The effects of vitamin D repletion on endothelial function and inflammation in patients with coronary artery disease

Abstract

Adequate vitamin D levels may promote cardiovascular health by improving endothelial function and down-regulating inflammation. The objective of this pilot trial was to investigate the effects of vitamin D repletion on endothelial function and inflammation in patients with coronary artery disease (CAD). Using a double-blind placebo wait-list control design, 90 subjects with CAD and vitamin D deficiency (< 20 ng/ml) were randomized 1:1 to 50,000 IU of oral ergocalciferol or placebo weekly for 12 weeks. Endothelial function (reactive hyperemia peripheral arterial tonometry, RH-PAT), circulating adhesion molecules, and pro-inflammatory cytokines were measured at baseline and 12 weeks. The median increase in serum 25-vitamin D from baseline was 26 ± 17 ng/ml in the active group and 4 ± 8 ng/ml in the placebo group (between-group difference = 22 ng/ml, p < 0.001). The median within-subject change in RH-PAT score was 0.13 ± 0.73 with active treatment and −0.04 ± 0.63 with placebo (between-group difference = 0.17, p = 0.44). Within-group and between-group differences in intercellular adhesion molecule levels were greater with placebo (between-group difference = 6 ng/ml, p = 0.048). Vascular cell adhesion molecule levels decreased in both groups by a similar magnitude (median difference between groups = 8.5 ng/ml, p = 0.79). There was no difference between groups in magnitude of reduction in interleukin (IL)-12 (−8.6 ng/ml, p = 0.72) and interferon-gamma (0.52 ng/ml, p = 0.88). No significant differences in blood pressure, e-selectin, high-sensitivity c-reactive protein, IL-6 or the chemokine CXCL-10 were found with treatment. In conclusion, repleting vitamin D levels in subjects with CAD failed to demonstrate any benefits on surrogate markers of cardiovascular health. These results question the role of vitamin D supplementation in modifying cardiovascular disease. ClinicalTrials.gov Identifier: NCT01570309.

Effectiveness of Vitamin D Supplementation for Cardiovascular Health Outcomes

“…In terms of brachial FMD, improvements were reported among African Americans [87] and patients with T2DM [56], whilst brachial FMD was improved after 8 weeks in stroke patients, but this did not persist at 16 weeks [69]. No improvements in brachial FMD were observed among patients with coronary artery disease [88], patients with T2DM [57,65], HIV-infected individuals [89] and postmenopausal women [61,90]. Lastly, VitD was found to have no effect on the reactive hyphaemia index in patients with T2DM or after MI [63,73].…”

Impact of vitamin D supplementation on endothelial and inflammatory markers in adults: A systematic review

“…Seven studies recruited participants in this category [21][22][23][24][25][26][27] of which two reported significant improvement in FMD and CRP respectively. In one study, FMD was significantly better in the vitamin D group at 8 weeks compared to the placebo group (mean ± SD) 6.9 ± 3.5 % vs 3.7 ± 3.1 %, P = 0.007), but not at 16 weeks [23].…”

Impact of vitamin D supplementation on C-reactive protein; a systematic review and meta-analysis of randomized controlled trials

“…Twoenty one studies used cholecalciferol in a dosage range from 0 IU/d [28] to 200,000 IU/d [29]. In two of the studies, particciopants were summplemned with ergocalciferol at a dose of 50,000 IU at baseline for 26 [30] or 12 [31] weeks. In three studies, calcium supplements had also been administered in doses of 200 [32], 1000 [33], 1200 [34] mg/d, respectively.…”