older Irish population. The concentrations of 25-hydroxyvitamin D (25(OH)D) and CRP was measured in 5,381 community dwelling Irish adults aged ≥50 years from the Irish Longitudinal Study on Ageing (TILDA). Demographic, health and lifestyle variables were assessed by questionnaire and categorical proportions of CRP were generated by vitamin D status and age. Multi-nominal logistic regression was used to investigate the association of 25(OH)D and CRP status. The prevalence (mean; 95% confidence interval (95% CI)) of normal CRP status (0-5 mg/dL) was 83.9% (82.6-85.0%), elevated status (5-10 mg/dL) 11.0% (9.9-12.0%) and high status (>10 mg/dL) was 5.1% (4.5-5.8%). Mean (95% CI) CRP concentrations were lower in those with normal vs. deficient 25(OH)D status (2.02 mg/dL (1.95-2.08) vs. 2.60 mg/dL (2.41-2.82); p<0.0001). In a logistic regression analysis, those with insufficient or sufficient 25(OH)D status were less likely to have a high CRP status compared to those with deficient 25(OH)D status (insufficient: coefficient (CE) -0.732, 95% CI -1.12-0.33, p<0.0001; sufficient: CE -0.599, 95% CI -0.95-0.24, p = 0.001). In conclusion older adults with deficient vitamin D status had higher levels of inflammation as measured by CRP. Given that inflammation is an important pathological driver of chronic diseases of ageing, and that emerging evidence suggests that vitamin D therapy can reduce inflammation in some disease settings, optimising vitamin D status could represent an effective low risk/low-cost pathway to modulate inflammation in community dwelling older adults.
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Affiliation(s)
- Eamon Laird
- School of Physical Education and Sports Science, University of Limerick, Limerick, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Anne M Molloy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Martin Healy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Nollaig Bourke
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- The TILDA Study, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Golüke NM, Schoffelmeer MA, De Jonghe A, Emmelot-Vonk MH, De Jong PA, Koek HL. Serum biomarkers for arterial calcification in humans: A systematic review. Bone Rep 2022; 17:101599. [PMID: 35769144 PMCID: PMC9234354 DOI: 10.1016/j.bonr.2022.101599] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 11/25/2022] Open
Abstract
Aim To clarify the role of mediators of ectopic mineralization as biomarkers for arterial calcifications. Methods MEDLINE and Embase were searched for relevant literature, until January 4th 2022. The investigated biomarkers were: calcium, phosphate, parathyroid hormone, vitamin D, pyrophosphate, osteoprotegerin, receptor activator of nuclear factor-kappa B ligand (RANKL), fibroblast growth factor-23 (FGF-23), Klotho, osteopontin, osteocalcin, Matrix Gla protein (MGP) and its inactive forms and vitamin K. Studies solely performed in patients with kidney insufficiency or diabetes mellitus were excluded. Results After screening of 8985 articles, a total of 129 articles were included in this systematic review. For all biomarkers included in this review, the results were variable and more than half of the studies for each specific biomarker had a non-significant result. Also, the overall quality of the included studies was low, partly as a result of the mostly cross-sectional study designs. The largest body of evidence is available for phosphate, osteopontin and FGF-23, as a little over half of the studies showed a significant, positive association. Firm statements for these biomarkers cannot be drawn, as the number of studies was limited and hampered by residual confounding or had non-significant results. The associations of the other mediators of ectopic mineralization with arterial calcifications were not clear. Conclusion Associations between biomarkers of ectopic mineralization and arterial calcification are variable in the published literature. Future longitudinal studies differentiating medial and intimal calcification could add to the knowledge of biomarkers and mechanisms of arterial calcifications. We researched the association between biomarkers and arterial calcifications. This review focused on biomarkers of bone metabolism and Matrix Gla protein. Associations between biomarkers and arterial calcification are variable. Future studies should differentiate between medial and intimal calcifications.
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Key Words
- 1,25(OH)2D, 1,25-dihydroxyvitamin D
- 25(OH)D, 25-hydroxyvitamin D
- Arterial calcification
- Biomarkers
- CAC, coronary artery calcification
- CAD, coronary artery disease
- CVD, cardiovascular disease
- FGF-23, fibroblast growth factor-23
- GACI, generalized arterial calcification of infancy
- MGP, matrix Gla protein
- MK, menaquinone
- OPG, osteoprotegerin
- PIVKA-2, protein induced by vitamin K absence or antagonist-2
- PK, phylloquinone
- PTH, parathyroid hormone
- PXE, pseudoxanthoma elasticum
- RANKL, receptor activator of nuclear factor-kappa B ligand
- Review
- dp-cMGP, carboxylated but dephosphorylated MGP
- dp-ucMGP, uncarboxylated an dephosphorylated MGP
- uc-MGP, uncarboxylated MGP
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Affiliation(s)
- Nienke M.S. Golüke
- University Medical Center Utrecht, Department of Geriatrics, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
- Tergooi Hospitals, Department of Geriatrics, Rijksstraatweg 1, 1261 AN Blaricum, the Netherlands
- Corresponding author at: Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands.
| | - Marit A. Schoffelmeer
- University Medical Center Utrecht, Department of Geriatrics, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Annemarieke De Jonghe
- Tergooi Hospitals, Department of Geriatrics, Rijksstraatweg 1, 1261 AN Blaricum, the Netherlands
| | - Mariëlle H. Emmelot-Vonk
- University Medical Center Utrecht, Department of Geriatrics, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Pim A. De Jong
- University Medical Center Utrecht, Department of Radiology, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Huiberdina L. Koek
- University Medical Center Utrecht, Department of Geriatrics, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
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Vitamin D gene polymorphisms and risk of acute cardiovascular events. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.05.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Rafiq R, El Haddaoui H, de Mutsert R, Rosendaal FR, Hiemstra PS, Cobbaert CM, den Heijer M, de Jongh RT. Adiposity is a confounding factor which largely explains the association of serum vitamin D concentrations with C-reactive protein, leptin and adiponectin. Cytokine 2020; 131:155104. [PMID: 32325367 DOI: 10.1016/j.cyto.2020.155104] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 03/18/2020] [Accepted: 04/13/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The role of adiposity in the relationship between vitamin D and inflammation is unknown. Our aim was therefore to assess the association of serum 25-hydroxyvitamin D (25(OH)D) with C-reactive protein (CRP), leptin and adiponectin and the role of adiposity in this relationship. METHODS This is a cross-sectional analysis of The Netherlands Epidemiology of Obesity Study (NEO), a population-based cohort study in men and women aged 45 to 65 years. Main outcome measures were CRP, leptin and adiponectin. In the linear regression analyses we adjusted for age, sex, ethnicity, creatinine, education, alcohol use, smoking status, physical activity, number of chronic diseases, season, total body fat and waist circumference. RESULTS Of the 6287 participants, 21% were vitamin D deficient (serum 25(OH)D < 50 nmol/L). Mean (SD) age and BMI were 56 (6) years and 26.3 (4.4) kg/m2, respectively. Although after adjustment for most examined potential confounders, each 10 nmol/L increase in serum 25(OH)D was associated with 2.3% (95%CI: -4.0 to -0.5) lower CRP, 3.5% (-4.7 to -2.2) lower leptin, and 0.13 ng/mL (0.04-0.21) higher adiponectin, most of these associations seemed to largely stem from an additional potential confounder - adiposity - as they either disappeared (leptin and CRP) or were largely diminished (adiponectin) upon further adjustment for adiposity indices (total body fat and waist circumference). CONCLUSION We found that measures of adiposity largely explained the negative association of serum 25(OH)D with the pro-inflammatory CRP and leptin, and the positive association with the anti-inflammatory adiponectin. These results suggest that future studies should take the effect of adiposity into account.
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Affiliation(s)
- Rachida Rafiq
- Department of Internal Medicine and Endocrinology, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
| | - Hassana El Haddaoui
- Department of Internal Medicine and Endocrinology, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Pieter S Hiemstra
- Department of Pulmonology, Leiden University Medical Center, Leiden, the Netherlands
| | - Christa M Cobbaert
- Department of Clinical Chemistry, Leiden University Medical Center, Leiden, the Netherlands
| | - Martin den Heijer
- Department of Internal Medicine and Endocrinology, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Renate T de Jongh
- Department of Internal Medicine and Endocrinology, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands
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Huff H, Merchant AT, Lonn E, Pullenayegum E, Smaill F, Smieja M. Vitamin D and progression of carotid intima-media thickness in HIV-positive Canadians. HIV Med 2017; 19:143-151. [PMID: 29110385 DOI: 10.1111/hiv.12563] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Based on a growing body of evidence implicating low vitamin D status in the development of cardiovascular disease (CVD), we hypothesized that in Canadian HIV-positive adults, low 25-hydroxyvitamin D (25(OH)D) concentration would be associated with increased subclinical vascular disease progression. METHODS We prospectively studied the relationship between baseline 25(OH)D and subsequent progression of carotid intima-media thickness (CIMT) between 2002 and 2011, in the Canadian HIV Vascular Study using stored blood specimens. RESULTS Of the 128 participants, 89.1% were men, the mean age (standard deviation [SD]) was 46.5 (8.2) years, 93.8% were white, and 36.7% were current smokers. Mean (SD) annual CIMT follow-up was 5.9 (1.8) years (maximum 8.5 years), providing approximately 750 patient-years of follow-up. Mean (SD) CIMT progression was 0.027 (0.030) mm/year. Mean (SD) 25(OH)D was 95.0 (46.9) nmol/L. Only 13.3% of participants were vitamin D deficient (25(OH)D < 50 nmol/L), whereas 61.7% had a 25(OH)D exceeding the sufficiency threshold (75 nmol/L). Vitamin D quartiles were inversely associated with body mass index (BMI) (P = 0.034), total cholesterol to high-density lipoprotein (HDL) cholesterol ratio (P = 0.001) and parathyroid hormone concentration (P = 0.003), but not efavirenz exposure (P = 0.141). In linear regression analyses, baseline 25(OH)D as a continuous variable was inversely associated with CIMT progression in univariable (P < 0.001) and multivariable (P < 0.001) models. CONCLUSIONS Baseline 25(OH)D was associated with CIMT progression in this relatively vitamin D replete, predominately white and male, Canadian HIV-positive population. Future research needs to establish causality as this may warrant more targeted screening or supplementation.
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Affiliation(s)
- H Huff
- Department of Clinical Education, Canadian College of Naturopathic Medicine, Toronto, ON, Canada.,Department of Clinical Epidemiology and Biostatistics, Health Research Methods, McMaster University, Hamilton, ON, Canada
| | - A T Merchant
- Department of Clinical Epidemiology and Biostatistics, Health Research Methods, McMaster University, Hamilton, ON, Canada.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - E Lonn
- Department of Clinical Epidemiology and Biostatistics, Health Research Methods, McMaster University, Hamilton, ON, Canada.,Department of Medicine, Cardiology, McMaster University Faculty of Health Sciences, Hamilton, ON, Canada
| | - E Pullenayegum
- Department of Clinical Epidemiology and Biostatistics, Health Research Methods, McMaster University, Hamilton, ON, Canada.,Sick Kids Research Institute, Hospital for Sick Children, Toronto, ON, Canada
| | - F Smaill
- Department of Pathology and Molecular Medicine, McMaster University Faculty of Health Sciences, Hamilton, ON, Canada
| | - M Smieja
- Department of Clinical Epidemiology and Biostatistics, Health Research Methods, McMaster University, Hamilton, ON, Canada.,Department of Pathology and Molecular Medicine, McMaster University Faculty of Health Sciences, Hamilton, ON, Canada
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Lee YH, Kweon SS, Choi JS, Nam HS, Park KS, Choi SW, Ryu SY, Oh SH, Shin MH. Association of serum vitamin D and parathyroid hormone with subclinical atherosclerotic phenotypes: The Dong-gu Study. PLoS One 2017; 12:e0186421. [PMID: 29088221 PMCID: PMC5663373 DOI: 10.1371/journal.pone.0186421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 09/29/2017] [Indexed: 12/12/2022] Open
Abstract
Background Although previous studies reported an association between serum vitamin D and parathyroid hormone (PTH) with carotid atherosclerosis or arterial stiffness, these were inconsistent. We examined the independent association between serum vitamin D and PTH with multiple subclinical markers of atherosclerosis. Methods A total of 8,217 subjects who participated in the Dong-gu Study in Korea were included in the final analysis. The carotid artery structure, including intima-media thickness (IMT), plaques, and luminal diameter, was evaluated using a high-resolution B-mode ultrasound. The brachial-ankle pulse wave velocity (baPWV) was determined using an automatic waveform analysis device, and the mean of the left and right baPWV was used. Results The PTH concentration was positively associated with carotid luminal diameter and baPWV, but not with carotid IMT and plaques. The mean carotid luminal diameter of individuals with PTH levels in the second, third, and fourth quartiles was significantly larger compared with those in the first quartile (P-trend < 0.01). The mean baPWV of individuals with PTH levels in the fourth quartile was significantly greater than those with PTH levels in the first quartile (P-trend = 0.01). However, there was no significant association between vitamin D and any atherosclerotic phenotypes, including carotid IMT, plaques, luminal diameter, and baPWV. Conclusion This suggests that PTH might affect the development of atherosclerosis by altering vascular compliance.
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Affiliation(s)
- Young-Hoon Lee
- Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Jeonbuk, Republic of Korea
- Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Jeonbuk, Republic of Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Republic of Korea
- Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea
| | - Jin-Su Choi
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Republic of Korea
| | - Hae-Sung Nam
- Department of Preventive Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Kyeong-Soo Park
- Department of Preventive Medicine, Seonam University College of Medicine, Namwon, Jeonbuk, Republic of Korea
| | - Seong-Woo Choi
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea
| | - So-Yeon Ryu
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea
| | - Su-Hyun Oh
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Republic of Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Republic of Korea
- * E-mail:
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Mousa A, Naderpoor N, de Courten MPJ, Scragg R, de Courten B. 25-hydroxyvitamin D is associated with adiposity and cardiometabolic risk factors in a predominantly vitamin D-deficient and overweight/obese but otherwise healthy cohort. J Steroid Biochem Mol Biol 2017; 173:258-264. [PMID: 28007531 DOI: 10.1016/j.jsbmb.2016.12.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 12/14/2016] [Accepted: 12/17/2016] [Indexed: 02/06/2023]
Abstract
Vitamin D deficiency has reached epidemic proportions worldwide and has recently been linked to cardiometabolic risk factors including obesity, insulin resistance, hypertension, dyslipidemia, as well as type 2 diabetes and cardiovascular disease. The objective of this study was to examine the associations between circulating 25-hydrovitamin D (25(OH)D) levels and cardiometabolic risk factors using direct measures of adiposity, glucose intolerance, and insulin resistance, as well as lipids, blood pressure, and plasma markers of inflammation. We measured circulating 25(OH)D, physical activity (International Physical Activity Questionnaire- IPAQ), anthropometry (body mass index (BMI), waist-to-hip ratio (WHR), % body fat (dual energy X-ray absorptiometry)), metabolic parameters (fasting and 2-h plasma glucose levels during oral glucose tolerance test; insulin sensitivity (M, hyperinsulinaemic-euglycaemic clamp), and cardiovascular and inflammatory profiles (blood pressure (BP), pulse pressure (PP), mean arterial pressure (MAP), plasma lipid levels, white blood cell count (WBC), and plasma high-sensitivity C-reactive protein levels (hsCRP)) in 111 healthy, non-diabetic adults (66 males/45 females; age 31.1±9.2years; % body fat 36.0±10.2%). Mean 25(OH)D was 39.8±19.8 nmol/L with no difference between genders (p=0.4). On univariate analysis, 25(OH)D was associated with% body fat (r=-0.27; p=0.005), 2-h glucose (r=-0.21; p=0.03), PP (r=0.26; p=0.006), and insulin sensitivity (r=0.20, p=0.04), but not with age, BMI, WHR, fasting glucose, BP, MAP, lipids, or inflammatory markers (all p>0.05). After adjusting for age and sex, 25(OH)D remained associated with% body fat (β=-0.12%; p=0.003), 2-h glucose (β=-0.13mmol/L; p=0.02), PP (β=0.12mmHg; p=0.009), and insulin sensitivity (β=0.22mg/kg/min; p=0.03), and became associated with fasting glucose (β=-0.04mmol/L; p=0.04) and hsCRP (β=-0.51mg/L; p=0.04). After adjusting for age, sex, and % body fat, 25(OH)D was no longer associated with insulin sensitivity, 2-h glucose, or hsCRP, but remained associated with fasting glucose (β=-0.05mmol/L; p=0.03) and PP (β=0.10mmHg; p=0.03). 25(OH)D remained associated with fasting glucose (β=-0.06mmol/L; p=0.02) after hsCRP and physical activity were added to the model with % body fat, age, and sex. These cross-sectional data suggest that associations between vitamin D and cardiometabolic risk among healthy, non-diabetic adults are largely mediated by adiposity. Large-scale intervention and mechanistic studies are needed to further investigate whether vitamin D has an independent role in the prevention and/or management of cardiometabolic risk and disease.
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Affiliation(s)
- Aya Mousa
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, MHRP, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia
| | - Negar Naderpoor
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, MHRP, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; Diabetes and Vascular Medicine Unit, Monash Health, Locked Bag 29, Clayton, VIC 3168, Australia
| | | | - Robert Scragg
- School of Population Health, The University of Auckland, New Zealand
| | - Barbora de Courten
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, MHRP, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; Diabetes and Vascular Medicine Unit, Monash Health, Locked Bag 29, Clayton, VIC 3168, Australia.
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Ding YH, Wei TM, Qian LY, Ma Y, Lao DB, Yao B, Pang J. Association between serum 25-hydroxyvitamin D and carotid atherosclerotic plaque in Chinese type 2 diabetic patients. Medicine (Baltimore) 2017; 96:e6445. [PMID: 28353575 PMCID: PMC5380259 DOI: 10.1097/md.0000000000006445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
In this study, we investigated the distribution of vitamin D and its association with carotid atherosclerotic plaque (CP) in Chinese type 2 diabetic (T2D) patients. We performed a cross-sectional study in 210 T2D and 94 age- and gender-matched nondiabetic patients during winter months, by determining serum 25-hydroxyvitamin D (25(OH)D) levels in both diabetic and nondiabetic controls. We carried out measurements of B-mode ultrasonography of carotid arteries in each T2D patient. The 25(OH)D concentration was 26.25 nmol/L among the T2D patients. About 93.3% T2D patients suffered from hypovitaminosis D. First, we found a clear inverse correlation between the 25(OH)D concentration and CP (P <0.001). Second, an association between 25(OH)D and macrovascular disease was significant (P = 0.005). In multivariate logistic regression analysis, decreasing 25(OH)D concentration was markedly associated with CP in T2D patients. Third, after adjusting for the confounding factors, we also observed a positive correlation between low levels of 25(OH)D in T2D patients with CP, when the following parameters were measured: old age (odds ratio [OR] = 2.533, P = 0.013); smoking (OR = 3.872, P = 0.001); and high level of low-density lipoprotein (LDL) cholesterol (OR = 2.776, P = 0.009). Thus, we concluded that high prevalence of hypovitaminosis D exists in Chinese T2D patients. Further, we found a significant association between low concentration of serum 25(OH)D and the existence of high body mass index, and high circulating LDL to be substantially positive predictors of patients with CP in T2D.
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Affiliation(s)
- Ya-Hui Ding
- Department of Cardiology, Zhejiang Provincial People's Hospital
| | - Tie-Ming Wei
- Department of Cardiology, Lishui Central Hospital, Lishui, Zhejiang Province
| | - Lin-Yan Qian
- Department of Cardiology, Zhejiang Provincial People's Hospital
| | - Yuan Ma
- Department of Cardiology, Zhejiang Provincial People's Hospital
| | | | - Bin Yao
- Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Jie Pang
- Department of Cardiology, Zhejiang Provincial People's Hospital
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Al-khalidi B, Kimball SM, Rotondi MA, Ardern CI. Standardized serum 25-hydroxyvitamin D concentrations are inversely associated with cardiometabolic disease in U.S. adults: a cross-sectional analysis of NHANES, 2001-2010. Nutr J 2017; 16:16. [PMID: 28241878 PMCID: PMC5329954 DOI: 10.1186/s12937-017-0237-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 02/22/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Previously reported associations between vitamin D status, as measured by serum 25-hydroxyvitamin D [25(OH)D] concentrations, and cardiometabolic risk factors were largely limited by variability in 25(OH)D assay performance. In accordance with the Vitamin D Standardization Program, serum 25(OH)D measurement was recently standardized in the National Health and Nutrition Examination Survey (NHANES) to reduce laboratory and method related differences in serum 25(OH)D results. We evaluated the overall and ethnic-specific associations between the newly standardized serum 25(OH)D concentrations and cardiometabolic risk in U.S. adults. METHODS This study examined standardized 25(OH)D data from five cycles of the NHANES (2001-2010). The total sample included 7674 participants (1794 Mexican-Americans, 4289 non-Hispanic whites, and 1591 non-Hispanic blacks) aged ≥ 20 years who were examined in the morning after overnight fasting. Serum 25(OH)D was directly measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 2007-2010, and was predicted from LC-MS/MS equivalents for 2001-2006. Serum 25(OH)D levels were categorized into quartiles (<43.4, 43.4-58.6, 58.7-74.2, ≥74.3 nmol/L). Cardiometabolic risk was defined by the homeostatic model assessment of insulin resistance (HOMA-IR), metabolic syndrome (MetS), and Framingham cardiovascular disease (CVD) risk. Prevalence ratios and 95% confidence intervals were calculated using modified Poisson regression. RESULTS After full adjustment for confounders, serum 25(OH)D ≥74.3 nmol/L was associated with lower cardiometabolic risk compared to 25(OH)D <43.4 nmol/L in the overall sample [HOMA-IR: 0.70 (0.59, 0.84); MetS: 0.82 (0.74, 0.91); CVD risk: 0.78 (0.66, 0.91)]. These associations remained significant in Mexican-Americans [HOMA-IR: 0.54 (0.35, 0.82); MetS: 0.73 (0.55, 0.96)], non-Hispanic whites [HOMA-IR: 0.81 (0.68, 0.96); MetS: 0.84 (0.73, 0.95); CVD risk: 0.78 (0.64, 0.93)]; and in non-Hispanic blacks [HOMA-IR: 0.67 (0.45, 0.99); MetS: 0.75 (0.56, 0.97); CVD risk: 0.58 (0.41, 0.81)]. CONCLUSIONS Low vitamin D status is a significant risk factor for cardiometabolic disease in U.S. adults based on standardized serum 25(OH)D results, irrespective of ethnic background. Future studies using standardized 25(OH)D data are needed to confirm these results, particularly amongst U.S. blacks with 25(OH)D concentrations above 75 nmol/L.
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Affiliation(s)
- Banaz Al-khalidi
- School of Kinesiology and Heath Science, York University, Toronto, M3J1P3 ON Canada
| | | | - Michael A. Rotondi
- School of Kinesiology and Heath Science, York University, Toronto, M3J1P3 ON Canada
| | - Chris I. Ardern
- School of Kinesiology and Heath Science, York University, Toronto, M3J1P3 ON Canada
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Vitamin D and inflammatory markers: cross-sectional analyses using data from the English Longitudinal Study of Ageing (ELSA). J Nutr Sci 2017; 6:e1. [PMID: 28620476 PMCID: PMC5465858 DOI: 10.1017/jns.2016.37] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 08/30/2016] [Indexed: 12/16/2022] Open
Abstract
Recent evidence suggests that low vitamin D concentrations are associated with increased levels of inflammatory markers. However, there are limited studies investigating associations between vitamin D levels and inflammatory markers in the general population and much of this evidence in older adults is inconclusive. Therefore, this study investigates the cross-sectional association of serum 25-hydroxyvitamin D (25(OH)D) levels with inflammatory markers in 5870 older English adults from wave 6 (2012–2013) of the English Longitudinal Study of Ageing (ELSA). ELSA is a large prospective observational study of community-dwelling people aged 50 years and over in England. Serum 25(OH)D levels, C-reactive protein (CRP) levels, plasma fibrinogen levels, white blood cell count (WBC), age, season of blood collection, waist circumference, total non-pension household wealth, measures of health and health behaviours that included depression, number of cardiovascular, non-cardiovascular conditions and difficulties in activities of daily living, smoking, and physical activity were measured. There was a significant negative association between low 25(OH)D levels (≤30 nmol/l) and CRP (OR 1·23, 95 % CI 1·00, 1·51) and WBC (OR 1·35, 95 % CI 1·13, 1·60) that remained after adjustment for a wide range of covariates of clinical significance. However, for fibrinogen, the association did not remain significant when waist circumference was entered in the final model. Our findings showed that 25(OH)D levels were associated with two out the three inflammatory markers investigated. The independent and inverse association between serum 25(OH)D levels and inflammation suggests a potential anti-inflammatory role for vitamin D in older English individuals from the general population.
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The Effect of Serum 25-Hydroxyvitamin D Concentrations on Elevated Serum C-Reactive Protein Concentrations in Normal Weight, Overweight and Obese Participants of a Preventive Health Program. Nutrients 2016; 8:nu8110696. [PMID: 27827910 PMCID: PMC5133083 DOI: 10.3390/nu8110696] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 10/27/2016] [Accepted: 11/01/2016] [Indexed: 01/05/2023] Open
Abstract
The hypothesized effect of vitamin D on C-reactive protein (CRP) has received substantial attention as a potential means to alleviate the risk for cardiovascular disease. However, observational studies have been inconsistent in their reporting of associations between serum 25-hydroxyvitamin D (25(OH)D) and CRP concentrations, and trials and meta analyses have been inconsistent in their conclusions regarding the effect of vitamin D supplementation on CRP concentrations. These supplementation trials were mostly conducted among patients with more or less inflammatory complications and did not consider potential distinctive effects by weight status. To further our understanding of the potential influences of vitamin D on CRP, we analyzed longitudinal observations of 6755 participants of a preventative health program. On average, serum 25(OH)D concentrations increased from 88.3 to 121.0 nmol/L and those of CRP decreased from 1.7 to 1.6 mg/L between baseline and follow up. Relative to obese participants without temporal increases in 25(OH)D, those who showed improvements of <25, 25-50, 50-75, and more than 75 nmol/L at follow up were 0.57 (95% confidence interval: 0.37-0.88), 0.54 (0.34-0.85), 0.49 (0.30-0.80), and 0.48 (0.29-0.78) times as likely to have elevated CRP concentrations (≥1 mg/L), respectively. These associations were less pronounced and not statistically significant for normal weight and overweight participants. Herewith, the findings suggest that promotion of adequate serum 25(OH)D concentrations among obese individuals along with healthy lifestyles may alleviate the public health burden associated with cardiovascular disease.
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The associations among vitamin D deficiency, C-reactive protein, and depressive symptoms. J Psychosom Res 2016; 90:98-104. [PMID: 27772566 DOI: 10.1016/j.jpsychores.2016.10.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 09/12/2016] [Accepted: 10/01/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Vitamin D deficiency has been reported to be associated with depression, but the underlying mechanisms aren't well understood. Our study aims to investigate the associations among serum vitamin D, C-reactive protein (CRP) level, and depressive symptoms. METHODS Serum levels of Vitamin D and CRP were measured from 52,228 participants. Depressive symptoms were assessed using a Korean version of the CES-D scale. We used logistic regression to calculate the odds ratio (ORs) of depressive symptoms according to vitamin D and CRP levels. The regressions were adjusted for covariates, and each model was adjusted mutually for vitamin D and CRP levels. RESULTS A significant difference was found in vitamin D status between depressed and non-depressed participants, but CRP status was not significantly different. The OR for the presence of depressive symptoms was significantly increased in participants with vitamin D deficiency after adjusting for potentially confounding factors (Adjusted OR=1.158, 95% CI=1.003-1.336, p=0.046). The OR of depressive symptoms was not significantly increased in individuals with high (3.01-10mg/L) CRP level compared to individuals with low (≤3mg/L) CRP level (Adjusted OR=1.004, 95% CI=0.821-1.227, p=0.97). There was no significant association between vitamin D and CRP level. Additional adjustment for serum CRP level did not weaken the resulting association between vitamin D deficiency and the presence of depressive symptoms. CONCLUSION Vitamin D deficiency was associated with depressive symptoms, but elevated serum CRP level was not. The results indicate that CRP level does not account for the association between vitamin D deficiency and the presence of depressive symptoms.
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Relationship between Vitamin D Status and Autonomic Nervous System Activity. Nutrients 2016; 8:nu8090565. [PMID: 27649235 PMCID: PMC5037550 DOI: 10.3390/nu8090565] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 08/31/2016] [Accepted: 09/06/2016] [Indexed: 12/16/2022] Open
Abstract
Vitamin D deficiency is associated with increased arterial stiffness. However, the mechanisms underlying this association have not been clarified. The aim was to investigate whether changes in autonomic nervous system activity could underlie an association between 25 hydroxy vitamin D and arterial stiffness. A total of 49 subjects (age = 60 ± 8 years, body mass index = 26.7 ± 4.6 kg/m², 25 hydroxy vitamin D = 69 ± 22 nmol/L) underwent measurements of pulse wave velocity (PWV) and augmentation index (AIx), spontaneous baroreflex sensitivity, plasma metanephrines and 25 hydroxy vitamin D. Subjects with 25 hydroxy vitamin D ≤ 50 nmol/L were restudied after 200,000 International Units 25 hydroxy vitamin D. Plasma metanephrine was positively associated with AIx (p = 0.02) independent of age, sex, smoking and cholesterol and negatively associated with 25 hydroxy vitamin D (p = 0.002) independent of age, sex and season. In contrast, there was no association between baroreflex sensitivity and 25 hydroxy vitamin D (p = 0.54). Treatment with vitamin D increased 25 hydroxy vitamin D from 43 ± 5 to 96 ± 24 nmol/L (p < 0.0001) but there was no significant change in plasma metanephrine (115 ± 25 vs. 99 ± 39 pmol/L, p = 0.12). We conclude that as plasma metanephrine was negatively associated with 25 hydroxy vitamin D and positively with AIx, it could mediate an association between these two variables. This hypothesis should be tested in larger interventional studies.
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Lee S, Ahuja V, Masaki K, Evans RW, Barinas-Mitchell EJM, Ueshima H, Shin C, Choo J, Hassen L, Edmundowicz D, Kuller LH, Willcox B, Sekikawa A. A Significant Positive Association of Vitamin D Deficiency with Coronary Artery Calcification among Middle-aged Men: For the ERA JUMP Study. J Am Coll Nutr 2016; 35:614-620. [PMID: 27315115 DOI: 10.1080/07315724.2015.1118651] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Although a significant positive association of vitamin D deficiency with coronary heart disease has been demonstrated in cross-sectional as well as prospective studies, only a few studies have examined the association of vitamin D deficiency with subclinical atherosclerosis. We examined whether vitamin D deficiency is associated with subclinical atherosclerosis, as measured by coronary artery calcification (CAC) in asymptomatic adults. METHODS In a population-based cross-sectional study, 195 men aged 40 to 49 years without cardiovascular disease were randomly selected (98 Caucasian and 97 Japanese American men). Liquid chromatography-tandem mass spectrometry was utilized to measure serum vitamin D. CAC was examined by electron beam computed tomography using standardized protocols and read centrally at the University of Pittsburgh using Agatston's methods. To investigate an association between vitamin D deficiency (defined as 25-hydroxyvitamin D [25(OH)D] < 20 ng/mL) and CAC (defined as Agatston score ≥ 10), we utilized multivariable logistic regression models. RESULTS Prevalence of CAC and vitamin D deficiency was 27.2% and 10.3%, respectively. Participants with CAC were significantly older, had significantly higher body mass index (BMI), and had higher rates of smoking. Those with CAC were 3.31 times likely to be vitamin D deficient, after adjusting for traditional cardiovascular risk factors (odds ratio [OR] = 3.31, 95% confidence interval [CI], 1.12-9.77). CONCLUSIONS In this population-based study of healthy middle-aged men, vitamin D deficiency had a significant positive association with the presence of CAC.
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Affiliation(s)
- Sunghee Lee
- a Institute of Human Genomic Study, Korea University Ansan Hospital , Ansan , SOUTH KOREA
| | - Vasudha Ahuja
- c Department of Epidemiology , Graduate School of Public Health, University of Pittsburgh , Pittsburgh , Pennsylvania
| | - Kamal Masaki
- d Department of Geriatric Medicine , the John A. Burns School of Medicine, University of Hawaii , Honolulu , Hawaii
| | - Rhobert W Evans
- c Department of Epidemiology , Graduate School of Public Health, University of Pittsburgh , Pittsburgh , Pennsylvania
| | - Emma J M Barinas-Mitchell
- c Department of Epidemiology , Graduate School of Public Health, University of Pittsburgh , Pittsburgh , Pennsylvania
| | - Hirotsugu Ueshima
- e Department of Health Science , Shiga University of Medical Science , Otsu , Shiga , JAPAN
| | - Chol Shin
- b Department of Internal Medicine , Korea University Ansan Hospital , Ansan , SOUTH KOREA
| | - Jina Choo
- g Korea University College of Nursing , Seoul , SOUTH KOREA
| | - Lauren Hassen
- c Department of Epidemiology , Graduate School of Public Health, University of Pittsburgh , Pittsburgh , Pennsylvania
| | - Daniel Edmundowicz
- f Cardiovascular Institute, University of Pittsburgh Medical Center , Pittsburgh , Pennsylvania
| | - Lewis H Kuller
- c Department of Epidemiology , Graduate School of Public Health, University of Pittsburgh , Pittsburgh , Pennsylvania
| | - Bradley Willcox
- d Department of Geriatric Medicine , the John A. Burns School of Medicine, University of Hawaii , Honolulu , Hawaii
| | - Akira Sekikawa
- c Department of Epidemiology , Graduate School of Public Health, University of Pittsburgh , Pittsburgh , Pennsylvania.,e Department of Health Science , Shiga University of Medical Science , Otsu , Shiga , JAPAN
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Blondon M, Cushman M, Jenny N, Michos ED, Smith NL, Kestenbaum B, de Boer IH. Associations of Serum 25-Hydroxyvitamin D With Hemostatic and Inflammatory Biomarkers in the Multi-Ethnic Study of Atherosclerosis. J Clin Endocrinol Metab 2016; 101:2348-57. [PMID: 27023449 PMCID: PMC4891795 DOI: 10.1210/jc.2016-1368] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
CONTEXT Mechanisms explaining documented associations of 25-hydroxyvitamin D [25(OH)D] deficiency with increased risks of cardiovascular disease (CVD) and venous thromboembolism may relate to adverse hemostatic and inflammatory responses. OBJECTIVE To evaluate whether 25(OH)D deficiency is associated with a prothrombotic and proinflammatory biological profile. DESIGN Cross-sectional analyses. SETTING The Multi-Ethnic Study of Atherosclerosis, a multicenter prospective cohort of American adults. PARTICIPANTS Up to 6554 adults free of CVD. MAIN OUTCOME MEASURES Ten hemostatic biomarkers (D-dimer, fibrinogen, factor VIII, plasmin-antiplasmin, and homocysteine [n = 6443]; von Willebrand factor, soluble tissue factor, plasminogen activator inhibitor-1 (PAI-1), total tissue factor pathway inhibitor (TFPI), and soluble thrombomodulin [n = 814]), and three inflammatory biomarkers (IL-6, C-reactive protein [n = 6443], and TNF-α soluble receptor [n = 3802]). RESULTS Among 6443 subjects (46.6% men; mean age, 62.1 years; mean body mass index, 28.3 kg/m(2)) of White (37.8%), Black (27.2%), Chinese (12.2%), and Hispanic (21.8%) race/ethnicity, mean 25(OH)D was 25.3 ng/mL. After multiple adjustment, 25(OH)D concentrations were associated with concentrations of IL-6 and homocysteine and also with concentrations of PAI-1 and TFPI: per 10 ng/mL decrement in 25(OH)D, 5.1% higher IL-6 (95% confidence interval [CI], 3.4-6.9; P < .001); 3.7% higher homocysteine (95% CI, 3.0-4.3; P < .001); 7.0% higher PAI-1 (95% CI, 0.9-13.6; P = .025); and 2.1% higher TFPI (95% CI, 0.0-4.2; P = .047), without racial/ethnic heterogeneity. No significant associations were observed for other hemostatic and inflammatory biomarkers. CONCLUSIONS Increased inflammation as reflected by higher circulating IL-6 and increased homocysteine concentrations may represent mechanisms linking 25(OH)D deficiency to greater risks of CVD and perhaps venous thromboembolism. Low concentrations of 25(OH)D were also associated with PAI-1 and TFPI concentrations, but not with other hemostatic biomarkers.
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Affiliation(s)
- Marc Blondon
- Division of Angiology and Hemostasis (M.B.), Geneva University Hospitals and Faculty of Medicine, 1205 Geneva, Switzerland; Department of Medicine and Pathology & Laboratory Medicine (M.C.), University of Vermont College of Medicine, Burlington, Vermont 05401; Department of Pathology & Laboratory Medicine (N.J.), University of Vermont College of Medicine, Burlington, Vermont 05446; Department of Medicine (Cardiology) (E.D.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; Department of Epidemiology (N.L.S.), University of Washington, Seattle, Washington 98195; Group Health Research Institute (N.L.S.), Group Health Cooperative, Seattle, Washington 98112; Seattle Epidemiologic Research and Information Center (N.L.S.), Veterans Affairs Office of Research and Development, Seattle, Washington 98108; and Department of Epidemiology and Nephrology (B.K., I.H.d.B.), University of Washington, Seattle, Washington 98195
| | - Mary Cushman
- Division of Angiology and Hemostasis (M.B.), Geneva University Hospitals and Faculty of Medicine, 1205 Geneva, Switzerland; Department of Medicine and Pathology & Laboratory Medicine (M.C.), University of Vermont College of Medicine, Burlington, Vermont 05401; Department of Pathology & Laboratory Medicine (N.J.), University of Vermont College of Medicine, Burlington, Vermont 05446; Department of Medicine (Cardiology) (E.D.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; Department of Epidemiology (N.L.S.), University of Washington, Seattle, Washington 98195; Group Health Research Institute (N.L.S.), Group Health Cooperative, Seattle, Washington 98112; Seattle Epidemiologic Research and Information Center (N.L.S.), Veterans Affairs Office of Research and Development, Seattle, Washington 98108; and Department of Epidemiology and Nephrology (B.K., I.H.d.B.), University of Washington, Seattle, Washington 98195
| | - Nancy Jenny
- Division of Angiology and Hemostasis (M.B.), Geneva University Hospitals and Faculty of Medicine, 1205 Geneva, Switzerland; Department of Medicine and Pathology & Laboratory Medicine (M.C.), University of Vermont College of Medicine, Burlington, Vermont 05401; Department of Pathology & Laboratory Medicine (N.J.), University of Vermont College of Medicine, Burlington, Vermont 05446; Department of Medicine (Cardiology) (E.D.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; Department of Epidemiology (N.L.S.), University of Washington, Seattle, Washington 98195; Group Health Research Institute (N.L.S.), Group Health Cooperative, Seattle, Washington 98112; Seattle Epidemiologic Research and Information Center (N.L.S.), Veterans Affairs Office of Research and Development, Seattle, Washington 98108; and Department of Epidemiology and Nephrology (B.K., I.H.d.B.), University of Washington, Seattle, Washington 98195
| | - Erin D Michos
- Division of Angiology and Hemostasis (M.B.), Geneva University Hospitals and Faculty of Medicine, 1205 Geneva, Switzerland; Department of Medicine and Pathology & Laboratory Medicine (M.C.), University of Vermont College of Medicine, Burlington, Vermont 05401; Department of Pathology & Laboratory Medicine (N.J.), University of Vermont College of Medicine, Burlington, Vermont 05446; Department of Medicine (Cardiology) (E.D.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; Department of Epidemiology (N.L.S.), University of Washington, Seattle, Washington 98195; Group Health Research Institute (N.L.S.), Group Health Cooperative, Seattle, Washington 98112; Seattle Epidemiologic Research and Information Center (N.L.S.), Veterans Affairs Office of Research and Development, Seattle, Washington 98108; and Department of Epidemiology and Nephrology (B.K., I.H.d.B.), University of Washington, Seattle, Washington 98195
| | - Nicholas L Smith
- Division of Angiology and Hemostasis (M.B.), Geneva University Hospitals and Faculty of Medicine, 1205 Geneva, Switzerland; Department of Medicine and Pathology & Laboratory Medicine (M.C.), University of Vermont College of Medicine, Burlington, Vermont 05401; Department of Pathology & Laboratory Medicine (N.J.), University of Vermont College of Medicine, Burlington, Vermont 05446; Department of Medicine (Cardiology) (E.D.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; Department of Epidemiology (N.L.S.), University of Washington, Seattle, Washington 98195; Group Health Research Institute (N.L.S.), Group Health Cooperative, Seattle, Washington 98112; Seattle Epidemiologic Research and Information Center (N.L.S.), Veterans Affairs Office of Research and Development, Seattle, Washington 98108; and Department of Epidemiology and Nephrology (B.K., I.H.d.B.), University of Washington, Seattle, Washington 98195
| | - Bryan Kestenbaum
- Division of Angiology and Hemostasis (M.B.), Geneva University Hospitals and Faculty of Medicine, 1205 Geneva, Switzerland; Department of Medicine and Pathology & Laboratory Medicine (M.C.), University of Vermont College of Medicine, Burlington, Vermont 05401; Department of Pathology & Laboratory Medicine (N.J.), University of Vermont College of Medicine, Burlington, Vermont 05446; Department of Medicine (Cardiology) (E.D.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; Department of Epidemiology (N.L.S.), University of Washington, Seattle, Washington 98195; Group Health Research Institute (N.L.S.), Group Health Cooperative, Seattle, Washington 98112; Seattle Epidemiologic Research and Information Center (N.L.S.), Veterans Affairs Office of Research and Development, Seattle, Washington 98108; and Department of Epidemiology and Nephrology (B.K., I.H.d.B.), University of Washington, Seattle, Washington 98195
| | - Ian H de Boer
- Division of Angiology and Hemostasis (M.B.), Geneva University Hospitals and Faculty of Medicine, 1205 Geneva, Switzerland; Department of Medicine and Pathology & Laboratory Medicine (M.C.), University of Vermont College of Medicine, Burlington, Vermont 05401; Department of Pathology & Laboratory Medicine (N.J.), University of Vermont College of Medicine, Burlington, Vermont 05446; Department of Medicine (Cardiology) (E.D.M.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; Department of Epidemiology (N.L.S.), University of Washington, Seattle, Washington 98195; Group Health Research Institute (N.L.S.), Group Health Cooperative, Seattle, Washington 98112; Seattle Epidemiologic Research and Information Center (N.L.S.), Veterans Affairs Office of Research and Development, Seattle, Washington 98108; and Department of Epidemiology and Nephrology (B.K., I.H.d.B.), University of Washington, Seattle, Washington 98195
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Ho JS, Cannaday JJ, Barlow CE, Reinhardt DB, Wade WA, Ellis JR. Low 25-OH vitamin D levels are not associated with coronary artery calcium or obstructive stenoses. Coron Artery Dis 2016; 26:521-5. [PMID: 25946655 DOI: 10.1097/mca.0000000000000261] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND It is unclear whether low vitamin D is a significant risk factor for the presence of either calcific atherosclerosis or obstructive coronary artery stenoses. DESIGN In this study, we measured the 25-OH vitamin D levels of 1131 consecutive individuals who underwent coronary artery calcium (CAC) scoring and coronary computed tomographic angiography at our institution. PARTICIPANTS AND METHODS We looked for any association of 25-OH vitamin D levels with CAC scores. We also studied the relation of 25-OH vitamin D levels with the presence of 70% or more obstructive coronary artery stenoses, found initially by coronary computed tomographic angiography and confirmed subsequently by invasive angiography. RESULTS There were 132 (11.7%) 25-OH vitamin D deficient (<20 ng/ml) and 295 (26.1%) 25-OH vitamin D insufficient (21-29 ng/ml) individuals in this study. There was no detectable association between 25-OH vitamin D levels and CAC scores. The median (interquartile range) CAC score of 25-OH vitamin D deficient, insufficient, and adequate patients was 451 (80-1083), 338 (52-830), and 450 (100-1062), respectively. Also, no relation was noted between 25-OH vitamin D levels and the presence of severely obstructive coronary artery disease. The frequency of severe coronary artery disease in 25-OH vitamin D deficient, insufficient, and adequate patients was 3.8, 2.0, and 4.0%, respectively. CONCLUSION Low 25-OH vitamin D levels were not associated with CAC or severely obstructive stenoses.
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Affiliation(s)
- John S Ho
- aDepartment of Cardiovascular Imaging, Cooper Clinic bDepartment of Epidemiology and Statistics, The Cooper Institute, Dallas, Texas, USA
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Inflammation in diabetes and cardiovascular disease. Cardiovasc Endocrinol 2015. [DOI: 10.1097/xce.0000000000000062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Zagami RM, Di Pino A, Urbano F, Piro S, Purrello F, Rabuazzo AM. Low circulating vitamin D levels are associated with increased arterial stiffness in prediabetic subjects identified according to HbA1c. Atherosclerosis 2015; 243:395-401. [DOI: 10.1016/j.atherosclerosis.2015.09.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 09/25/2015] [Accepted: 09/29/2015] [Indexed: 02/07/2023]
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Hamdy Al-Said N, Abd El Ghaffar Mohamed N, Salam RF, Fawzy MW. Vitamin D as a risk factor for premature atherosclerosis in patients with type 2 diabetes. Ther Adv Endocrinol Metab 2015; 6:249-57. [PMID: 26623002 PMCID: PMC4647131 DOI: 10.1177/2042018815600640] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Several cardiovascular risk factors have been recognized in patients with diabetes and vitamin D deficiency is emerging as a new risk. The aim of this study was to determine the effect of vitamin D deficiency on the incidence of premature atherosclerosis in patients with type 2 diabetes. METHODS A total of 78 patients with type 2 diabetes were subjected to history taking, physical examination, fasting glucose level, homeostasis model assessment of insulin resistance, lipid profile, 25(OH) vitamin D measurement, and carotid Doppler. RESULTS Patients with normal carotid intima-media thickness (CIMT) had sufficient vitamin D. Of those with increased CIMT 23.1% had insufficient vitamin D while 76.9% had sufficient vitamin D (six patients had plaques, one of them had vitamin D insufficiency, and the other five patients had sufficient vitamin D). There was a statistically significant difference in the serum level of vitamin D between patients with increased CIMT, and those with normal intima, with a decreased level in the first group. There was a significant negative correlation between vitamin D and fasting blood glucose. There was a statistically significant correlation in left CIMT between the vitamin D sufficiency group and the vitamin D insufficiency group, with higher values in the second group. There was no statistically significant difference in serum cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol in patients with increased CIMT and those with normal intima. CONCLUSIONS Decreased vitamin D levels in patients with diabetes lead to increased CIMT. The absence of a statistically significance difference in lipid profile between increased and normal CIMT groups raises the possibility of underlying causes for atherosclerosis in patients with diabetes other than dyslipidemia.
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Affiliation(s)
- Nehal Hamdy Al-Said
- Department of Internal Medicine and Endocrinology, Cairo University, Cairo, Egypt
| | | | - Randa F. Salam
- Department of Internal Medicine and Endocrinology, Cairo University, Cairo, Egypt
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Chen WR, Chen YD, Shi Y, Yin DW, Wang H, Sha Y. Vitamin D, parathyroid hormone and risk factors for coronary artery disease in an elderly Chinese population. J Cardiovasc Med (Hagerstown) 2015; 16:59-68. [PMID: 24842466 DOI: 10.2459/jcm.0000000000000094] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AIMS Low vitamin D status has been shown to be associated with coronary artery disease; most studies have involved in adults, but few have involved elderly people. We planned to research the association between vitamin D, parathyroid hormone (PTH) and coronary artery disease in elderly people. METHODS A population-based study was conducted among 1245 Chinese participants, aged 60-102 years, in the spring of 2013. Serum 25-hydroxyvitamin D (25 (OH)D) was measured by chemiluminescence assay. The levels of PTH were measured by the electrochemiluminescence immunoassay (ECLIA) method. RESULTS One thousand two hundred and forty-five participants, including 543 women (43.6%), were evaluated in 2013. The median concentrations of serum 25 (OH)D and PTH for the entire group were 16.8 ng/ml and 41.0 pg/ml, respectively. The prevalence rates of diabetes, hypertension, hyperlipidemia and coronary artery disease were significantly different across the 25 (OH)D quartiles. The prevalence rates of diabetes, hypertension, hyperlipidemia and coronary artery disease were also significantly different across the PTH quartiles. In logistic regression analyses, serum 25 (OH)D levels were associated with risk of coronary artery disease in single and multiple regression models (P < 0.05). Serum PTH levels were also associated with the risk of coronary artery disease in single and multiple regression models (P < 0.05). Subgroup analyses stratified by sex or age yielded similar results. CONCLUSIONS Serum vitamin D and PTH levels are independently associated with risk of coronary artery disease in a Chinese elderly population.
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Affiliation(s)
- Wei R Chen
- aDepartment of Cardiology, PLA General Hospital at Beijing bDepartment of South-building Cardiology, PLA General Hospital at Beijing, China
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22
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Liefaard MC, Ligthart S, Vitezova A, Hofman A, Uitterlinden AG, Kiefte-de Jong JC, Franco OH, Zillikens MC, Dehghan A. Vitamin D and C-Reactive Protein: A Mendelian Randomization Study. PLoS One 2015; 10:e0131740. [PMID: 26147588 PMCID: PMC4492676 DOI: 10.1371/journal.pone.0131740] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 06/04/2015] [Indexed: 12/15/2022] Open
Abstract
Vitamin D deficiency is widely prevalent and has been associated with many diseases. It has been suggested that vitamin D has effects on the immune system and inhibits inflammation. The aim of our study was to investigate whether vitamin D has an inhibitory effect on systemic inflammation by assessing the association between serum levels of vitamin D and C-reactive protein. We studied the association between serum 25-hydroxyvitamin D and C-reactive protein through linear regression in 9,649 participants of the Rotterdam Study, an observational, prospective population-based cohort study. We used genetic variants related to vitamin D and CRP to compute a genetic risk score and perform bi-directional Mendelian randomization analysis. In linear regression adjusted for age, sex, cohort and other confounders, natural log-transformed CRP decreased with 0.06 (95% CI: -0.08, -0.03) unit per standard deviation increase in 25-hydroxyvitamin D. Bi-directional Mendelian randomization analyses showed no association between the vitamin D genetic risk score and lnCRP (Beta per SD = -0.018; p = 0.082) or the CRP genetic risk score and 25-hydroxyvitamin D (Beta per SD = 0.001; p = 0.998). In conclusion, higher levels of Vitamin D are associated with lower levels of C-reactive protein. In this study we did not find evidence for this to be the result of a causal relationship.
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Affiliation(s)
- Marte C. Liefaard
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Netherlands Institute for Health Sciences, Rotterdam, the Netherlands
| | - Symen Ligthart
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Anna Vitezova
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - André G. Uitterlinden
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - Oscar H. Franco
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - M. Carola Zillikens
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Abbas Dehghan
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- * E-mail:
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A review of the effect of diet on cardiovascular calcification. Int J Mol Sci 2015; 16:8861-83. [PMID: 25906474 PMCID: PMC4425113 DOI: 10.3390/ijms16048861] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 03/19/2015] [Accepted: 04/07/2015] [Indexed: 12/14/2022] Open
Abstract
Cardiovascular (CV) calcification is known as sub-clinical atherosclerosis and is recognised as a predictor of CV events and mortality. As yet there is no treatment for CV calcification and conventional CV risk factors are not consistently correlated, leaving clinicians uncertain as to optimum management for these patients. For this reason, a review of studies investigating diet and serum levels of macro- and micronutrients was carried out. Although there were few human studies of macronutrients, nevertheless transfats and simple sugars should be avoided, while long chain ω-3 fats from oily fish may be protective. Among the micronutrients, an intake of 800 μg/day calcium was beneficial in those without renal disease or hyperparathyroidism, while inorganic phosphorus from food preservatives and colas may induce calcification. A high intake of magnesium (≥380 mg/day) and phylloquinone (500 μg/day) proved protective, as did a serum 25(OH)D concentration of ≥75 nmol/L. Although oxidative damage appears to be a cause of CV calcification, the antioxidant vitamins proved to be largely ineffective, while supplementation of α-tocopherol may induce calcification. Nevertheless other antioxidant compounds (epigallocatechin gallate from green tea and resveratrol from red wine) were protective. Finally, a homocysteine concentration >12 µmol/L was predictive of CV calcification, although a plasma folate concentration of >39.4 nmol/L could both lower homocysteine and protect against calcification. In terms of a dietary programme, these recommendations indicate avoiding sugar and the transfats and preservatives found in processed foods and drinks and adopting a diet high in oily fish and vegetables. The micronutrients magnesium and vitamin K may be worthy of further investigation as a treatment option for CV calcification.
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Malik R, Aneni EC, Roberson L, Ogunmoroti O, Ali SS, Shaharyar S, Younus A, Jamal O, Aziz MA, Martin SS, Blaha MJ, Feldman T, Agatston AS, Veledar E, Nasir K. Measuring coronary artery calcification: Is serum vitamin D relevant? Atherosclerosis 2014; 237:734-8. [DOI: 10.1016/j.atherosclerosis.2014.10.087] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 10/24/2014] [Accepted: 10/27/2014] [Indexed: 11/24/2022]
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25
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Chen RH, Jiang XZ, Jiang Q, Gu Z, Gu PL, Zhou B, Zhu ZH, Xu LY, Zou YF. Correlations between serum levels of 25-hydroxyvitamin D and carotid atherosclerosis in patients with type 2 diabetes in Shanghai. ANNALES D'ENDOCRINOLOGIE 2014; 75:206-12. [PMID: 25168108 DOI: 10.1016/j.ando.2014.07.113] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 03/16/2014] [Accepted: 07/04/2014] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To explore the potential association between the serum levels of 25-hydroxyvitamin D [25(OH)D] and carotid atherosclerosis in patients with type 2 diabetes. MATERIAL AND METHODS Three hundred and fifty patients with type 2 diabetes were enrolled in this study in Shanghai, China. B-mode ultrasound was used to detect carotid plaques as indicators of atherosclerosis and measure carotid artery intima-media wall thickness (C-IMT) at two sites of carotid artery. Subjects were divided into group A (patients with carotid plaques) and group B (patients without carotid plaques) and be assessed clinically. Serum levels of 25(OH)D and other clinical parameters were measured. Multivariate logistic regression was performed to find predictors of carotid atherosclerosis in the entire group. RESULTS The levels of serum 25(OH)D were lower in group A than in group B[19.60 (13.30-25.73) vs 23.19 (18.10-30.06)ng/ml, P<0.001]. The C-IMT levels [(1.00±0.17 vs 0.88±0.20)mm, Ptrend<0.001] and proportion of people with carotid plaques(44/88 vs 20/87, Ptrend<0.001) in the lowest quartile of 25(OH)D were higher than in the highest quartile. Vitamin D concentrations were inversely associated with HbA1c in women(r=-0.194, P=0.006), and C-IMT in men(r=-0.409, P<0.001). Logistic regression analysis showed age, male sex, current smoke, history of hypertension, SBP, LDL-C and lg[25(OH)D] (OR: 0.924, 95%CI: 0.893-0.955, P<0.001) were independently associated with the presence of carotid plaques in T2DM. CONCLUSIONS Serum vitamin D level is significantly and independently associated with carotid atherosclerosis in patients with T2DM in Shanghai, China.
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Affiliation(s)
- Rui-hua Chen
- Department of endocrinology, Pudong New Area People's Hospital, 490, South Chuan Huan Road, Shanghai, China
| | - Xiao-zhen Jiang
- Department of endocrinology, Pudong New Area People's Hospital, 490, South Chuan Huan Road, Shanghai, China.
| | - Quan Jiang
- Department of ultrasonography, Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Zhe Gu
- Department of endocrinology, Pudong New Area People's Hospital, 490, South Chuan Huan Road, Shanghai, China
| | - Pei-li Gu
- Department of endocrinology, Pudong New Area People's Hospital, 490, South Chuan Huan Road, Shanghai, China
| | - Bin Zhou
- Department of endocrinology, Pudong New Area People's Hospital, 490, South Chuan Huan Road, Shanghai, China
| | - Zhen-hong Zhu
- Department of endocrinology, Pudong New Area People's Hospital, 490, South Chuan Huan Road, Shanghai, China
| | - Lin-yan Xu
- Department of endocrinology, Pudong New Area People's Hospital, 490, South Chuan Huan Road, Shanghai, China
| | - Yu-feng Zou
- Department of endocrinology, Pudong New Area People's Hospital, 490, South Chuan Huan Road, Shanghai, China
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26
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Mellenthin L, Wallaschofski H, Grotevendt A, Völzke H, Nauck M, Hannemann A. Association between serum vitamin D concentrations and inflammatory markers in the general adult population. Metabolism 2014; 63:1056-62. [PMID: 24928661 DOI: 10.1016/j.metabol.2014.05.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 04/09/2014] [Accepted: 05/04/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE In recent years links among vitamin D deficiency, inflammation and cardio-metabolic disease were proposed. As information regarding the associations between vitamin D and inflammatory markers in the general population is sparse, we investigated the associations of 25-hydroxy vitamin D [25(OH)D] with high-sensitivity C-reactive protein (hs-CRP), fibrinogen and white blood cell count (WBC). MATERIALS/METHODS The study population comprised 2723 men and women aged 25-88 years from the first follow-up of the Study of Health in Pomerania. Analyses of variance, linear and logistic regressions were performed to assess the associations between 25(OH)D and the three inflammatory markers. The models were adjusted for age, sex, waist circumference, diabetes mellitus, dyslipidemia, anti-inflammatory medication and month of blood sampling. The association between 25(OH)D and WBC was assessed separately in smokers (n = 718) and non-smokers (n = 2005) as effect modification was observed. RESULTS We detected a U-shaped association between 25(OH)D and hs-CRP with a nadir of 21-25 ng/ml in fully-adjusted linear regression models with restricted cubic splines (p < 0.01; p' < 0.01). We further detected an inverse association between 25(OH)D and fibrinogen (p < 0.01). In addition, there was an inverse association between 25(OH)D and WBC in smokers (p = 0.02) but no association in non-smokers (p = 0.73). CONCLUSION Our study confirms a potential role of 25(OH)D in chronic inflammation. Yet, different inflammatory biomarkers are differently associated with 25(OH)D. Beneficial effects of increasing 25(OH)D were observed for fibrinogen and WBC (in smokers only). In contrast, the U-shaped association between 25(OH)D and hs-CRP indicates that ever-increasing 25(OH)D concentrations may also be related to proinflammatory states.
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Affiliation(s)
- Liesa Mellenthin
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Henri Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Anne Grotevendt
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.
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27
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Strawbridge RJ, Deleskog A, McLeod O, Folkersen L, Kavousi M, Gertow K, Baldassarre D, Veglia F, Leander K, Gigante B, Kauhanen J, Rauramaa R, Smit AJ, Mannarino E, Giral P, Dehghan A, Hofman A, Franco OH, Humphries SE, Tremoli E, de Faire U, Gustafsson S, Östensson CG, Eriksson P, Öhrvik J, Hamsten A. A serum 25-hydroxyvitamin D concentration-associated genetic variant in DHCR7 interacts with type 2 diabetes status to influence subclinical atherosclerosis (measured by carotid intima-media thickness). Diabetologia 2014; 57:1159-72. [PMID: 24663808 DOI: 10.1007/s00125-014-3215-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 02/25/2014] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS The findings of studies investigating whether or not low serum 25-hydroxyvitamin D [25(OH)D] concentration promotes development of atherosclerosis have been contradictory. The present study employed a Mendelian randomisation approach and carotid artery intima-media thickness (cIMT), a surrogate marker of coronary artery disease, to address this question. METHODS The multicentre, longitudinal Carotid Intima-Media Thickness and IMT-Progression as Predictors of Vascular Events in a High-Risk European Population (IMPROVE) cohort study, which enrolled individuals with at least three cardiovascular risk factors and no history or symptoms of cardiovascular disease, was used for the present investigation. Participants underwent carotid ultrasound examination at baseline and at months 15 and 30. Six single nucleotide polymorphisms (SNPs) associated with serum 25(OH)D concentration in genome-wide association studies were identified and genotyped in 3,418 individuals, of whom 929 had type 2 diabetes. RESULTS SNPs in the genes encoding vitamin D binding protein (GC; rs2282679 and rs7041) and 7-dehydrocholesterol reductase/NAD synthetase-1 (DHCR7; rs12785878 and rs3829251) were negatively associated with 25(OH)D levels. Effect sizes and significance of associations between SNPs and 25(OH)D levels differed between individuals with and without type 2 diabetes, although no significant interactions were observed. A SNP in DHCR7 interacted with type 2 diabetes to significantly influence progression of cIMT measures independent of 25(OH)D levels and established risk factors. Expression analysis demonstrated that this SNP modulates DHCR7 mRNA levels in aortic adventitia. CONCLUSIONS/INTERPRETATION SNPs in GC and DHCR7 were associated with serum levels of 25(OH)D, but only rs3829251 (DHCR7) influenced progression of subclinical atherosclerosis, as measured by cIMT, in a manner dependent on type 2 diabetes status but independent of 25(OH)D levels.
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Affiliation(s)
- Rona J Strawbridge
- Atherosclerosis Research Unit, Centre for Molecular Medicine, Building L8:03, Karolinska University Hospital Solna, 17176, Stockholm, Sweden,
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28
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Hao Y, Ma X, Luo Y, Ni J, Dou J, Zhu J, Bao Y, Jia W. Additional role of serum 25-hydroxyvitamin D3levels in atherosclerosis in Chinese middle-aged and elderly men. Clin Exp Pharmacol Physiol 2014; 41:174-9. [PMID: 24471522 DOI: 10.1111/1440-1681.12200] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 01/02/2014] [Accepted: 01/15/2014] [Indexed: 01/01/2023]
Affiliation(s)
- Yaping Hao
- Department of Endocrinology and Metabolism; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai China
- Shanghai Clinical Center for Diabetes; Shanghai China
- Shanghai Key Clinical Center for Metabolic Disease; Shanghai China
- Shanghai Diabetes Institute; Shanghai China
- Shanghai Key Laboratory of Diabetes Mellitus; Shanghai China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai China
- Shanghai Clinical Center for Diabetes; Shanghai China
- Shanghai Key Clinical Center for Metabolic Disease; Shanghai China
- Shanghai Diabetes Institute; Shanghai China
- Shanghai Key Laboratory of Diabetes Mellitus; Shanghai China
| | - Yuqi Luo
- Department of Endocrinology and Metabolism; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai China
- Shanghai Clinical Center for Diabetes; Shanghai China
- Shanghai Key Clinical Center for Metabolic Disease; Shanghai China
- Shanghai Diabetes Institute; Shanghai China
- Shanghai Key Laboratory of Diabetes Mellitus; Shanghai China
| | - Jie Ni
- Department of Endocrinology and Metabolism; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai China
- Shanghai Clinical Center for Diabetes; Shanghai China
- Shanghai Key Clinical Center for Metabolic Disease; Shanghai China
- Shanghai Diabetes Institute; Shanghai China
- Shanghai Key Laboratory of Diabetes Mellitus; Shanghai China
| | - Jianxin Dou
- Department of Endocrinology and Metabolism; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai China
- Shanghai Clinical Center for Diabetes; Shanghai China
- Shanghai Key Clinical Center for Metabolic Disease; Shanghai China
- Shanghai Diabetes Institute; Shanghai China
- Shanghai Key Laboratory of Diabetes Mellitus; Shanghai China
| | - Jiaan Zhu
- Department of Ultrasound; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai China
- Shanghai Institute of Ultrasound in Medicine; Shanghai China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai China
- Shanghai Clinical Center for Diabetes; Shanghai China
- Shanghai Key Clinical Center for Metabolic Disease; Shanghai China
- Shanghai Diabetes Institute; Shanghai China
- Shanghai Key Laboratory of Diabetes Mellitus; Shanghai China
| | - Weiping Jia
- Department of Endocrinology and Metabolism; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai China
- Shanghai Clinical Center for Diabetes; Shanghai China
- Shanghai Key Clinical Center for Metabolic Disease; Shanghai China
- Shanghai Diabetes Institute; Shanghai China
- Shanghai Key Laboratory of Diabetes Mellitus; Shanghai China
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Carbone F, Montecucco F. The role of the intraplaque vitamin d system in atherogenesis. SCIENTIFICA 2013; 2013:620504. [PMID: 24459602 PMCID: PMC3888771 DOI: 10.1155/2013/620504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 12/10/2013] [Indexed: 06/03/2023]
Abstract
Vitamin D has been shown to play critical activities in several physiological pathways not involving the calcium/phosphorus homeostasis. The ubiquitous distribution of the vitamin D receptor that is expressed in a variety of human and mouse tissues has strongly supported research on these "nonclassical" activities of vitamin D. On the other hand, the recent discovery of the expression also for vitamin D-related enzymes (such as 25-hydroxyvitamin D-1 α -hydroxylase and the catabolic enzyme 1,25-dihydroxyvitamin D-24-hydroxylase) in several tissues suggested that the vitamin D system is more complex than previously shown and it may act within tissues through autocrine and paracrine pathways. This updated model of vitamin D axis within peripheral tissues has been particularly investigated in atherosclerotic pathophysiology. This review aims at updating the role of the local vitamin D within atherosclerotic plaques, providing an overview of both intracellular mechanisms and cell-to-cell interactions. In addition, clinical findings about the potential causal relationship between vitamin D deficiency and atherogenesis will be analysed and discussed.
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Affiliation(s)
- Federico Carbone
- Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, 6 Viale Benedetto XV, 16132 Genoa, Italy
- Cardiology Division, Foundation for Medical Researches, Department of Internal Medicine, University of Geneva, 64, Avenue de la Roseraie, 1211 Geneva, Switzerland
| | - Fabrizio Montecucco
- Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, 6 Viale Benedetto XV, 16132 Genoa, Italy
- Division of Laboratory Medicine, Department of Genetics and Laboratory Medicine, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1205 Geneva, Switzerland
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Association of circulating vitamin D concentrations with intestinal but not systemic inflammation in inflammatory bowel disease. Inflamm Bowel Dis 2013; 19:2634-43. [PMID: 24105392 DOI: 10.1097/01.mib.0000436957.77533.b2] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Vitamin D may mediate immunomodulatory effects in patients with inflammatory bowel disease (IBD). The relationships between disease activity and circulating levels of total, free, and bioavailable 25(OH) vitamin D (25(OH)D) are poorly defined. The aim of this study was to measure circulating components of the vitamin D axis in patients with IBD and healthy controls and to correlate these with markers of disease activity, adjusting for potential confounders. METHODS Clinical data were obtained and serum was analyzed for 25(OH)D and vitamin D-binding protein in patients with IBD and controls. Markers of systemic and intestinal (fecal calprotectin) inflammation were measured. RESULTS Serum 25(OH)D concentration was similar across 23 controls, 40 patients with Crohn's disease, and 31 with ulcerative colitis. An inverse correlation between 25(OH)D and calprotectin was noted in Crohn's disease (Pearson's r = -0.35, P = 0.040), ulcerative colitis (r = -0.39, P = 0.039), and all IBD together (r = -0.37, P = 0.003), but not with systemic markers. A similar trend was noted for free and bioavailable 25(OH)D. This inverse correlation remained after partial correlation analysis correcting for sunlight exposure, total oral vitamin D intake, and obesity and was also noted among the subgroup without small intestinal involvement. CONCLUSIONS Despite total, free, and bioavailable 25(OH)D concentrations being similar to those in a healthy control population, they inversely correlated strongly with intestinal inflammation. This was independent of potential malabsorption, sunlight exposure, and total vitamin D intake and obesity. Vitamin D may play an immunomodulatory role in IBD.
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Deleskog A, Piksasova O, Silveira A, Gertow K, Baldassarre D, Veglia F, Sennblad B, Strawbridge RJ, Larsson M, Leander K, Gigante B, Kauhanen J, Rauramaa R, Smit AJ, Mannarino E, Giral P, Gustafsson S, Östenson CG, Humphries SE, Tremoli E, de Faire U, Öhrvik J, Hamsten A. Serum 25-Hydroxyvitamin D Concentration in Subclinical Carotid Atherosclerosis. Arterioscler Thromb Vasc Biol 2013; 33:2633-8. [DOI: 10.1161/atvbaha.113.301593] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
Vitamin D deficiency has been implicated in cardiovascular disease and is associated with multiple cardiovascular risk factors. We investigated the serum 25-hydroxyvitamin D (25(OH)D) concentration in relation to latitude, baseline carotid intima-media thickness (IMT), and IMT progression, the carotid IMT measures being surrogate markers of subclinical atherosclerosis and cardiovascular disease risk.
Approach and Results—
Serum 25(OH)D concentration was related to high-resolution carotid IMT measures in 3430 middle-aged and elderly subjects with high cardiovascular risk but no prevalent disease, who were recruited at 7 centers in Finland, Sweden, The Netherlands, France, and Italy. Participants underwent carotid ultrasound examination at baseline and at months 15 and 30 after entry into the study, whereas blood samples, clinical data, and information about lifestyle were collected at baseline. Serum 25(OH)D levels were positively associated with latitude (Jonckheere–Terpstra χ=166.643;
P
<0.001) and, as previously reported, associated with a range of cardiovascular risk factors. There were no independent relationships between 25(OH)D and segment-specific or composite IMT measures in the entire cohort. In analyses stratified by sex, diabetes mellitus, and statin treatment, weak associations with some baseline and progression measures of carotid IMT were observed in males, diabetics, and nonstatin-treated individuals.
Conclusions—
Levels of 25(OH)D differed across Europe, were highest in the North, showed multiple associations with established and emerging cardiovascular risk factors but were not consistently, independently related to measures of carotid IMT. This argues against a protective role of vitamin D against subclinical atherosclerosis in high-risk individuals.
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Affiliation(s)
- Anna Deleskog
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Olga Piksasova
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Angela Silveira
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Karl Gertow
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Damiano Baldassarre
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Fabrizio Veglia
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Bengt Sennblad
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Rona J. Strawbridge
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Malin Larsson
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Karin Leander
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Bruna Gigante
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Jussi Kauhanen
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Rainer Rauramaa
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Andries J. Smit
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Elmo Mannarino
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Philippe Giral
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Sven Gustafsson
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Claes-Göran Östenson
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Steve E. Humphries
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Elena Tremoli
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Ulf de Faire
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - John Öhrvik
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
| | - Anders Hamsten
- From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of
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Pilz S, Gaksch M, O'Hartaigh B, Tomaschitz A, März W. The role of vitamin D deficiency in cardiovascular disease: where do we stand in 2013? Arch Toxicol 2013; 87:2083-103. [PMID: 24173581 DOI: 10.1007/s00204-013-1152-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 10/22/2013] [Indexed: 12/14/2022]
Abstract
The high worldwide prevalence of vitamin D deficiency is largely the result of low sunlight exposure with subsequently limited cutaneous vitamin D production. Classic manifestations of vitamin D deficiency are linked to disturbances in bone and mineral metabolism, but the identification of the vitamin D receptor in almost every human cell suggests a broader role of vitamin D for overall and cardiovascular health. The various cardiovascular protective actions of vitamin D such as anti-diabetic and anti-hypertensive effects including renin suppression as well as protection against atherosclerosis and heart diseases are well defined in previous experimental studies. In line with this, large epidemiological studies have highlighted vitamin D deficiency as a marker of cardiovascular risk. However, randomized controlled trials (RCTs) on vitamin D have largely failed to show its beneficial effects on cardiovascular diseases and its conventional risk factors. While most prior vitamin D RCTs were not designed to assess cardiovascular outcomes, some large RCTs have been initiated to evaluate the efficacy of vitamin D supplementation on cardiovascular events in the general population. When considering the history of previous disappointing vitamin RCTs in general populations, more emphasis should be placed on RCTs among severely vitamin D-deficient populations who would most likely benefit from vitamin D treatment. At present, vitamin D deficiency can only be considered a cardiovascular risk marker, as vitamin D supplementation with doses recommended for osteoporosis treatment is neither proven to be beneficial nor harmful in cardiovascular diseases.
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Affiliation(s)
- Stefan Pilz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria,
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Sachs MC, Brunzell JD, Cleary PA, Hoofnagle AN, Lachin JM, Molitch ME, Steffes MW, Zinman B, de Boer IH. Circulating vitamin D metabolites and subclinical atherosclerosis in type 1 diabetes. Diabetes Care 2013; 36:2423-9. [PMID: 23530012 PMCID: PMC3714470 DOI: 10.2337/dc12-2020] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE People with type 1 diabetes are at high risk of premature atherosclerosis. Existing evidence suggests that impaired vitamin D metabolism may contribute to the development of atherosclerosis. We tested associations of circulating vitamin D metabolite concentrations with subclinical atherosclerosis among 1,193 participants with type 1 diabetes in the DCCT/EDIC study. RESEARCH DESIGN AND METHODS We measured plasma concentrations of 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D, and 24,25-dihydroxyvitamin D by mass spectrometry at the end of the DCCT. In a staggered cross-sectional design, we tested associations with coronary artery calcium (CAC), measured by computed tomography a median of 10 years later, and with common and internal carotid intima-media thickness (IMT), measured by B-mode ultrasonography on two occasions a median of 4 years later and a median of 10 years later. We hypothesized that lower concentrations of each vitamin D metabolite would be associated with increased risk of CAC and greater carotid IMT. RESULTS At the time metabolites were measured, mean age was 32.4 years and mean duration of diabetes was 7.5 years. The prevalence and severity of CAC tended to be lower-not higher-with lower concentrations of each vitamin D metabolite. For instance, in a fully adjusted multinomial logistic model, a 25 nmol/L lower 25-hydroxyvitamin D was associated with a 0.8-fold decrease in the odds of having higher CAC (95% CI 0.68-0.96, P = 0.01). No vitamin D metabolite was associated with either common or internal mean IMT. CONCLUSIONS We did not find evidence linking impaired vitamin D metabolism with increased subclinical atherosclerosis in type 1 diabetes.
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Blondon M, Sachs M, Hoofnagle AN, Ix JH, Michos ED, Korcarz C, Gepner AD, Siscovick DS, Kaufman JD, Stein JH, Kestenbaum B, de Boer IH. 25-Hydroxyvitamin D and parathyroid hormone are not associated with carotid intima-media thickness or plaque in the multi-ethnic study of atherosclerosis. Arterioscler Thromb Vasc Biol 2013; 33:2639-45. [PMID: 23814117 DOI: 10.1161/atvbaha.113.301781] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Observational evidence supports independent associations of 25-hydroxyvitamin D (25-OHD) and parathyroid hormone (PTH) with cardiovascular risk. A plausible hypothesis for these associations is accelerated development of atherosclerosis. APPROACH AND RESULTS We evaluated cross-sectional and longitudinal associations of 25-OHD and PTH with carotid intima-media thickness (IMT) and carotid plaques among 3251 participants free of cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis. 25-OHD and PTH were measured at baseline by mass spectrometry and immunoassay, respectively. All subjects underwent a carotid ultrasound examination at baseline and 9.4 years later (median, range 8-11.1 years). Multivariable linear and logistic regressions were used to test associations of 25-OHD and PTH with the extent and progression of IMT and the prevalence and incidence of carotid plaque. Mean (SD) 25-OHD and PTH were 25.8 ng/mL (10.6) and 44.2 pg/mL (20.2), respectively. No independent associations were found between 25-OHD or PTH and IMT at baseline (increment of 1.9 μm [95% confidence interval, -5.1 to 8.9] per 10 ng/mL lower 25-OHD; increment of 0.8 μm [95% confidence interval, -3.2 to 4.8] per 10 pg/mL higher PTH) or progression of IMT (increment of 2.6 μm [95% confidence interval, -2.5 to 7.8] per 10 ng/mL lower 25-OHD, increment of 1.6 μm [95% confidence interval, -1.9 to 5.2] per 10 pg/mL higher PTH). No associations were found with the baseline prevalence of carotid plaque or the incidence of new plaques during the study period. We did not observe any interaction by race or ethnicity (White, Chinese, Black, and Hispanic). CONCLUSIONS The consistent lack of association of vitamin D and PTH with carotid IMT and plaque suggests that these hormones may influence cardiovascular risk through pathways not reflected by carotid atherosclerosis.
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Affiliation(s)
- Marc Blondon
- From the Department of Epidemiology (M.B., D.S.S., J.D.K., B.K., I.H.d.B.), Division of Nephrology and Kidney Research Institute (M.S., B.K., I.H.d.B.), Department of Laboratory Medicine (A.N.H.), Department of Environmental and Occupational Health Sciences (J.D.K.), Department of Medicine (D.S.S., J.D.K., B.K., I.H.d.B.), Cardiovascular Health Research Unit (M.B., D.S.S.), University of Washington, Seattle, WA; Department of Medicine, Geneva University Hospitals, Geneva, Switzerland (M.B.); Division of Nephrology, University of California, San Diego, CA (J.H.I.); Department of Medicine, Johns Hopkins University, Baltimore, MD (E.D.M.); and Divison of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (C.K., A.D.G., J.H.S.)
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Yildirim I, Hur E, Kokturk F. Inflammatory Markers: C-Reactive Protein, Erythrocyte Sedimentation Rate, and Leukocyte Count in Vitamin D Deficient Patients with and without Chronic Kidney Disease. Int J Endocrinol 2013; 2013:802165. [PMID: 23878538 PMCID: PMC3710598 DOI: 10.1155/2013/802165] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 06/09/2013] [Indexed: 01/22/2023] Open
Abstract
Although some studies revealed a positive relationship between vitamin D3 deficiency and inflammatory markers, there have been also many studies that failed to find this relationship. The aim of this large scaled study is to determine the association between the level of plasma 25 hydroxy vitamin D3 [25-(OH) D3] and inflammatory markers in the general population without chronic kidney disease (CKD) and in patients with CKD. Participants with simultaneously measured inflammatory markers and 25-(OH) D3 levels were retrospectively analyzed (n = 1897). The incidence of all-cause inflammation infection, hospitalization, chronic renal failure, and vitamin B12 deficiency was evaluated. The medians of serum creatinine levels in subjects without renal failure were lower in 25-(OH) D3 deficient group. Patients with CKD were more likely to have vitamin D3 deficiency compared with normal GFR. 25-(OH) D3 levels were associated with a greater incidence of all-cause hospitalization, hypoalbuminemia, and vitamin B12 deficiency. However, there was no relationship between inflammatory markers and vitamin D3 levels. In 25-(OH) D3 deficient patients, inflammatory markers can be related to other inflammatory and infectious status such as malnutrition and cachexia. We believed that there must be a relationship between vitamin deficiency and inflammatory markers due to other causes than low 25-(OH) D3 status.
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Affiliation(s)
- Ibrahim Yildirim
- Division of Nephrology, Department of Internal Medicine, University of Bulent Ecevit, 67600 Zonguldak, Turkey
- *Ibrahim Yildirim:
| | - Ender Hur
- Division of Nephrology, Department of Internal Medicine, University of Bulent Ecevit, 67600 Zonguldak, Turkey
| | - Furuzan Kokturk
- Department of Biostatistics, University of Bulent Ecevit, 67600 Zonguldak, Turkey
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Welsh P, Doolin O, McConnachie A, Boulton E, McNeil G, Macdonald H, Hardcastle A, Hart C, Upton M, Watt G, Sattar N. Circulating 25OHD, dietary vitamin D, PTH, and calcium associations with incident cardiovascular disease and mortality: the MIDSPAN Family Study. J Clin Endocrinol Metab 2012; 97:4578-87. [PMID: 23071162 DOI: 10.1210/jc.2012-2272] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
CONTEXT Observational studies relating circulating 25-hydroxyvitamin D (25OHD) and dietary vitamin D intake to cardiovascular disease (CVD) have reported conflicting results. OBJECTIVE Our objective was to investigate the association of 25OHD, dietary vitamin D, PTH, and adjusted calcium with CVD and mortality in a Scottish cohort. DESIGN AND SETTING The MIDSPAN Family Study is a prospective study of 1040 men and 1298 women from the West of Scotland recruited in 1996 and followed up for a median 14.4 yr. PARTICIPANTS Locally resident adult offspring of a general population cohort were recruited from 1972-1976. MAIN OUTCOME MEASURES CVD events (n = 416) and all-cause mortality (n = 100) were evaluated. RESULTS 25OHD was measured using liquid chromatography-tandem mass spectrometry in available plasma (n = 2081). Median plasma 25OHD was 18.6 ng/ml, and median vitamin D intake was 3.2 μg/d (128 IU/d). Vitamin D deficiency (25OHD <15 ng/ml) was present in 689 participants (33.1%). There was no evidence that dietary vitamin D intake, PTH, or adjusted calcium were associated with CVD events or with mortality. Vitamin D deficiency was not associated with CVD (fully adjusted hazard ratio = 1.00; 95% confidence interval = 0.77-1.31). Results were similar after excluding patients who reported an activity-limiting longstanding illness at baseline (18.8%) and those taking any vitamin supplements (21.7%). However, there was some evidence vitamin D deficiency was associated with all-cause mortality (fully adjusted hazard ratio = 2.02; 95% confidence interval = 1.17-3.51). CONCLUSION Vitamin D deficiency was not associated with risk of CVD in this cohort with very low 25OHD. Future trials of vitamin D supplementation in middle-aged cohorts should be powered to detect differences in mortality outcomes as well as CVD.
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Affiliation(s)
- Paul Welsh
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, United Kingdom.
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Abstract
PURPOSE OF REVIEW The pleotropic effects of vitamin D on chronic diseases have received significant attention; however, its role in acute illness is less understood. The purpose of this review is to summarize the current evidence regarding the role of vitamin D in acute stress and critical illness. RECENT FINDINGS 25-Hydroxyvitamin D levels may affect risk of developing acute illnesses (e.g. respiratory infections), and low concentrations are associated with unfavorable outcomes during critical care. Inflammatory changes alone do not explain the observed deterioration in vitamin D status following acute stress. Hemodilution, interstitial extravasation, decreased synthesis of binding proteins, and renal wasting of 25-hydroxyvitamin D, all appear to play a more significant role in the regulation of vitamin D status during critical illness. SUMMARY Single-point assessments of 25-hydroxyvitamin D following acute stress may provide an inaccurate assessment of vitamin D status. In such cases, measurement of binding proteins and free vitamin D metabolites may be essential to create a more realistic approximation of vitamin D status. Variations in patient responses to acute stress and critical illness may depend not only on the degree of systemic vitamin D insufficiency, but also on the individual tissue requirements.
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Affiliation(s)
- Sadeq A Quraishi
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
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Knox S, Welsh P, Bezlyak V, McConnachie A, Boulton E, Deans KA, Ford I, Batty GD, Burns H, Cavanagh J, Millar K, McInnes IB, McLean J, Velupillai Y, Shiels P, Tannahill C, Packard CJ, Michael Wallace A, Sattar N. 25-Hydroxyvitamin D is lower in deprived groups, but is not associated with carotid intima media thickness or plaques: results from pSoBid. Atherosclerosis 2012; 223:437-41. [PMID: 22632919 DOI: 10.1016/j.atherosclerosis.2012.05.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 04/25/2012] [Accepted: 05/01/2012] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The association of the circulating serum vitamin D metabolite 25-hydroxyvitamin D (25OHD) with atherosclerotic burden is unclear, with previous studies reporting disparate results. METHOD Psychological, social and biological determinants of ill health (pSoBid) is a study of participants aged 35-64 years from Glasgow who live at extremes of the socioeconomic spectrum. Vitamin D deficiency was defined as 25OHD < 25nmol/L, as per convention. Cross-sectional associations between circulating 25OHD concentrations and a range of socioeconomic, lifestyle, and biochemistry factors, as well as carotid intima media thickness (cIMT) and plaque presence were assessed in 625 participants. RESULTS Geometric mean levels of circulating 25OHD were higher among the least deprived (45.6 nmol/L, 1-SD range 24.4-85.5) versus most deprived (34.2 nmol/L, 1-SD range 16.9-69.2; p < 0.0001). In the least deprived group 15% were "deficient" in circulating 25OHD versus 30.8% in the most deprived (χ(2)p < 0.0001). Log 25OHD was 27% lower among smokers (p < 0.0001), 20% higher among the physically active versus inactive (p = 0.01), 2% lower per 1 kg/m(2) increase in body mass index (BMI) (p < 0.0001), and showed expected seasonal variation (χ(2)p < 0.0001). Log 25OHD was 13% lower in the most versus least deprived independent of the aforementioned lifestyle confounding factors (p = 0.03). One unit increase in log 25OHD was not associated with atherosclerotic burden in univariable models; cIMT (effect estimate 0.000 mm [95% CI -0.011, 0.012]); plaque presence (OR 0.88 [0.75, 1.03]), or in multivariable models. CONCLUSION There is no strong association of 25OHD with cIMT or plaque presence, despite strong evidence 25OHD associates with lifestyle factors and socioeconomic deprivation.
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Affiliation(s)
- Susan Knox
- Department of Clinical Biochemistry, Glasgow Royal Infirmary, Glasgow G31 2ER, UK
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Soares PAO, Kovacs C, Moreira P, Saleh MH, Magnoni D, Faintuch J. Is intake of vitamin D and calcium important for cardiovascular health in elderly obese patients? Obes Surg 2012; 22:437-44. [PMID: 22246394 DOI: 10.1007/s11695-012-0593-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
There is compelling evidence that bariatric weight loss reduces cardiovascular complications; however, these still tend to be the most common cause of late death after surgical intervention. In a prospective cohort study, correlations of dietary nutrients with indexes of vascular health were sought, with emphasis on vitamin D and calcium. Clinically stable obese outpatient subjects (>60 years old, N = 44) were interviewed about dietary macro and micronutrients. Nutritional assessment targeted anthropometric and bioimpedance analysis (BIA), hematologic counts, lipid profile, glucose homeostasis, and inflammatory markers. Carotid intima-media thickness (IMT) and brachial flow-mediated dilation (FMD), along with related vascular measurements, were documented, and results were correlated by uni- and multivariate analysis, corrected for known risk factors. IMT, FMD, and also brachial basal flow were positively influenced by vitamin D (P < 0.001). Calcium appeared beneficial for brachial basal flow only (P = 0.010). No association with IMT occurred, and a negative result for FMD was elicited. Also, vitamins A and B12 were advantageous for FMD, whereas iron was deleterious for IMT. Intake of many micronutrients including calcium and vitamin D did not meet recommendations. Vitamin D displayed a beneficial profile regarding vascular health, and more attention to this nutrient should be given, especially concerning obese patients with cardiometabolic risk. Calcium exhibited less straightforward results but deserves focus as well, along with antioxidant vitamin A as well as the B-complex which were mostly deficient in this experience.
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Amer M, Qayyum R. Relation between serum 25-hydroxyvitamin D and C-reactive protein in asymptomatic adults (from the continuous National Health and Nutrition Examination Survey 2001 to 2006). Am J Cardiol 2012; 109:226-30. [PMID: 21996139 DOI: 10.1016/j.amjcard.2011.08.032] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 08/28/2011] [Accepted: 08/28/2011] [Indexed: 10/16/2022]
Abstract
The inverse relation between vitamin D supplementation and inflammatory biomarkers among asymptomatic adults is not settled. We hypothesized that the inverse relation is present only at lower levels and disappears at higher serum levels of vitamin D. We examined the relation between 25-hydroxyvitamin D [25(OH)D] and C-reactive protein (CRP) using the continuous National Health and Nutrition Examination Survey data from 2001 to 2006. Linear spline [single knot at median serum levels of 25(OH)D] regression models were used. The median serum 25(OH)D and CRP level was 21 ng/ml (interquartile range 15 to 27) and 0.21 mg/dl (interquartile range 0.08 to 0.5), respectively. On univariate linear regression analysis, CRP decreased [geometric mean CRP change 0.285 mg/dl for each 10-ng/ml change in 25(OH)D, 95% confidence interval [CI] -0.33 to -0.23] as 25(OH)D increased ≤21 ng/ml. However, an increase in 25(OH)D to >21 ng/ml was not associated with any significant decrease [geometric mean CRP change 0.05 mg/dl for each 10-ng/ml change in 25(OH)D, 95% CI -0.11 to 0.005) in CRP. The inverse relation between 25(OH)D below its median and CRP remained significant [geometric mean CRP change 0.11 mg/dl for each 10-ng/ml change in 25(OH)D, 95% CI 0.16 to -0.04] on multivariate linear regression analysis. Additionally, we observed a positive relation between 25(OH)D above its median and CRP [geometric mean CRP change 0.06 mg/dl for each 10-ng/ml change in 25(OH)D, 95% CI 0.02 to 0.11) after adjusting for traditional cardiovascular risk factors. In conclusion, from this cohort of asymptomatic adults, independent of traditional cardiovascular risk factors, we observed a statistically significant inverse relation between 25(OH)D at levels <21 ng/ml and CRP. We found that 25(OH)D at a level ≥21 ng/ml is associated with an increase in serum CRP. It is possible that the role of vitamin D supplementation to reduce inflammation is beneficial only among those with a lower serum 25(OH)D.
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Joergensen C, Reinhard H, Schmedes A, Hansen PR, Wiinberg N, Petersen CL, Winther K, Parving HH, Jacobsen PK, Rossing P. Vitamin D levels and asymptomatic coronary artery disease in type 2 diabetic patients with elevated urinary albumin excretion rate. Diabetes Care 2012; 35:168-72. [PMID: 22040839 PMCID: PMC3241314 DOI: 10.2337/dc11-1372] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Coronary artery disease (CAD) is the major cause of morbidity and mortality in type 2 diabetic patients. Severe vitamin D deficiency has been shown to predict cardiovascular mortality in type 2 diabetic patients. RESEARCH DESIGN AND METHODS We investigated the association among severe vitamin D deficiency, coronary calcium score (CCS), and asymptomatic CAD in type 2 diabetic patients with elevated urinary albumin excretion rate (UAER) >30 mg/24 h. This was a cross-sectional study including 200 type 2 diabetic patients without a history of CAD. Severe vitamin D deficiency was defined as plasma 25-hydroxyvitamin D (p-25[OH]D3) <12.5 nmol/L. Patients with plasma N-terminal pro-brain natriuretic peptide >45.2 ng/L or CCS ≥400 were stratified as being high risk for CAD (n= 133). High-risk patients were examined by myocardial perfusion imaging (MPI; n = 109), computed tomography angiography (n = 20), or coronary angiography (CAG; n = 86). Patients' p-25(OH)D3 levels were determined by high-performance liquid chromatography/tandem mass spectrometry. RESULTS The median (range) vitamin D level was 36.9 (3.8-118.6) nmol/L. The prevalence of severe vitamin D deficiency was 9.5% (19/200). MPI or CAG demonstrated significant CAD in 70 patients (35%). The prevalence of CCS ≥400 was 34% (68/200). Severe vitamin D deficiency was associated with CCS ≥400 (odds ratio [OR] 4.3, 95% CI [1.5-12.1], P = 0.005). This association persisted after adjusting for risk factors (4.6, 1.5-13.9, P = 0.007). Furthermore, severe vitamin D deficiency was associated with asymptomatic CAD (adjusted OR 2.9, 1.02-7.66, P = 0.047). CONCLUSIONS In high-risk type 2 diabetic patients with elevated UAER, low levels of vitamin D are associated with asymptomatic CAD.
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Pilz S, Tomaschitz A, März W, Drechsler C, Ritz E, Zittermann A, Cavalier E, Pieber TR, Lappe JM, Grant WB, Holick MF, Dekker JM. Vitamin D, cardiovascular disease and mortality. Clin Endocrinol (Oxf) 2011; 75:575-84. [PMID: 21682758 DOI: 10.1111/j.1365-2265.2011.04147.x] [Citation(s) in RCA: 160] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
A poor vitamin D status, i.e. low serum levels of 25-hydroxyvitamin D [25(OH)D], is common in the general population. This finding is of concern not only because of the classic vitamin D effects on musculoskeletal outcomes, but also because expression of the vitamin D receptor (VDR) and vitamin D metabolizing enzymes in the heart and blood vessels suggests a role of vitamin D in the cardiovascular system. VDR-knockout mice suffer from cardiovascular disease (CVD), and various experimental studies suggest cardiovascular protection by vitamin D, including antiatherosclerotic, anti-inflammatory and direct cardio-protective actions, beneficial effects on classic cardiovascular risk factors as well as suppression of parathyroid hormone (PTH) levels. In epidemiological studies, low levels of 25(OH)D are associated with increased risk of CVD and mortality. Data from randomized controlled trials (RCTs) are sparse and have partially, but not consistently, shown some beneficial effects of vitamin D supplementation on cardiovascular risk factors (e.g. arterial hypertension). We have insufficient data on vitamin D effects on cardiovascular events, but meta-analyses of RCTs indicate that vitamin D may modestly reduce all-cause mortality. Despite accumulating data suggesting that a sufficient vitamin D status may protect against CVD, we still must wait for results of large-scale RCTs before raising general recommendations for vitamin D in the prevention and treatment of CVD. In current clinical practice, the overall risks and costs of vitamin D supplementation should be weighed against the potential adverse consequences of untreated vitamin D deficiency.
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Affiliation(s)
- Stefan Pilz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
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Clendenen TV, Koenig KL, Arslan AA, Lukanova A, Berrino F, Gu Y, Hallmans G, Idahl A, Krogh V, Lokshin AE, Lundin E, Muti P, Marrangoni A, Nolen BM, Ohlson N, Shore RE, Sieri S, Zeleniuch-Jacquotte A. Factors associated with inflammation markers, a cross-sectional analysis. Cytokine 2011; 56:769-78. [PMID: 22015105 DOI: 10.1016/j.cyto.2011.09.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2011] [Revised: 08/31/2011] [Accepted: 09/19/2011] [Indexed: 12/19/2022]
Abstract
Epidemiological studies have reported associations between circulating inflammation markers and risk of chronic diseases. It is of interest to examine whether risk factors for these diseases are associated with inflammation. We conducted a cross-sectional analysis to evaluate whether reproductive and lifestyle factors and circulating vitamin D were associated with inflammation markers, including C-reactive protein, cytokines (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12p40, IL-12p70, IL-13, TNFα), and cytokine modulators (IL-1RA, sIL-1RII, sIL-2Ra, sIL-4R, sIL-6R, sTNF-R1/R2), among 616 healthy women. We confirmed associations of several inflammation markers with age and BMI. We also observed significantly higher levels of certain inflammation markers in postmenopausal vs. premenopausal women (TNFα, sIL-1RII, sIL-2Ra), with increasing parity (IL-12p40), and with higher circulating 25(OH) vitamin D (IL-13) and lower levels among current users of non-steroidal anti-inflammatory drugs (NSAIDs) (IL-1β, IL-2, IL-10, IL-12p70, and IL-12p40), current smokers (IL-4, IL-13, IL-12p40), and women with a family history of breast or ovarian cancer (IL-4, IL-10, IL-13). Our findings suggest that risk factors for chronic diseases (age, BMI, menopausal status, parity, NSAID use, family history of breast and ovarian cancer, and smoking) are associated with inflammation markers in healthy women.
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Affiliation(s)
- Tess V Clendenen
- Department of Environmental Medicine, Division of Epidemiology, New York University School of Medicine, New York, NY, USA.
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Vitamin D, parathyroid hormone, and blood pressure in the National Health and Nutrition Examination Surveys . Am J Hypertens 2011; 24:911-7. [PMID: 21525968 DOI: 10.1038/ajh.2011.73] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Previous research shows serum 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone (PTH) are each associated with blood pressure (BP), but it is unclear whether these associations are independent. METHODS Cross-sectional data from the US National Health and Nutrition Examination Surveys (NHANES) during 2003-2006. Analyses were restricted to 7,561 participants aged ≥20 years with measurements of 25(OH)D, PTH, BP, BP treatment, smoking, physical activity, serum calcium, and creatinine. Results were adjusted for these plus demographic variables. RESULTS Serum 25(OH)D was more strongly associated (inversely) with systolic than diastolic BP. Adjusted mean (standard error) difference in BP for the lowest 25(OH)D quintile (≤13 ng/ml) was 3.5 (0.7) mm Hg for systolic BP and 1.8 (0.6) mm Hg for diastolic BP, compared with the highest quintile (≥30 ng/ml). In contrast, PTH was positively associated with both systolic and diastolic BP (P < 0.0001). Adjusted mean (standard error) difference in BP for the highest PTH quintile (≥59 ng/l) was 5.9 (0.8) mm Hg for systolic BP and 4.5 (0.5) mm Hg for diastolic BP, compared with the lowest quintile (≤27 ng/l). When both 25(OH)D and PTH were included in the same model, the associations of PTH with systolic and diastolic BP were unchanged. However, the associations between 25(OH)D and BP were attenuated, with mean (standard error) difference between the highest and lowest quintiles being 2.2 (0.6) mm Hg for systolic BP (P < 0.01) and 0.8 (0.6) mm Hg for diastolic BP. CONCLUSION PTH may mediate most of the association between 25(OH)D and BP, which was not significant when also adjusting for body mass index.
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Carrelli AL, Walker MD, Lowe H, McMahon DJ, Rundek T, Sacco RL, Silverberg SJ. Vitamin D deficiency is associated with subclinical carotid atherosclerosis: the Northern Manhattan study. Stroke 2011; 42:2240-5. [PMID: 21719770 DOI: 10.1161/strokeaha.110.608539] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to assess the association of vitamin D deficiency and indices of mineral metabolism with subclinical carotid markers that predict cardiovascular events. METHODS Two hundred three community-dwelling adults (Northern Manhattan Study; age, 68 ± 11; age range, 50 to 93 years) had serum measurements (calcium, phosphorus, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, parathyroid hormone) and carotid ultrasound (plaque presence, number, maximal carotid plaque thickness, intima-media thickness). RESULTS Adjusting for cardiovascular risk factors, plaque number was associated with phosphorus levels (β=0.39 per 1-mg/dL increase; P=0.02) and calcium-phosphorus product (β=0.36 per 10-U increase; P=0.03). In those with plaque (N=116 [57%]), the association of plaque number with phosphorus and calcium-phosphorus product persisted. In addition, 25-hydroxyvitamin D was inversely associated with both intima-media thickness (β=-0.01 per 10-ng/mL increase; P=0.05) and maximal carotid plaque thickness (β=-0.10 per 10-ng/mL increase; P=0.03). In a model containing traditional cardiac risk factors and indices of mineral metabolism, 25-hydroxyvitamin D accounted for 13% of the variance in both intima-media thickness and maximal carotid plaque thickness. Calcium, parathyroid hormone, and 1,25-dihydroxyvitamin D levels were not associated with carotid measures. CONCLUSIONS After adjusting for cardiovascular risk factors and renal function, serum phosphorus and calcium-phosphorus product were associated with a greater burden of subclinical carotid atherosclerosis. Low 25-hydroxyvitamin D levels were associated with increased intima-media thickness and maximal carotid plaque thickness in those with plaque, and 25-hydroxyvitamin D contributed in a robust manner to the variance in both. These results confirm and extend data on the association of low vitamin D levels with subclinical carotid atherosclerosis. The precise nature of this association and the optimum levels of vitamin D for vascular health remain to be elucidated.
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Affiliation(s)
- Angela L Carrelli
- Department of Medicine, College of Physicians and Surgeons, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA
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Abstract
Hypovitaminosis D is suspected to be linked to several types of cancer, metabolic syndrome, cardiovascular disease, and all-cause mortality. This review explores the relationship of vitamin D to blood pressure and hypertension, a major cardiovascular disease risk factor. The literature up to June 2009 was searched without language or time restrictions from MEDLINE and PubMed, and it was supplemented with references from included studies. Ten observational studies and nine randomized control trials concerned with the association between vitamin D and blood pressure were identified and analyzed. Of these, eight observational studies and three randomized control trials supported an inverse association between vitamin D and blood pressure. Current observational studies strongly support an inverse association between vitamin D and blood pressure, but this association has yet to be convincingly supported with randomized control trials. More research is needed to determine the amount of vitamin D supplementation or ultraviolet B irradiation needed to maintain optimal serum 25-hydroxyvitamin D levels and to lower high blood pressure and to determine who can benefit from vitamin D supplementation or ultraviolet B irradiation.
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Young KA, Snell-Bergeon JK, Naik RG, Hokanson JE, Tarullo D, Gottlieb PA, Garg SK, Rewers M. Vitamin D deficiency and coronary artery calcification in subjects with type 1 diabetes. Diabetes Care 2011; 34:454-8. [PMID: 20978098 PMCID: PMC3024366 DOI: 10.2337/dc10-0757] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The objective of this study is to examine the relationship among serum levels of 25-hydroxyvitamin D (25[OH]D), polymorphisms in vitamin D-associated genes, and the presence and progression of coronary artery calcification (CAC) in adults with type 1 diabetes. RESEARCH DESIGN AND METHODS This prospective study included 374 non-Hispanic white individuals with type 1 diabetes (mean age 40 ± 9 years; 46% were male). CAC was measured at the baseline and 3- and 6-year follow-up visits were determined by electron beam computed tomography. Serum 25[OH]D levels were measured by liquid chromatography tandem mass spectrometry at the 3-year visit. RESULTS Normal (>30 ng/mL), insufficient (20-30 ng/mL), and deficient (<20 ng/mL) 25-[OH]D levels were present in 65%, 25%, and 10% of the individuals with type 1 diabetes, respectively. 25[OH]D deficiency was associated with the presence of CAC at the 3-year visit, odds ratio (OR) = 3.3 (95% CI 1.6-7.0), adjusting for age, sex, and hours of daylight. In subjects free of CAC at the 3-year visit, 25[OH]D deficiency predicted the development of CAC over the next 3 years in those with the vitamin D receptor M1T CC genotype (OR = 6.5 [1.1-40.2], P = 0.04) than in those with the CT or TT genotype (OR = 1.6 [0.3-8.6], P = 0.57). CONCLUSIONS Vitamin D deficiency independently predicts prevalence and development of CAC, a marker of coronary artery plaque burden, in individuals with type 1 diabetes.
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Affiliation(s)
- Kendra A Young
- Colorado School of Public Health, University of Colorado, Denver, Colorado, USA
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Vilarrasa N, Vendrell J, Maravall J, Elío I, Solano E, San José P, García I, Virgili N, Soler J, Gómez JM. Is plasma 25(OH) D related to adipokines, inflammatory cytokines and insulin resistance in both a healthy and morbidly obese population? Endocrine 2010; 38:235-42. [PMID: 21046484 DOI: 10.1007/s12020-010-9379-4] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Accepted: 07/07/2010] [Indexed: 01/03/2023]
Abstract
To analyse in a cohort of healthy subjects and in a group of morbidly obese patients, we studied the association amongst 25(OH) D and plasma concentrations of adipocytokines, inflammatory cytokines and insulin resistance. We also aimed to determine whether vitamin D-deficient patients showed a greater inflammatory profile. In the observational study that the authors conducted, plasma concentrations of 25(OH) D, leptin, resistin, adiponectin and interleukine-18 were determined in 134 healthy men and 127 women. In the population consisting of 44 patients with morbid obesity, plasma concentrations of 25(OH) D, leptin, resistin, adiponectin, interleukine-18, soluble tumor necrosis factor receptors 1 and 2 and C-reactive protein were analysed. In the healthy population, plasma 25(OH) D showed a negative correlation with body mass index, body fat, waist, hip circumference and with leptin. However, no significant associations were found amongst 25(OH) D and plasma concentrations of resistin, adiponectin or interleukine-18. Patients with vitamin D deficiency showed higher body mass index, fat mass percentage and higher leptin concentrations compared with subjects with normal 25(OH) D concentrations. In the morbidly obese subjects, 25(OH) D did not correlate with leptin, resistin, adiponectin, interleukine-18, soluble tumor necrosis factor receptors 1 and 2 or with C-reactive protein. In patients with morbid obesity, no differences were found in adipokines and inflammatory cytokines concentrations regarding 25(OH) D status. No associations were found either between 25(OH) D and plasma glucose and insulin resistance or with lipid profile. Plasma 25(OH) D concentrations are associated with adiposity markers but not with adipocytokines implicated in inflammation. This lack of association does not support a major role of 25(OH) D in the pro-inflammatory environment observed in morbidly obese subjects. In addition, subjects with vitamin D deficiency are not characterized by a greater inflammatory state.
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Affiliation(s)
- Núria Vilarrasa
- Endocrinology and Diabetes Unit, Hospital Universitari de Bellvitge, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
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Shen H, Bielak LF, Ferguson JF, Streeten EA, Yerges-Armstrong LM, Liu J, Post W, O'Connell JR, Hixson JE, Kardia SLR, Sun YV, Jhun MA, Wang X, Mehta NN, Li M, Koller DL, Hakonarson H, Keating BJ, Rader DJ, Shuldiner AR, Peyser PA, Reilly MP, Mitchell BD. Association of the vitamin D metabolism gene CYP24A1 with coronary artery calcification. Arterioscler Thromb Vasc Biol 2010; 30:2648-54. [PMID: 20847308 DOI: 10.1161/atvbaha.110.211805] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The vitamin D endocrine system is essential for calcium homeostasis, and low levels of vitamin D metabolites have been associated with cardiovascular disease risk. We hypothesized that DNA sequence variation in genes regulating vitamin D metabolism and signaling pathways might influence variation in coronary artery calcification (CAC). METHODS AND RESULTS We genotyped single-nucleotide polymorphisms (SNPs) in GC, CYP27B1, CYP24A1, and VDR and tested their association with CAC quantity, as measured by electron beam computed tomography. Initial association studies were carried out in a discovery sample comprising 697 Amish subjects, and SNPs nominally associated with CAC quantity (4 SNPs in CYP24A1, P=0.008 to 0.00003) were then tested for association with CAC quantity in 2 independent cohorts of subjects of white European ancestry (Genetic Epidemiology Network of Arteriopathy study [n=916] and the Penn Coronary Artery Calcification sample [n=2061]). One of the 4 SNPs, rs2762939, was associated with CAC quantity in both the Genetic Epidemiology Network of Arteriopathy (P=0.007) and Penn Coronary Artery Calcification (P=0.01) studies. In all 3 populations, the rs2762939 C allele was associated with lower CAC quantity. Metaanalysis for the association of this SNP with CAC quantity across all 3 studies yielded a P value of 2.9×10(-6). CONCLUSIONS A common SNP in the CYP24A1 gene was associated with CAC quantity in 3 independent populations. This result suggests a role for vitamin D metabolism in the development of CAC quantity.
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Affiliation(s)
- Haiqing Shen
- Division of Endocrinology, University of Maryland School of Medicine, Baltimore, Md 21201, USA
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Freedman BI, Wagenknecht LE, Hairston KG, Bowden DW, Carr JJ, Hightower RC, Gordon EJ, Xu J, Langefeld CD, Divers J. Vitamin d, adiposity, and calcified atherosclerotic plaque in african-americans. J Clin Endocrinol Metab 2010; 95:1076-83. [PMID: 20061416 PMCID: PMC2841532 DOI: 10.1210/jc.2009-1797] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Inverse associations are reported between circulating 25-hydroxyvitamin D and visceral adiposity. The effects of vitamin D levels on atherosclerosis are unknown. OBJECTIVE The objective of this study was to test for relationships between vitamin D, adiposity, bone density, and atherosclerosis in African-Americans. DESIGN Circulating 25-hydroxyvitamin D, 1,25 dihydroxyvitamin D, intact PTH, C-reactive protein and computed tomography-derived calcified atherosclerotic plaque (CP), bone density, and fat volumes were measured. SETTING Examinations were performed at a single outpatient general clinical research center visit. SUBJECTS Three hundred forty African-Americans with type 2 diabetes were evaluated. Mean +/- SD age was 55.6 +/- 9.6 yr, diabetes duration 10.6 +/- 8.3 yr, glomerular filtration rate 1.6 +/- 0.5 ml/sec, body mass index 35.6 +/- 8.7 kg/m(2), and 25-hydroxyvitamin D concentration 50.4 +/- 30.5 nmol/liter. MAIN OUTCOME MEASURE Biomarkers were tested for association with pericardial, visceral, im, and sc adipose tissues; thoracic and lumbar vertebral bone density; and aorta, coronary, and carotid artery CP. RESULTS Adjusting for age, gender, body mass index, glycosylated hemoglobin, and glomerular filtration rate, 25-hydroxyvitamin D was negatively associated with visceral adiposity (P = 0.009) and positively associated with carotid artery CP and aorta CP (P = 0.013 and 0.014, respectively) but not with coronary artery CP or bone density. CONCLUSIONS We confirmed an inverse association between vitamin D and visceral adiposity in African-Americans with diabetes. In addition, positive associations exist between 25-hydroxyvitamin D and aorta and carotid artery CP in African-Americans. The effects of supplementing vitamin D to raise the serum 25-hydroxyvitamin D level on atherosclerosis in African-Americans are unknown. Prospective trials are needed to determine the cardiovascular effects of supplemental vitamin D in this ethnic group.
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Affiliation(s)
- Barry I Freedman
- Section on Nephrology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina 27157-1053, USA.
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