Association Between 25-Hydroxyvitamin D Levels and the Carotid Intima-Media Thickness

Document Type: Original Article

Authors

1 Echocardiography Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

2 Cardiac Primary Prevention Research Center, Department of Cardiology, School of Medical Sciences, Tehran, IR Iran.

3 Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

4 Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran.

5 Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran.

Abstract

Background: There are insufficient data on the association between the serum level of vitamin D and the carotid intima-media thickness (CIMT). The aim of this study was to investigate the association between the level of serum 25-hydroxyvitamin D and the CIMT. Methods: This cross-sectional study recruited 341 patients. The level of 25-hydroxyvitamin D was measured with radioimmunoassay, and the CIMT was measured with color Doppler ultrasound. Results: The mean serum level of 25-hydroxyvitamin D was 14.88±14.63 ng/mL in the patients with asignificant carotid artery involvement and 17.02±13.56 ng/mL in those without a carotid involvement, with the difference between the 2 groups constituting statistical significance (P=0.034). The prevalence rate of vitamin D deficiency in those with and without a carotid involvement was 88.6% and 74.4%; the rate was significantly higher in the former group (P=0.039). Conclusions: Our study confirmed recent suggestions regarding the association between vitamin D deficiency and the progress of atherosclerosis in carotid arteries as CIMT.

Keywords


1.          Martins D, Wolf M, Pan D, Zadshir A, Tareen N, Thadhani R, et al. Prevalence of cardiovascular riskfactors and the serum levels of 25-hydroxyvitamin D in the United States: data the Third NationalHealth and Nutrition Examination Survey. Arch Intern Med. 2007;167: 1159–1165.

2.          Lim S, Kim MJ, Choi SH, Shin CS, Park KS, Jang HC, et al. Association of vitamin D deficiency with incidenceof type 2 diabetes in high-risk Asian subjects. Am J Clin Nutr. 2013;97: 524–doi: 10.3945/ajcn.112.048496 PMID: 23364011.

3.          O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK., Jr Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med. 1999;340:14–22.

4.          Rundek T, Arif H, Boden-Albala B, Elkind MS, Paik MC, Sacco RL. Carotid plaque, a subclinical precursor of vascular events: the Northern Manhattan Study. Neurology. 2008;70:1200–1207.  

5.          Kienrich K, Tomaschitz A, Verheyen N, et al. Vitamin D and cardiovascular disease. Nutrients 2013;5:3005–21.

6.        Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, Benjamin EJ, D’Agostino RB,  Wolf  M,  Vasan  RS.  Vitamin  D  Deficiency  and  Risk  of  Cardiovascular  Disease. Circulation. 2008;117:503–511.

7.        Dobnig H, Pilz S, Scharnagl H, Renner W, Seelhorst U, Wellnitz B, Kinkeldei J, Boehm BO, Weihrauch G, Maerz W. Independent Association of Low Serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels with All-Cause and Cardiovascular Mortality.  Arch Intern Med. 2008;168:1340–1349.

8.          Anagnostis, P. Athyros, V. G. Adamidou, F. Florentin, M. Karagiannis, A. Vitamin D and cardiovascular disease: a novel agent for reducing cardiovascular risk?. Curr Vasc Pharmacol. 2010 Sep; 8 (5): 720-30.

9.          Zittermann A, Schleithoff SS, Koerfer R. Vitamin D and vascular calcification. Curr Opin Lipidol. 2007 Feb;18(1):41–6.

10.      Wang  TJ,  Pencina  MJ,  Booth  SL,  Jacques  PF,  Ingelsson  E,  Lanier  K,  Benjamin  EJ, D'Agostino RB, Wolf M, Vasan RS. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008 Jan 29;117(4):503–11.

11.      D. Somjen, Y. Weisman, F. Kohen et al., “25-Hydroxyvitamin D3-1alpha-hydroxylase is expressed in human vascular smooth muscle cells and is upregulated by parathyroid hormone and estrogenic compounds,” Circulation, vol. 111, no. 13, pp. 1666–1671, 2005.

12.      J. H. Lee, R. Gadi, J. A. Spertus, F. Tang, and J. H. O'Keefe, “Prevalence of vitamin D deficiency in patients with acute myocardial infarction,” The American Journal of Cardiology, vol. 107, no. 11, pp. 1636–1638, 2011.

13.      A Kablak-Ziembicka, W Tracz, T Przewlocki, T Przewlocki, P Pieniazek, A Sokolowski, and M Konieczynska   Association of increased carotid intima-media thicknesswith the extent of coronary artery disease Heart. 2004 Nov; 90(11): 1286–1290.

14.      Targher G, Bertolini  L, Padovani R,  Zenari L, Scala  L,  Cigolini  M, et al. Serum  25-hydroxyvitamin D3 concentrations and carotid artery intima-media thickness among type 2 diabetic patients. Clin Endocrinol (Oxf). 2006;65:593-7.

15.      Carrelli AL, Walker MD, Lowe H, McMahon DJ, Rundek T, Sacco RL, et al. Vitamin D deficiency is associated with subclinical carotid atherosclerosis: the Northern Manhattan study. Stroke. 2011;42:2240-5.

16.      Ganesh SK, Stack AG, Levin NW, Hulbert-Shearon T, Port FK. Association of elevated serum PO4, CaxPO4 product, and parathyroid hormone  with  cardiac  mortality risk  in  chronic hemodialysis patients. J Am Soc Nephrol. 2001;12:2131–2138.

17.      Rasouli M, Kiasari AM. Serum calcium and phosphorus associate with the occurrence and severity of angiographically documented coronary heart disease, possibly through correlation with atherogenic (apo)lipoproteins. Clin Chem Lab Med. 2006;44:43–50.

18.      Grimes DS, Hindle E, Dyer T. Sunlight, cholesterol and coronary heart disease. QJM. 1996 Aug;89(8):579–89.

19.      Sugden JA, Davies JI, Witham MD, Morris AD, Struthers AD. Vitamin D improves endothelial function in patients with Type 2 diabetes mellitus and low vitamin D levels. Diabet Med. 2008 Mar;25(3):320–5.