Improved HDL Cholesterol through Vitamin D Status Correction Substantially Lowers 10-Year Atherosclerotic Cardiovascular Disease Risk Score in Vitamin D-Deficient Arab Adults

Abstract

This interventional study aimed to determine whether correcting vitamin D status in deficient Arab adults [25(OH)D <50 nmol/L] improves their 10-year risk of Atherosclerotic Cardiovascular Disease (ASCVD) risk scores. Saudi adults (58 males 62 females) with baseline vitamin D deficiency (<50 nmol/L) were given 50,000 IU cholecalciferol weekly for 2 months, then twice a month, followed by daily 1000 IU until month 6. Fasting blood samples were collected pre- and post-intervention and assessed for glucose, lipids, and 25(OH)D levels. The predicted 10-year ASCVD risk scores were calculated at baseline and after intervention. At baseline, significantly higher 10-year ASCDV risk scores were observed in males than females (9% vs. 3%, p < 0.001). After 6 months, only 21% (25 out of 120) achieved 25(OH)D levels above optimal level (≥75 nmol/L). While modest improvements were seen in glucose and lipid profiles, only HDL cholesterol showed favorable significant changes in all participants, which translated to significantly improved 10-year ASCVD risk scores independent of whether they achieved optimum vitamin D status. Still, those who achieved optimal vitamin D levels had a modestly larger decrease in ASCVD risk scores than those with less optimal 25(OH)D levels (−23% versus −18%) and this improvement was slightly more pronounced in males (−26% versus −10%, or 16% improvement) than females (−47% versus −32%, or 15% improvement). In conclusion, vitamin D status correction significantly enhances HDL cholesterol which prospectively reduces 10-year ASCVD risk as vitamin D levels approach optimum status among adult Arabs with baseline vitamin D deficiency. This improvement appears to be slightly more apparent in males than females.

Impact of Vitamin D Status Correction on Serum Lipid Profile, Carboxypeptidase N and Nitric Oxide Levels in Saudi Adults

“…VD supplementation is considered one of the most effective ways to improve the lipid profile. One prospective study found that VD supplementation over 12 months increased HDL cholesterol levels among adults, consequently reducing the atherosclerotic cardiovascular disease risk score [45]. Furthermore, a consistently positive correlation between VD status and HDL-C is in accordance with several observational studies conducted with children [46].…”

“…This finding supports many hypotheses that VD will increase or regulate good cholesterol, especially in males, who are at higher risk for CVD and heart disease. We have previously observed that VD status correction among VD deficient Saudi adults corresponds to a substantial reduction in atherosclerotic cardiovascular disease [45] since they do not have a high level of estrogen, as women do. Higher levels of estrogen in premenopausal women have been found to increase levels of HDL; thus, women are much less susceptible to coronary heart disease (CHD) and other atherosclerotic diseases compared to men [46,47].…”

“…Sample size calculation was carried out based on data obtained from previous findings ascertaining the effects of 25(OH)D correction [45,55]. G*Power was used to determine sample size given the effect size of 0.27 and the power of 0.85.…”

Vitamin D and Dyslipidemia: Is There Really a Link? A Narrative Review

“…In a very recent interventional study, the correction of vitamin D deficiency in Arab adults seemed to improve their 10-year risk of atherosclerotic cardiovascular disease (ASCVD). This result is very interesting; once optimal vitamin D levels were achieved, there was a modest improvement in glucose and HDL-C levels, resulting in a decrease in ASCVD risk scores [ 112 ]. However, a study by Schwetz et al demonstrated that vitamin D supplementation significantly increased TC, TGs, VLDL-C, LDL-C, HDL-C, ApoB, and ApoB, indicating a negative effect on lipid profile [ 113 ].…”

Evidence That Increasing Serum 25(OH)D Concentrations to 30 ng/mL in the Kingdom of Saudi Arabia and the United Arab Emirates Could Greatly Improve Health Outcomes

“…A recent vitamin D supplementation trial conducted in KSA involving 120 participants of whom 32 had 25(OH)D concentrations <10 ng/mL and 88 had 25(OH)Ds between 10 and 20 ng/mL [ 82 ]. Those in the treatment arm were given 50,000 IU/week vitamin D 3 for two months, then twice a month, followed by daily 1000 IU until month 6, while those in the control arm were given a placebo.…”