Vitamin D and cardiovascular disease: From atherosclerosis to myocardial infarction and stroke

Muscogiuri, Giovanna; Annweiler, Cédric; Duval, Guillaume; Karras, Spyridon Ν.; Tirabassi, Giacomo; Salvio, Gianmaria; Balercia, Giancarlo; Kimball, Samantha; Kotsa, Kalliopi; Mascitelli, Luca; Bhattoa, Harjit Pal; Colao, Annamaria

doi:10.1016/j.ijcard.2016.12.053

Cited by 112 publications

(92 citation statements)

References 87 publications

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“…Vitamin D deficiency is associated with various conditions, including obesity, insulin resistance, diabetes, metabolic syndrome, hypertension, and hyperlipidemia 9,10,32. Significant relationships also exist between vitamin D-associated abnormalities and major cardiovascular events, such as heart failure, myocardial infarction, sudden cardiac death, stroke, atrial fibrillation, and peripheral vascular disease 17,33…”

Section: Discussionmentioning

confidence: 99%

Evaluation of vitamin D levels in relation to coronary CT angiographic findings in an Iranian population

Moradi¹,

Foroutanfar²

2017

VHRM

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BackgroundVitamin D deficiency, as a predisposing factor for coronary artery disease (CAD), is a subject of increasing interest. However, its role as a risk factor has not been proven. This study aimed to investigate the relationship between serum vitamin D levels and CAD.Materials and methodsUsing a cross-sectional design, 180 patients who were candidates for coronary computed tomography angiography (CCTA) were selected. Serum levels of vitamin D were measured and compared with the results of CCTA (including calcium score, and presence and severity of coronary artery involvement due to atherosclerotic plaques).ResultsThe mean age of the participants was 60.5±10.6 years and the mean serum vitamin D level was 26.2±15.9 ng/dL (range, 3.5–83.2 ng/dL). Overall, 6.1% of the participants (n=11) had vitamin D deficiency, 56.1% (n=101) had insufficient levels of vitamin D, and 37.8% (n=68) had sufficient levels of vitamin D. The mean serum vitamin D level was significantly lower in patients with severe CAD (P=0.004). The serum vitamin D level in the “positive for CAD” group was 20.98 ng/mL, significantly lower than the level in the “negative for CAD” group (30.47 ng/mL; P<0.001). The mean calcium score among participants was 533.5±87.9. Based on the Spearman test, a significant negative correlation (−0.21) was detected between the serum vitamin D level and coronary artery calcium score (CACS) (P=0.005). Conversely, the mean CACS in the vitamin D deficient group was significantly higher than in the insufficient and sufficient vitamin D groups (P<0.001 for both comparisons).ConclusionVitamin D deficiency was associated with coronary artery calcification and severity of coronary artery stenosis in Iranian patients.

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Section: Discussionmentioning

confidence: 99%

Evaluation of vitamin D levels in relation to coronary CT angiographic findings in an Iranian population

Moradi¹,

Foroutanfar²

2017

VHRM

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“…However, to our knowledge, no research has examined the effects of vitamin D on the BBB in MS. Vitamin D deficiency has been linked with increased cardiovascular risk due to endothelial dysfunction 37. Furthermore, vitamin D has been shown to play a direct role in controlling BBB permeability in a mouse model of ischaemic injury through a VDR-NF-κB-MMP-9-mediated pathway 38.…”

Section: Environmental Influencesmentioning

confidence: 99%

Vascular pathology in multiple sclerosis: reframing pathogenesis around the blood-brain barrier

Spencer

Bell

DeLuca

2017

J Neurol Neurosurg Psychiatry

119

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Blood-brain barrier (BBB) disruption has long been recognised as an important early feature of multiple sclerosis (MS) pathology. Traditionally, this has been seen as a by-product of the myelin-specific immune response. Here, we consider whether vascular changes instead play a central role in disease pathogenesis, rather than representing a secondary effect of neuroinflammation or neurodegeneration. Importantly, this is not necessarily mutually exclusive from current hypotheses. Vascular pathology in a genetically predisposed individual, influenced by environmental factors such as pathogens, hypovitaminosis D and smoking, may be a critical initiator of a series of events including hypoxia, protein deposition and immune cell egress that allows the development of a CNS-specific immune response and the classical pathological and clinical hallmarks of disease. We review the changes that occur in BBB function and cerebral perfusion in patients with MS and highlight genetic and environmental risk factors that, in addition to modulating immune function, may also converge to act on the vasculature. Further context is provided by contrasting these changes with other neurological diseases in which there is also BBB malfunction, and highlighting current disease-modifying therapies that may also have an effect on the BBB. Indeed, in reframing current evidence in this model, the vasculature could become an important therapeutic target in MS.

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“…Therefore, accumulating evidence suggests a highly complex role of vitamin D. It is noteworthy that vitamin D regulates several adipose tissue cytokines including leptin [123]. Recent evidence on the association between vitamin D deficiency and obesity clearly indicates that the functions of this vitamin are not limited to the maintenance of bone tissue and calcium metabolism [124], [125], [126], [127], [128].…”

Section: Characteristics Of Her2 Expressionmentioning

confidence: 99%

Tumor-linked HER2 expression: association with obesity and lipid-related microenvironment

Ray

2017

Hormone Molecular Biology and Clinical Investigation

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Abstract:Obesity is associated with the risk of several health disorders including certain cancers. Among obesity-related cancers, postmenopausal breast carcinoma is a well-studied one. Apart from an increase in certain types of lipids in obesity, excess adipose tissue releases many hormone-like cytokines/adipokines, which are usually pro-inflammatory in nature. Leptin is one of such adipokines and significantly linked with the intracellular signaling pathways of other growth factors such as insulin-like growth factor-1 (IGF-1), vascular endothelial growth factor (VEGF), human epidermal growth factor receptor 2 (HER2). In general, HER2 is overexpressed in roughly 30% of breast carcinomas; its presence indicates aggressive tumor behavior. Conversely, HER2 has certain effects in normal conditions such as differentiation of preadipocytes, cardiovascular health and vitamin D metabolism. HER2 has no known endogenous ligand, but it may form dimers with other three members of the epidermal growth factor receptor (EGFR) family and can activate downstream signaling pathways. Furthermore, HER2 is intimately connected with several enzymes, e.g. fatty acid synthase (FASN), phosphatidylinositol 3-kinase (PI3K), AKT and mechanistic target of rapamycin (mTOR), all of which play significant regulatory roles in lipogenic pathways or lipid metabolism. In obesity-related carcinogenesis, characteristics like insulin resistance and elevated IGF-1 are commonly observed. Both IGF-1 and leptin can modulate EGFR and HER2 signaling pathways. Although clinical studies have shown mixed results, the behavior of HER2+ tumor cells including HER2 levels can be altered by several factors such as obesity, leptin and fatty acids. A precise knowledge is useful in new therapeutic approaches against HER+ tumors.

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Vitamin D and cardiovascular disease: From atherosclerosis to myocardial infarction and stroke

Cited by 112 publications

References 87 publications

Evaluation of vitamin D levels in relation to coronary CT angiographic findings in an Iranian population

Evaluation of vitamin D levels in relation to coronary CT angiographic findings in an Iranian population

Vascular pathology in multiple sclerosis: reframing pathogenesis around the blood-brain barrier

Tumor-linked HER2 expression: association with obesity and lipid-related microenvironment

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