Subclinical Vitamin C Plasma Levels Associated with Increased Risk of CAD Diagnosis via Inflammation: Results from the NHANES 2003–2006 Surveys

Abstract

Vitamin C remains an important, yet frequently unassessed, component of a healthy immune system though it may prove useful in alleviating the chronic inflammatory processes underlying chronic diseases such as coronary artery disease (CAD). Recent research identified a sizeable proportion of the United States population with insufficient vitamin C plasma levels and significant associations to both acute and chronic inflammation. This cross-sectional study used the 2003–2006 NHANES surveys data to extrapolate associations between plasma vitamin C levels (deficiency, hypovitaminosis, inadequate, adequate, and saturating) and CAD through inflammation (C-reactive protein and red cell distribution width). Increased reports of CAD diagnosis were identified in participants with vitamin C deficiency (OR: 2.31, CI: 1.49–3.58) and inadequate plasma levels (OR: 1.39, CI: 1.03–1.87). No significant correlation was identified between any other plasma vitamin C quintiles and CAD. When inflammation was controlled, previous associations in the deficient level of plasma vitamin C were no longer significant in association with CAD and participants with inadequate plasma vitamin C showed a reduced association to CAD diagnoses (OR: 0.33, CI: 0.13-0.86). Most chronic inflammation and vitamin C plasma statuses do not demonstrate specific signs or symptoms until the deficient level of vitamin C and/or disease. Thus, increased surveillance of both, and healthy nutritional habits remain crucial modifiable risk factors for disease prevention.

Nutrition in chronic inflammatory conditions: Bypassing the mucosal block for micronutrients

“…379 Low vitamin C levels are often reported in patients suffering from chronic inflammatory diseases such as asthma, 380 elderly people with a high risk of subclinical inflammation and with cardiovascular diseases. 88,381 Vitamin C supplementation improved health outcomes and inflammation markers in several cohorts, such as obese subjects 382 and acute ischemic shock patients 383 and septic shock patients. 384 Hence, vitamin C strongly impacts immune cells.…”

“…Low vitamin C levels are often reported in patients suffering from chronic inflammatory diseases such as asthma, 380 elderly people with a high risk of subclinical inflammation and with cardiovascular diseases 88,381 …”

Association between homocysteine and blood pressure in the NHANES 2003–2006: the mediating role of Vitamin C

“…Quantitation of peak area was subsequently determined using a standard curve derived from three distinct concentrations of an external standard (0.025, 0.150, and 0.500 mg/dL). The quality assurance and quality control protocols implemented by NHANES adhered to the mandates of the 1988 Clinical Laboratory Improvement Act (19).…”