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Yaman AE, Ceylan US. Effects of Vitamin D Levels on Long-Term Coronary Events in Patients with Proven Coronary Artery Disease: Six-Year Follow-Up. J Clin Med 2023; 12:6835. [PMID: 37959300 PMCID: PMC10650784 DOI: 10.3390/jcm12216835] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Although some clinical studies have claimed that low-dose vitamin D (Vit-D) increases the risk of long-term cardiac events, in others, no association was found. To better understand the impact of Vit-D levels on long-term cardiac events in coronary artery disease patients, this study was designed. There were 408 patients with coronary artery disease (CAD). The patients were separated into three groups based on their Vit-D levels: group 1 had levels below 10 ng/mL, group 2 had levels between 10 and 20, and group 3 had levels above 20 ng/mL. Six years were spent monitoring the patients for non-fatal MI, death, vascular revascularization, and stable course data. Mortality was found to be similar between groups (group 1: 24.5%; group 2: 13.8%; group 3: 17.4%; p > 0.05). In group 3, 47.8% of the patients did not experience any cardiac event, while 28.7% in group 2 and 27.6% in group 1 did not experience any cardiac event, and these values were found to be significant in favor of group 3 (p = 0.006). Group 3 was found to have considerably lower rates of non-ST-elevated myocardial infarction (non-STEMI) and unstable angina (UA) than the other groups did (group 1: 49%; group 2: 38%; group 3: 27%; p = 0.001). In conclusion, although vitamin D deficiency does not accompany an increase in mortality, it is associated with an increase in non-STEMI and UA in patients who have previously been diagnosed with CAD.
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Affiliation(s)
- Aysun Erdem Yaman
- Siyami Ersek Thoracic Surgery Research and Training Hospital, Department of Cardiology, 34668 Istanbul, Turkey
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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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El Mokadem M, Boshra H, Abd El Hady Y, Abd El Hameed AS. Relationship of serum vitamin D deficiency with coronary artery disease severity using multislice CT coronary angiography. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2021; 33:282-288. [PMID: 33906751 DOI: 10.1016/j.arteri.2021.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/05/2021] [Accepted: 02/11/2021] [Indexed: 12/29/2022]
Abstract
AIM To assess the relationship between vitamin D deficiency and severity of coronary artery disease using multislice CT coronary angiography. METHODS 100 patients diagnosed with coronary artery disease during multislice CT coronary angiography were subjected to full evaluation of coronary artery disease severity followed by measurement of serum vitamin D level. RESULTS The mean value of serum vitamin D level was 13.35±7.49ng/ml. 76% of the patients had vitamin D deficiency (<20ng/ml). 41% of the patients had single vessel disease, 28% had two vessel diseases, and 31% had multi-vessel disease. Patients with vitamin D deficiency had higher degree of coronary stenosis, higher coronary Ca score (p<0.001) and higher number of affected vessels compared with normal vitamin D level subgroup (p<0.001). Vitamin D level showed a significant negative correlations with age (r=-0.290, p=0.003), coronary Ca score (r=-0.630, p<0.001) and severity of coronary lesions. Multivariate linear regression analysis showed that dyslipidemia and vitamin D level were independent predictors of percent severity of coronary stenosis. CONCLUSION In addition to traditional cardiovascular risk factors, vitamin D deficiency looks to be independent predictor of coronary artery disease severity including percent stenosis, number of the affected vessels as well as degree of coronary calcification.
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Affiliation(s)
- Mostafa El Mokadem
- Cardiology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
| | - Hesham Boshra
- Cardiology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Yasser Abd El Hady
- Cardiology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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El Mokadem M, Boshra H, Abd el Hady Y, Abd el Hameed AS. Relationship of serum vitamin D deficiency with coronary artery disease severity using multislice CT coronary angiography. CLÍNICA E INVESTIGACIÓN EN ARTERIOSCLEROSIS (ENGLISH EDITION) 2021; 33:289-295. [DOI: 10.1016/j.artere.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Feuchtner G, Suppersberger S, Langer C, Beyer C, Rauch S, Thurner T, Friedrich G, Dichtl W, Widmann G, Plank F, Barbieri F. The Effect of Vitamin D on Coronary Atherosclerosis: A Propensity Score Matched Case-Control Coronary CTA Study. J Cardiovasc Dev Dis 2021; 8:jcdd8080085. [PMID: 34436227 PMCID: PMC8397201 DOI: 10.3390/jcdd8080085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/18/2021] [Accepted: 07/23/2021] [Indexed: 01/01/2023] Open
Abstract
Background: Vitamin D supplementation may be associated with lower cardiovascular (CV) events, but the data are controversial. It remains speculative whether vitamin D supplementation has a direct effect on coronary atherosclerosis. We therefore set out to assess the influence of vitamin D supplementation on the coronary atherosclerosis profile quantified by coronary computed tomography angiography (CTA) in a retrospective case–control cohort study. Methods: 176 patients (age: 62.4 ± 10.4) referred to coronary CTA for clinical indications were included. A total of 88 patients receiving vitamin D supplementation (mean duration 65.3 ± 81 months) were 1:1 propensity score matched with 88 controls for age, gender, smoking, arterial hypertension, positive family history, dyslipidemia, and diabetes. Coronary stenosis severity (CAD-RADSTM), mixed plaque burden (weighted for non-calcified), high-risk-plaque (HRP) features, and plaque density (HU) were quantified by CTA. Serum 25-hydroxyvitamin D (OH)-levels were measured in 138 patients and categorized into four groups (0: <20 ng/mL; 1: 20–40 ng/mL; 2: 40–60 ng/mL; and 3: >60 ng/mL) and compared with CTA. Results: The prevalence of atherosclerosis by CTA was similar in both groups (75.6% versus 74.3%, p = 0.999), >50% coronary stenosis was slightly higher in controls (p = 0.046), but stenosis severity score (CAD-RADS) was not different (p = 0.106). Mixed plaque burden (weighted for non-calcified) was lower in patients receiving vitamin D supplementation (p = 0.002) and high-risk-plaque prevalence was markedly lower (3.8% versus 32%, p < 0.001). CT plaque density (HU) was higher (p < 0.001) in the vitamin D group. Patients with serum vitamin D (OH) levels >60 ng/mL had higher plaque density (p = 0.04), indicating more calcified and less vulnerable plaque. Conclusions: In this retrospective case–control cohort study, vitamin D supplementation was associated with less high-risk plaque, less non-calcified plaque burden, and a higher calcified plaque independent of CV risk factors.
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Affiliation(s)
- Gudrun Feuchtner
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (G.F.); (S.S.); (C.L.); (S.R.); (G.W.)
| | - Simon Suppersberger
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (G.F.); (S.S.); (C.L.); (S.R.); (G.W.)
| | - Christian Langer
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (G.F.); (S.S.); (C.L.); (S.R.); (G.W.)
| | - Christoph Beyer
- Department of Internal Medicine III, Medical University of Innsbruck, 6020 Innsbruck, Austria; (C.B.); (G.F.); (W.D.); (F.P.)
| | - Stefan Rauch
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (G.F.); (S.S.); (C.L.); (S.R.); (G.W.)
| | | | - Guy Friedrich
- Department of Internal Medicine III, Medical University of Innsbruck, 6020 Innsbruck, Austria; (C.B.); (G.F.); (W.D.); (F.P.)
| | - Wolfgang Dichtl
- Department of Internal Medicine III, Medical University of Innsbruck, 6020 Innsbruck, Austria; (C.B.); (G.F.); (W.D.); (F.P.)
| | - Gerlig Widmann
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (G.F.); (S.S.); (C.L.); (S.R.); (G.W.)
| | - Fabian Plank
- Department of Internal Medicine III, Medical University of Innsbruck, 6020 Innsbruck, Austria; (C.B.); (G.F.); (W.D.); (F.P.)
| | - Fabian Barbieri
- Department of Internal Medicine III, Medical University of Innsbruck, 6020 Innsbruck, Austria; (C.B.); (G.F.); (W.D.); (F.P.)
- Department of Cardiology, Charité University Medicine, Campus Benjamin Franklin, 12203 Berlin, Germany
- Correspondence: ; Tel.: +43-512-504-82546
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Billington EO, Burt LA, Plett R, Rose MS, Boyd SK, Hanley DA. Effect of high-dose vitamin D supplementation on peripheral arterial calcification: secondary analysis of a randomized controlled trial. Osteoporos Int 2020; 31:2141-2150. [PMID: 32556518 DOI: 10.1007/s00198-020-05500-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/08/2020] [Indexed: 10/24/2022]
Abstract
UNLABELLED Although high-dose vitamin D supplementation is common, effects on arterial calcification remain unexplored. Tibial artery calcification was identified and quantified over 3 years in participants randomized to 400, 4000, or 10,000 IU vitamin D3 daily. High-dose vitamin D supplementation did not affect the development or progression of arterial calcification. INTRODUCTION To determine whether vitamin D supplementation has a dose-dependent effect on development and progression of arterial calcification. METHODS This was a secondary analysis of the Calgary Vitamin D Study, a 3-year, double-blind, randomized controlled trial conducted at a single-center in Calgary, Canada. Participants were community-dwelling adults aged 55-70 years with serum 25-hydroxyvitamin D 30-125 nmol/L. Participants were randomized 1:1:1 to receive vitamin D3 400, 4000, or 10,000 IU/day for 3 years. Tibial artery calcification was identified and quantified (in milligrams of hydroxyapatite, mgHA) using high-resolution peripheral quantitative computed tomography (HR-pQCT) at baseline and 6, 12, 24, and 36 months. Changes in calcification over time and treatment group interaction were evaluated using a constrained linear mixed effects model. RESULTS Of 311 randomized participants, 302 (400: 105, 4000: 96, 10,000: 101) were eligible for analysis of arterial calcification (54% male, mean (SD) age 62 (4) years, mean (SD) 25-hydroxyvitamin D 78.9 (19.9) nmol/L). At baseline, 85 (28%) had tibial artery calcification, and mean (95% CI) calcification quantity was 2.8 mgHA (95% CI 1.7-3.9). In these 85 participants, calcification quantity increased linearly by 0.020 mgHA/month (95% CI 0.012-0.029) throughout the study, with no evidence of a treatment-group effect (p = 0.645 for interaction). No participants developed new arterial calcifications during the study. CONCLUSIONS In this population of community-dwelling adults who were vitamin D replete at baseline, supplementation with vitamin D 400, 4000, or 10,000 IU/day did not have differential effects on the development or progression of arterial calcification over 3 years. TRIAL REGISTRATION clinicaltrials.gov (NCT01900860).
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Affiliation(s)
- E O Billington
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.
- Division of Endocrinology, Cumming School of Medicine, University of Calgary, Calgary, Canada.
- Dr. David Hanley Osteoporosis Clinic, 1820 Richmond Road SW, Calgary, Alberta, T2T 3C5, Canada.
| | - L A Burt
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - R Plett
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - M S Rose
- Research Facilitation, Alberta Health Services, Calgary, Canada
| | - S K Boyd
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - D A Hanley
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Division of Endocrinology, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Birgani FK, Shahi MM, Cheraghian B, Haybar H. Investigating the Relationship the Severity of Coronary Artery Disease with Serum Levels of Vitamin D in Men after Eliminating the Effect of Diet. CURRENT NUTRITION & FOOD SCIENCE 2020. [DOI: 10.2174/1573401314666181105143051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:Coronary artery disease (CAD) is one of the most common cardiovascular diseases that can lead to mortality, inability, and lower productivity levels.Objective:The aim of this study was to determine the relationship between serum vitamin D level and cardiovascular risk factors and the severity of CAD after determining and eliminating the confounding effects of dietary patterns in male patients undergoing angiography.Methods:This descriptive-analytic study was carried out on 132 men undergoing angiography during 2017 and 2018. To this end, food frequency questionnaire (FFQ) and physical activity questionnaire (PAQ) were completed for the patients. Fasting blood sugar (FBS), triglyceride, total cholesterol, HDL-C, LDL-C and vitamin D levels were also investigated.Results:Serum vitamin D levels significantly decreased with an increase in CAD severity (p=0.001). Also, low serum levels led to the highest severity of CAD (p=0.005). However, there was no significant difference between patients with vitamin D deficiency with different degrees of CAD (p=0.084). Also, the highest percentage of individuals with normal serum levels of vitamin D was observed in the group without any blocked blood arteries (normal) (p=0.023).Conclusion:This study shows an inverse relationship between serum 25(OH) D level and the severity of CAD. Our data show that vitamin D plays an important role in preventing CAD. These findings could help design prospective studies and clinical trials on a wider scale to investigate the effects of vitamin D interventions in preventing the development of CAD.
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Affiliation(s)
- Farshad K. Birgani
- Department of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Majid M. Shahi
- Hyperlipidemia Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Department of Epidemiology, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Habib Haybar
- Cardiovascular Research Center and Department of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Abstract
PURPOSE OF REVIEW Vitamin D (VitD) deficiency is highly prevalent among HIV-infected individuals. Given the overlapping risk for several chronic disease and immunomodulatory outcomes from both long-standing HIV and VitD deficiency, there is great interest in clarifying the clinical role of VitD for this population. RECENT FINDINGS Recent studies have expanded our knowledge regarding the epidemiology and mechanisms of VitD deficiency-associated outcomes in the setting of HIV. Clinical trials focusing on VitD supplementation have demonstrated a positive impact on bone mineral density in subgroups of HIV-infected individuals initiating ART or on suppressive ART regimens; however, significant heterogeneity exists between studies and data are less consistent with other clinical outcomes. Further research is needed to clarify uncertainly in several domains, including identifying patients at greatest risk for poor outcomes from VitD deficiency, standardizing definitions and measurement techniques, and better quantifying the benefits and risks of VitD supplementation across different demographic strata for skeletal and extra-skeletal outcomes.
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Affiliation(s)
- Evelyn Hsieh
- Section of Rheumatology, Yale School of Medicine, 300 Cedar Street, TAC S-525, PO Box 208031, New Haven, CT, 06517, USA.
| | - Michael T Yin
- Division of Infectious Diseases, Columbia University Medical Center, New York, NY, USA
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Moradi M, Foroutanfar A. Evaluation of vitamin D levels in relation to coronary CT angiographic findings in an Iranian population. Vasc Health Risk Manag 2017; 13:361-367. [PMID: 29042790 PMCID: PMC5633284 DOI: 10.2147/vhrm.s142721] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Vitamin D deficiency, as a predisposing factor for coronary artery disease (CAD), is a subject of increasing interest. However, its role as a risk factor has not been proven. This study aimed to investigate the relationship between serum vitamin D levels and CAD. Materials and methods Using a cross-sectional design, 180 patients who were candidates for coronary computed tomography angiography (CCTA) were selected. Serum levels of vitamin D were measured and compared with the results of CCTA (including calcium score, and presence and severity of coronary artery involvement due to atherosclerotic plaques). Results The mean age of the participants was 60.5±10.6 years and the mean serum vitamin D level was 26.2±15.9 ng/dL (range, 3.5–83.2 ng/dL). Overall, 6.1% of the participants (n=11) had vitamin D deficiency, 56.1% (n=101) had insufficient levels of vitamin D, and 37.8% (n=68) had sufficient levels of vitamin D. The mean serum vitamin D level was significantly lower in patients with severe CAD (P=0.004). The serum vitamin D level in the “positive for CAD” group was 20.98 ng/mL, significantly lower than the level in the “negative for CAD” group (30.47 ng/mL; P<0.001). The mean calcium score among participants was 533.5±87.9. Based on the Spearman test, a significant negative correlation (−0.21) was detected between the serum vitamin D level and coronary artery calcium score (CACS) (P=0.005). Conversely, the mean CACS in the vitamin D deficient group was significantly higher than in the insufficient and sufficient vitamin D groups (P<0.001 for both comparisons). Conclusion Vitamin D deficiency was associated with coronary artery calcification and severity of coronary artery stenosis in Iranian patients.
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Affiliation(s)
- Maryam Moradi
- Radiology Department, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Foroutanfar
- Radiology Department, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
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Li K, Yang X, Wang L, Chen M, Xu L, Yang X. Interaction Between Vitamin D and Lipoprotein (a) on the Presence and Extent of Coronary Heart Disease. Heart Lung Circ 2017; 26:1079-1084. [DOI: 10.1016/j.hlc.2016.11.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/13/2016] [Accepted: 11/20/2016] [Indexed: 12/13/2022]
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Pérez-Hernández N, Aptilon-Duque G, Nostroza-Hernández MC, Vargas-Alarcón G, Rodríguez-Pérez JM, Blachman-Braun R. Vitamin D and its effects on cardiovascular diseases: a comprehensive review. Korean J Intern Med 2016; 31:1018-1029. [PMID: 27117316 PMCID: PMC5094929 DOI: 10.3904/kjim.2015.224] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 10/10/2015] [Indexed: 12/15/2022] Open
Abstract
Vitamin D is a molecule that is actively involved in multiple metabolic pathways. It is mostly known for its implications related to calcium metabolism. It has also been determined that it actively participates in the cardiovascular system, influencing blood pressure, coronary artery disease and other vascular diseases, such as heart failure and atrial fibrillation. Furthermore, it has been established that this vitamin is extensively involved in the regulation of both the renin angiotensin aldosterone system and the immune system. In this review, we present the different vitamin D metabolic pathways associated with the cardiovascular pathophysiology, and we include studies in animal and human models, as well as some of the controversies found in the literature. This review also incorporates an overview of the implications in the molecular biology and public health fields.
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Affiliation(s)
- Nonanzit Pérez-Hernández
- Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
- Nonanzit Pérez-Hernández, Ph.D. Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Juan Badiano No. 1, Col. Sección XVI, Tlalpan 14080, Mexico City, Mexico Tel: +52-55-55732911 Fax: +52-55-551365811 E-mail:
| | - Gad Aptilon-Duque
- Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
- Faculty of Health Sciences, Anahuac University, Huixquilucan, Mexico
| | | | - Gilberto Vargas-Alarcón
- Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
| | | | - Ruben Blachman-Braun
- Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
- Faculty of Health Sciences, Anahuac University, Huixquilucan, Mexico
- Correspondence to Ruben Blachman-Braun, M.D. Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Juan Badiano No. 1, Col. Sección XVI, Tlalpan 14080, Mexico City, Mexico Tel: +52-55-55732911 Fax: +52-55-551365811 E-mail:
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Li K, Yang X, Wang L, Chen M, Zhao W, Xu L, Yang X. Modification of the association between smoking status and severity of coronary stenosis by vitamin D in patients suspected of coronary heart disease. Medicine (Baltimore) 2016; 95:e4817. [PMID: 27603397 PMCID: PMC5023920 DOI: 10.1097/md.0000000000004817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Given both smoking and vitamin D are associated with coronary heart disease (CHD) via inflammation and smoking may interfere with the local antiinflammatory effects of vitamin D. We hypothesized that the relationship between smoking and severity of CHD may be modified by vitamin D.A cross-sectional study was conducted. 25-OH vitamin D values were determined in 348 consecutive patients (mean age 62.4 ± 10.5 years; 56.3% male) undergoing coronary angiography at the Heart Center of Chaoyang Hospital affiliated to Capital Medical University between the period of September 2014 and May 2015. We categorized the patients into 2 groups based on 25-OH vitamin D levels, that is, severe hypovitaminosis D (25-OH vitamin D < 10 ng/mL) and higher vitamin D (25-OH vitamin D > = 10 ng/mL). Multivariable logistic regression models were used to estimate odds ratios (ORs) of severe coronary stenosis or higher Gensini score across three smoking status, that is, never smokers, former smokers, and current smokers in severe hypovitaminosis D and higher vitamin D groups, respectively.Of these patients, we identified 212 (60.9%) cases of severe CHD and 161 (46.3%) cases of severe hypovitaminosis D. Multivariable logistic regression model showed the ORs of severe CHD were 1.94 (95% confidence interval [CI]: 0.47, 7.98) for former smokers and 2.62 (95% CI: 0.83, 8.24) for current smokers, compared with never smokers in group with severe hypovitaminosis D (P-trend = 0.005). In contrast, smoking was not found to be significantly associated with severe CHD in group with higher 25-OH vitamin D (P-trend = 0.115). We found a significant interaction between smoking status and vitamin D on presence of severe CHD (P-interaction = 0.015). In terms of Gensini score as a dependent variable, similar results were identified.Our finding indicated the association between smoking and severity of CHD appeared to be substantially stronger among patients with severe hypovitaminosis D as compared with those with higher vitamin D levels. This suggests vitamin D sufficiency may have a protective effect against the damaging effects of smoking on coronary artery. Future cohort studies are warranted to confirm this finding.
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Affiliation(s)
| | | | | | | | | | | | - Xinchun Yang
- Heart Center of Beijing Chaoyang Hospital Affiliated to Capital Medical University, Chaoyang District, Beijing, China
- Correspondence: Xinchun Yang, Heart Center of Chaoyang Hospital Affiliated to Capital Medical University, Beijing City, Beijing 100020, China (e-mail: )
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Sung KC, Chang Y, Ryu S, Chung HK. High levels of serum vitamin D are associated with a decreased risk of metabolic diseases in both men and women, but an increased risk for coronary artery calcification in Korean men. Cardiovasc Diabetol 2016; 15:112. [PMID: 27519883 PMCID: PMC4983097 DOI: 10.1186/s12933-016-0432-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 08/02/2016] [Indexed: 02/06/2023] Open
Abstract
Background There are conflicting results for relationships between serum vitamin D levels and metabolic diseases. The aim of this study was to investigate whether serum vitamin D levels were associated with various metabolic diseases including insulin resistance (IR), metabolic syndrome (MS), fatty liver (FL), and coronary artery calcification (CAC), along with assessing gender differences for these relationships in Korean adults. Methods A total of 180,918 subjects (98,412 men and 82,506 women) who participated in a comprehensive health examination in the 2012–2013 period at Kangbuk Samsung Hospital, College of Medicine, Sungkyunkwan University were included. Serum vitamin D and metabolic markers were analyzed and CAC was estimated. Subjects were divided according to quartile groups of serum vitamin D. To examine the relationships of serum vitamin D to metabolic diseases and metabolic factors, multivariate logistic analysis was conducted. Results High levels of serum vitamin D was associated with lower ORs for MS, IR and FL both in men and women (all p < 0.05). For men, ORs for CAC were significantly higher in third and the highest quartile groups for serum vitamin D in all the analyzed models (all p < 0.05). However, women showed no significant results between serum vitamin D and CAC. Conclusions High levels of serum vitamin D were associated with lower risk of MS, IR and FL in both Korean men and women, but were associated with higher risk of CAC only in men, and not in women. Electronic supplementary material The online version of this article (doi:10.1186/s12933-016-0432-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ki-Chul Sung
- Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, 110-746, South Korea.
| | - Yoosoo Chang
- Department of Occupational and Environmental Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seungho Ryu
- Department of Occupational and Environmental Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hye-Kyung Chung
- Severance institute for vascular and metabolic research, Yonsei University College of Medicine, Seoul, 120-749, South Korea.
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The Role of Vitamin D in Diabetes and Cardiovascular Disease: An Updated Review of the Literature. DISEASE MARKERS 2015; 2015:580474. [PMID: 26576069 PMCID: PMC4630385 DOI: 10.1155/2015/580474] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 09/22/2015] [Accepted: 09/29/2015] [Indexed: 02/06/2023]
Abstract
The dietary reference values for Vitamin D were set primarily considering its role in bone health, but with the discovery of Vitamin D receptors throughout body tissues, new links with other health conditions are now studied, such as for diabetes and cardiovascular diseases (CVD). This paper shall analyze and examine all new research studies carried out, especially in 2013–2015 regarding diabetes mellitus (DM) and cardiovascular diseases (CVD). Vast research has been carried out to establish strong relationship between Vitamin D serum levels, supplementation, diabetes, and CVD. However, the results from researches identified in this paper are disputable. Benefits of Vitamin D adequate levels were recognized from gestational period until later in disease development such as diabetes and/or CVD, but since not all studies are in agreement further investigation is suggested. Researches conducting large randomized controlled trials, exploring range of supplement doses, with variable baseline serum Vitamin D levels, and inclusion of array of associated parameters, are still required to conduct large-scale analysis and draw conclusion as a risk factor. Until then it is possible to conclude that maintenance of serum Vitamin D levels holds advantageous aspects in diabetic and cardiovascular conditions, and people should strive to attain them.
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Alsancak Y, Cengel A, Akyel A, Ozkan S, Sezenoz B, Unlu S, Kiziltunc E, Akboga MK, Alsancak AD, Elbeg S, Sahinarslan A, Yalcın MR. Relationship between serum vitamin D levels and angiographic severity and extent of coronary artery disease. Eur J Clin Invest 2015; 45:940-8. [PMID: 26248116 DOI: 10.1111/eci.12490] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 07/01/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND Vitamin D is known for its effect in calcium and bone homeostasis. There is an increasing evidence for health benefits accomplished by activated vitamin D that go beyond these classical functions. Previous studies have suggested that lower vitamin D levels are associated with increased cardiovascular disease risk. Therefore, we aimed to evaluate relationship between vitamin D levels and extent and severity of coronary artery disease. MATERIALS AND METHODS A total of 746 patients in whom coronary angiography was performed between August 2012 and July 2013 were enrolled in this study. Serum vitamin D levels were measured, and patients were grouped according to their serum vitamin D levels (vitamin D <20 ng/mL (n = 602) Group 1 versus >20 ng/dL (n = 144) Group 2). Gensini score system was used to evaluate the association between serum vitamin D levels and severity and extent of coronary artery disease. RESULTS There was no significant difference between the groups in terms of baseline characteristics and demographic characteristics. Mean serum vitamin D levels of all patient cohort was 15.54 ± 7.46 ng/mL. Group 1 and Group 2 had an average serum vitamin D levels of 12.6 ± 3.3 ng/mL and 27.5 ± 7.8 ng/mL, respectively. Gensini score for all cohort was 26.25 ± 34.32. Group 1 had an average Gensini score of 26.4 ± 35.7; on the other hand, Gensini score was 25.5 ± 27.5 in Group 2 (P = 0.097). CONCLUSIONS This study failed to demonstrate significant relationship between serum vitamin D levels and the severity and extent of coronary artery disease. Further studies with more participation and homogenous groups with comparable individual and environmental features are needed to evaluate the association of serum vitamin D levels and cardiovascular diseases.
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Affiliation(s)
- Yakup Alsancak
- Department of Cardiology, Ataturk Education and Research Hospital, Ankara, Türkiye
| | - Atiye Cengel
- Department of Cardiology, Gazi University Medical Faculty, Ankara, Türkiye
| | - Ahmet Akyel
- Department of Cardiology, Dıskapı Education and Research Hospital, Ankara, Türkiye
| | - Selcuk Ozkan
- Department of Cardiology, 29 Mayıs State Hospital, Ankara, Türkiye
| | - Burak Sezenoz
- Department of Cardiology, Gazi Mustafa Kemal State Hospital, Ankara, Türkiye
| | - Serkan Unlu
- Department of Cardiology, Gazi University Medical Faculty, Ankara, Türkiye
| | - Emrullah Kiziltunc
- Department of Cardiology, Numune Education and Research Hospital, Ankara, Türkiye
| | - Mehmet Kadri Akboga
- Department of Cardiology, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Aybuke Demir Alsancak
- Department of Family Medicine, Numune Education and Research Hospital, Ankara, Türkiye
| | - Sehri Elbeg
- Department of Biochemistry, Gazi University Medical Faculty, Ankara, Türkiye
| | - Asife Sahinarslan
- Department of Cardiology, Gazi University Medical Faculty, Ankara, Türkiye
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Clinical implications of vitamin D deficiency. MENOPAUSE REVIEW 2015; 14:75-81. [PMID: 26327893 PMCID: PMC4498026 DOI: 10.5114/pm.2015.52149] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 05/19/2015] [Accepted: 05/19/2015] [Indexed: 12/29/2022]
Abstract
Vitamin D deficiency is a common medical problem worldwide and its prevalence rises along with latitude, obesity, sedentary lifestyle, limited sunlight exposure and aging. A great body of evidence has shown that patients with vitamin D deficiency have increased cardiovascular risks and total mortality. Conversely, the presence of comorbidities progressive with age such as abdominal obesity, insulin resistance, type 2 diabetes and hypertension places the patients at an increased risk of vitamin D deficiency. The multidirectional effect of vitamin D deficiency is present in different phases of the aging process. Based on the literature review, the risk factors for vitamin D insufficiency most often found in post-menopausal women include limited sun exposure and time spent outdoors, inadequate dietary vitamin D intake, winter season and increased age. Vitamin D supplementation in this group might offer prevention of falls and fractures and may be beneficial for cardiovascular health, what may be especially important in osteoporotic and elderly populations. Prevention and treatment processes involve education regarding sunlight exposure and pharmacological cholecalciferol supplementation according to the recommendations for Central Europe. This manuscript reviews the role of vitamin D and its deficiency and considers their clinical implications, with particular regard to peri- and postmenopausal women.
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