Relation of Vitamin D Deficiency to Cardiovascular Risk Factors, Disease Status, and Incident Events in a General Healthcare Population

Anderson, Jeffrey L.; May, Heidi T.; Horne, Benjamin D.; Bair, Tami L; Hall, Nathaniel; Carlquist, John F.; Lappé, Donald; Muhlestein, Joseph B.

doi:10.1016/j.amjcard.2010.05.027

Cited by 574 publications

(482 citation statements)

References 10 publications

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“…As hypertension represents a major factor responsible for the development of CHF 3 , we investigated patients with CHF secondary to hypertension in more detail. Data revealed that patients suffering from hypertension have significantly lower VD status, which is in line with previous findings by Anderson et al demonstrating that VD deficiency highly correlates with hypertension prevalence 22 . Interestingly, these CHF patients had drastically increased serum IL- NYHA class V D d e fi c i e n t V D I n s u fi c i e n t…”

Section: Milovanovic Et Al Vitamin D Il-17 and Tnfα In Chronic Heartsupporting

confidence: 82%

A Deficiência de vitamina d está associada com níveis aumentados de il-17 e tnfα em pacientes com insuficiência cardíaca crônica

Milovanović¹,

Pesic²,

Nikolić³

et al. 2012

Arq. Bras. Cardiol.

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Section: Milovanovic Et Al Vitamin D Il-17 and Tnfα In Chronic Heartsupporting

confidence: 82%

A Deficiência de vitamina d está associada com níveis aumentados de il-17 e tnfα em pacientes com insuficiência cardíaca crônica

Milovanović¹,

Pesic²,

Nikolić³

et al. 2012

Arq. Bras. Cardiol.

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“…The same group found free 25(OH)D concentrations to be better correlated with bone mineral density than the total 25(OH)D concentrations in young adults (10) . Prospective cohort studies have provided evidence that indicates that low concentrations of total 25(OH)D are associated with an increased risk of CVD (11,12) . The discovery that 1α-hydroxylase is expressed in extra-renal tissues, including the vascular endothelium (13)(14)(15)(16) may help provide a mechanistic basis for an effect of vitamin D status on the processes associated with the development of CVD.…”

Section: Al Found That Black Americans Had Lower Total 25(oh)d Concementioning

confidence: 99%

Vitamin D and risk of CVD: a review of the evidence

Fry

Sanders

2015

Proc. Nutr. Soc.

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This review summarises evidence for an association between vitamin D status and CVD and the mechanisms involved. Vitamin D 3 is predominantly provided by the action of UVB from sunlight on skin. Average UK diets supply 2-3 μg/d vitamin D but diets containing at least one portion of oily fish per week supply about 7 μg/d. Pharmacological doses of vitamin D 2 (bolus injection of 7500 μg or intakes >50 μg/d) result in a smaller increase in plasma 25 (OH)D than those of D 3 but physiological doses 5-25 μg/d seem equivalent. Plasma 25 (OH)D concentrations are also influenced by clothing, obesity and skin pigmentation. Up to 40 % of the population have plasma 25(OH)D concentrations <25 nmol/l in the winter compared with <10 % in the summer. The relative risk of CVD death is 1·41 (95 % CI 1·18, 1·68) greater in the lowest quintile of plasma 25(OH)D according to meta-analysis of prospective cohort studies. Acute deficiency may inhibit insulin secretion and promote inflammation thus increasing the risk of plaque rupture and arterial thrombosis. Chronic insufficiency may increase arterial stiffness. There is no evidence to support claims of reduced CVD from existing trials with bone-related health outcomes where vitamin D was usually co-administered with calcium. Although several trials with cardiovascular endpoints are in progress, these are using pharmacological doses. In view of the potential toxicity of pharmacological doses, there remains a need for long-term trials of physiological doses of D 2 and D 3 with CVD incidence as the primary outcome. Ergocalciferol: Cholecalciferol: Cardiovascular riskVitamin D deficiency causes rickets in children and osteomalacia in adults and may contribute to the causation of CVD. Cholecalciferol (vitamin D 3 ) is made by the action of UVB light on the skin but is also provided in the diet from foods of animal origin (eggs, oily fish and meat). Ergocalciferol (vitamin D 2 ) is present in fungi that have been exposed to UVB irradiation. Both forms of vitamin D undergo 25-hydroxylation in the liver to form 25(OH) metabolites, most of which circulate in plasma bound to the vitamin D binding protein (VDBP). In the kidney, 25 hydroxyvitamin D (25(OH)D) is converted to the biologically active metabolite 1,25 dihydroxyvitamin D (1,25 (OH) 2 D) by the action of 1α-hydroxylase (Fig. 1). This then binds to the vitamin D receptor, which is a highaffinity nuclear hormone receptor that regulates gene expression (1) . Measurement of serum 25(OH)D to assess vitamin D status has predominantly used immunoassays, which show lower sensitivity (about 30 %) to D 2 metabolites than gold-standard methods such as HPLC/tandem MS. Formerly, a lack of standardisation of methods and appropriate quality control made comparisons between studies difficult (2) . The situation has been remedied by the availability (3) of standard reference serum (SRM 972, National Institute of Standards and Technology) and a quality control programme in the UK organised by the Vitamin D External Quality Assessment Scheme (4) . It has...

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“…of type 2 diabetes mellitus, hypertension, hyperlipidemia, and peripheral vascular disease, coronary artery disease, myocardial infarction, heart failure, and stroke. 17 Similar but weaker associations have been found in longitudinal study, whereas no evidence for such association has been discovered by trials. 29 Many of these associations are well established; causation, however, is yet to be proven.…”

Section: Potential Role Of Vitamin D In Older Peoplementioning

confidence: 51%

“…28 An important prospective study with a large sample of patients revealed that 25(OH)D <15 ng/mL compared to 25(OH)D >30 ng/mL was associated with highly significant increases in the prevalence Bone Conflicting data about vitamin D supplementation effects on bone fracture risk [11][12][13][14] Vitamin D supplementation has little effect on BMD 15,16 Cardiometabolic Low vitamin D is associated with hypertension, hyperlipidemia, peripheral vascular disease, coronary artery disease, heart failure, and stroke 17 Vitamin D supplementation reduces the incidence of diabetes 18 Central nervous system Hypovitaminosis D is predictor for dementia 19 No significant associations between lower levels of 25(OH)D and lower cognitive test scores…”

Section: Cardiovascular Effectsmentioning

confidence: 99%

“…It is known that vitamin D has a wide range of biological actions (Table 2), [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] and that vitamin D receptor is present in most tissues and cells in the body. 26 As a result, it is not unexpected that multiple studies 27 have associated vitamin D deficiency with cardiovascular diseases, type 2 diabetes, hypertension, many types of cancer, rheumatoid arthritis, Crohn's disease, multiple sclerosis, asthma, and infectious diseases.…”

Section: Vitamin D and Extraskeletal Diseasesmentioning

confidence: 99%

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Potential role of vitamin D in prevention of skeletal and extraskeletal diseases in older people

Montagnani

Nardi²,

Cercignani

et al. 2015

Ital J Med

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Vitamin D and calcium are essential for bone health. An adequate calcium-phosphorus product determines a high quality mineralization long lifetime. In older people, both calcium and vitamin D levels may be lower causing osteomalacia and/or osteoporosis with a higher risk of fracture. Epidemiological data have clearly associated serum vitamin D lower levels (deficiency) with bone fracture in older people, however, not univocal data exist in regard to a beneficial effect of vitamin D supplementation in general population. Although not systematic, the present review aims to make a narrative synthesis of the most recent published data on vitamin D effect not only on bone, classical target associated with vitamin D studies, but namely on extraskeletal diseases. In fact, recently, there has been an increasing interest on this latter issue with surprising findings. Vitamin D, and in particular its deficiency, seems to have a role in pathophysiological pathways in several diseases involving cardiovascular, central nervous system and neoplastic process. On the other hand, vitamin D supplementation may modify the outcome of a wide range of illnesses. Up to date the data are conflicting mainly because of difficulty to establish a consensus on the threshold of vitamin D deficit. The US Institute of Medicine recommends to distinguish a level of insufficiency [defined as 30-50 nmol/L or 16-25 ng/mL of 25(OH)D] and another of deficiency identified by 25(OH)D levels lower than 30 nmol/L (or <16 ng/mL). This latter level is considered a minimum level necessary in older adults to minimize the risk of falls, fracture and probably to have some effects of vitamin D supplementation in extraskeletal diseases. Although there are no absolute certainties in such issue, the most recent data suggest that vitamin D deficiency, and its supplementation, may play an important role in a wide range of diseases other than in bone metabolic diseases in older but not in general population. For such reason a widespread measurement of vitamin D levels in general population, and not only in older, seems to be inappropriate and it could induce an overuse of vitamin D supplementation in situations in which its efficacy and cost-effectiveness have not been proven.

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Relation of Vitamin D Deficiency to Cardiovascular Risk Factors, Disease Status, and Incident Events in a General Healthcare Population

Cited by 574 publications

References 10 publications

A Deficiência de vitamina d está associada com níveis aumentados de il-17 e tnfα em pacientes com insuficiência cardíaca crônica

A Deficiência de vitamina d está associada com níveis aumentados de il-17 e tnfα em pacientes com insuficiência cardíaca crônica

Vitamin D and risk of CVD: a review of the evidence

Potential role of vitamin D in prevention of skeletal and extraskeletal diseases in older people

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