Circulating Vitamin D, Supplement Use, and Cardiovascular Disease Risk: The MrOS Sleep Study

Context: Evidence suggests an inverse association between circulating 25(OH) vitamin D and cardiovascular disease (CVD). Objective: To determine the association between serum 25(OH) vitamin D and risk for CVD events. Setting and Design: From March 2000 to April 2002, participants were recruited for the Osteoporotic Fractures in Men (MrOS) study. Between December 2003 and March 2005, members of the MrOS cohort were invited to participate in the MrOS Sleep Study. Participants were recruited from 6 clinical centers across the United States and followed for a mean of 5.9 years. Three-thousand-one-hundred-thirty-five men ages 65 and older were included from the MrOS cohort, of whom 116 were excluded for missing vitamin D or CVD data. Participants were divided into two groups based on serum 25(OH) vitamin D levels, <20 ng/mL and ≥20 ng/mL. Participants were followed for CVD endpoints including coronary heart disease (CHD) and cerebrovascular events. Age- and multivariable-adjusted hazard ratios were calculated and stratified by use of vitamin D containing supplements. Results: We observed no significant association between circulating 25(OH) vitamin D and risk of CVD event (HR, 0.91; 95% confidence interval (CI), 0.73–1.13) and CHD event (HR, 0.81; 95% CI, 0.61–1.07). For cerebrovascular events, men with vitamin D deficiency exhibited a higher risk (HR, 1.44; 95% CI, 1.00–2.08) using the minimally adjusted model and after excluding supplement users (HR, 1.70; 95% CI, 1.02–2.83). Conclusions: 25(OH) vitamin D was not associated with risk of CVD and CHD events. However, vitamin D deficiency may be associated with an increased risk of cerebrovascular events.

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Factors Associated with Vitamin D Deficiency and Inadequacy among Women of Childbearing Age in the United States

ISRN Obstetrics and Gynecology ◽

10.5402/2012/691486 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 16

Author(s):

Guixiang Zhao ◽

Earl S. Ford ◽

James Tsai ◽

Chaoyang Li ◽

Janet B. Croft

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

The United States ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Hydroxyvitamin D ◽

Supplement Use ◽

Increased Risk ◽

25 Hydroxyvitamin D ◽

Dietary Supplement Use

Objective. To examine the prevalence and correlates of vitamin D deficiency and inadequacy among US women of childbearing age. Methods. Data from 1,814 female participants (20–44 y) in the 2003–2006 NHANES were analyzed to estimate the age-adjusted prevalence and prevalence ratios with 95% confidence intervals (CIs) for vitamin D deficiency (defined as serum 25-hydroxyvitamin D [25(OH)D] <12.0 ng/mL) and inadequacy (defined as 25(OH)D: 12.0–<20.0 ng/mL). Results. The age-adjusted prevalence was 11.1% (95% CI: 8.8–14.0%) for vitamin D deficiency and 25.7% (95% CI: 22.3–29.5%) for vitamin D inadequacy. Race/ethnicity other than non-Hispanic white and obesity were associated with increased risks, whereas dietary supplement use, milk consumption of ≥1 time/day, and potential sunlight exposure during May-October were associated with decreased risks for both vitamin D deficiency and inadequacy (). Current smoking and having histories of diabetes and cardiovascular disease were also associated with an increased risk for vitamin D deficiency (). Conclusions. Among women of childbearing age, periconceptional intervention programs may focus on multiple risk factors for vitamin D deficiency and inadequacy to ultimately improve their vitamin D nutrition.

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Vitamin D and Cardiovascular Disease: An Updated Narrative Review

International Journal of Molecular Sciences ◽

10.3390/ijms22062896 ◽

2021 ◽

Vol 22 (6) ◽

pp. 2896

Author(s):

Armin Zittermann ◽

Christian Trummer ◽

Verena Theiler-Schwetz ◽

Elisabeth Lerchbaum ◽

Winfried März ◽

...

Keyword(s):

Cardiovascular Disease ◽

Vitamin D ◽

High Risk ◽

General Population ◽

Vitamin D Deficiency ◽

Specific Gene ◽

Vitamin D Status ◽

Cvd Risk ◽

Severe Vitamin ◽

Increased Risk

During the last two decades, the potential impact of vitamin D on the risk of cardiovascular disease (CVD) has been rigorously studied. Data regarding the effect of vitamin D on CVD risk are puzzling: observational data indicate an inverse nonlinear association between vitamin D status and CVD events, with the highest CVD risk at severe vitamin D deficiency; however, preclinical data and randomized controlled trials (RCTs) show several beneficial effects of vitamin D on the surrogate parameters of vascular and cardiac function. By contrast, Mendelian randomization studies and large RCTs in the general population and in patients with chronic kidney disease, a high-risk group for CVD events, largely report no significant beneficial effect of vitamin D treatment on CVD events. In patients with rickets and osteomalacia, cardiovascular complications are infrequently reported, except for an increased risk of heart failure. In conclusion, there is no strong evidence for beneficial vitamin D effects on CVD risk, either in the general population or in high-risk groups. Whether some subgroups such as individuals with severe vitamin D deficiency or a combination of low vitamin D status with specific gene variants and/or certain nutrition/lifestyle factors would benefit from vitamin D (metabolite) administration, remains to be studied.

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Abstract T P146: Vitamin D Deficiency is Associated With Stroke in Black and White Participants of the REGARDS Study

Stroke ◽

10.1161/str.45.suppl_1.tp146 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Suzanne E Judd ◽

Virginia J Howard ◽

Paul Muntner ◽

Brett M Kissela ◽

Bhupesh Panwar ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Racial Differences ◽

Sex Education ◽

The United States ◽

Dietary Vitamin ◽

Equal Distribution ◽

Black And White ◽

Increased Risk ◽

Regards Study

Objective: Black Americans are at greater risk of both stroke and vitamin D deficiency than white Americans. We have previously shown that both higher dietary vitamin D and sunlight exposure are associated with decreased risk of stroke; however, serum 25(OH) is thought to be a better marker of vitamin D status. Methods: Using a case cohort design, we examined the association of plasma 25(OH)D with incident stroke in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a cohort of black and white participants from across the United States enrolled between 2003 and 2007. Medical records were reviewed by physicians and strokes were classified on the basis of symptoms and neuroimaging. Strokes through July 1, 2011 were included. A stratified cohort sample was selected to ensure approximately equal numbers of black and white participants and an equal distribution across ages. We used Cox proportional hazards models weighted back to the original 30,239 participants, excluding those with history of stroke. Serum 25(OH)D was measured by Immunodetection Systems ELISA. Results: Over mean follow-up of 4.4 years, there were 539 ischemic and 71 hemorrhagic strokes. The stroke-free sub-cohort included 939 participants. After adjustment for age, race, sex, education, diabetes, hypertension, smoking, atrial fibrillation, heart disease, physical activity, kidney function, calcium and phosphorous, 25(OH)D level 30 ng/mL. The direction of association was similar for hemorrhagic stroke though not statistically significant (HR=1.59; 95%CI=0.78, 3.24). Vitamin D deficiency was associated with an increased risk of all stroke (HR=1.54; 95%CI=1.05, 2.23). This effect was greater in blacks (HR=2.09; 95%CI=1.09, 3.99) than whites (HR=1.38; 95%CI=0.78, 2.42). Results were not as strong when we modeled 25(OH)D as a continuous variable (HR=0.99 per 1 ng/ml change in 25(OH)D; 95%CI=0.98, 1.01). Discussion: Similar to low vitamin D intake, vitamin D deficiency is a risk factor for incident stroke. These findings support evidence from cardiovascular and cancer epidemiology that treating low 25(OH)D may prevent strokes.

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Timing of use of cod liver oil, a vitamin D source, and multiple sclerosis risk: The EnvIMS study

Multiple Sclerosis Journal ◽

10.1177/1352458515578770 ◽

2015 ◽

Vol 21 (14) ◽

pp. 1856-1864 ◽

Cited By ~ 28

Author(s):

Marianna Cortese ◽

Trond Riise ◽

Kjetil Bjørnevik ◽

Trygve Holmøy ◽

Margitta T Kampman ◽

...

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Inverse Association ◽

Cod Liver Oil ◽

Dose Response Relationship ◽

Supplement Use ◽

Multiple Sclerosis Risk ◽

Increased Risk ◽

Vitamin D Levels ◽

Control Study

Background: Low vitamin D levels have been associated with an increased risk of multiple sclerosis (MS), although it remains unknown whether this relationship varies by age. Objective: The objective of this paper is to investigate the association between vitamin D3 supplementation through cod liver oil at different postnatal ages and MS risk. Methods: In the Norwegian component of the multinational case-control study Environmental Factors In Multiple Sclerosis (EnvIMS), a total of 953 MS patients with maximum disease duration of 10 years and 1717 controls reported their cod liver oil use from childhood to adulthood. Results: Self-reported supplement use at ages 13–18 was associated with a reduced risk of MS (OR 0.67, 95% CI 0.52–0.86), whereas supplementation during childhood was not found to alter MS risk (OR 1.01, 95% CI 0.81–1.26), each compared to non-use during the respective period. An inverse association was found between MS risk and the dose of cod liver oil during adolescence, suggesting a dose-response relationship ( p trend = 0.001) with the strongest effect for an estimated vitamin D3 intake of 600–800 IU/d (OR 0.46, 95% CI 0.31–0.70). Conclusions: These findings not only support the hypothesis relating to low vitamin D as a risk factor for MS, but further point to adolescence as an important susceptibility period for adult-onset MS.

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Elevated Parathyroid Hormone, But Not Vitamin D Deficiency, Is Associated With Increased Risk of Heart Failure in Older Men With and Without Cardiovascular Disease

Circulation Heart Failure ◽

10.1161/circheartfailure.114.001272 ◽

2014 ◽

Vol 7 (5) ◽

pp. 732-739 ◽

Cited By ~ 42

Author(s):

S. Goya Wannamethee ◽

Paul Welsh ◽

Olia Papacosta ◽

Lucy Lennon ◽

Peter H. Whincup ◽

...

Keyword(s):

Heart Failure ◽

Cardiovascular Disease ◽

Vitamin D ◽

Parathyroid Hormone ◽

Vitamin D Deficiency ◽

Older Men ◽

Increased Risk

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The Impact of Obesity on the Association between Vitamin D Deficiency and Cardiovascular Disease

Nutrients ◽

10.3390/nu11102458 ◽

2019 ◽

Vol 11 (10) ◽

pp. 2458 ◽

Cited By ~ 4

Author(s):

Paschou ◽

Kosmopoulos ◽

Nikas ◽

Spartalis ◽

Kassi ◽

...

Keyword(s):

Cardiovascular Disease ◽

Vitamin D ◽

General Population ◽

Vitamin D Deficiency ◽

Strong Association ◽

Vitamin D Supplementation ◽

Obese Adults ◽

Increased Risk ◽

High Prevalence ◽

The Impact

The aim of this article is to review the literature regarding the relationship between vitamin D deficiency and cardiovascular disease (CVD) and its modification in the presence of obesity. Despite the strong association between vitamin D status and cardiovascular outcomes, vitamin D supplementation trials in the general population have failed to decrease the incidence of cardiovascular events and mortality. A comprehensive study of the published literature and a comparison with experimental data lead to the conclusion that obesity, due to its high prevalence and strong association with both vitamin D deficiency and CVD, may act as a critical confounder, which is responsible for the different results on this association. Adoption of a vitamin D preventive supplementation strategy for CVD is unlikely to yield any benefit to the general population. However, it might be particularly useful in obese adults with increased risk for CVD.

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Insights into the Association of Vitamin D Deficiency with Parathyroid Hormone Levels with Relevance to Renal Function and Insulin Resistance

Current Nutrition & Food Science ◽

10.2174/1573401313666170920145038 ◽

2019 ◽

Vol 15 (2) ◽

pp. 196-200 ◽

Cited By ~ 1

Author(s):

Iyyapu K. Mohan ◽

Siraj A. Khan ◽

Rachel Jacob ◽

Kompella S.S.S. Baba ◽

Tajamul Hussain ◽

...

Keyword(s):

Insulin Resistance ◽

Vitamin D ◽

Renal Function ◽

Parathyroid Hormone ◽

Serum Creatinine ◽

Vitamin D Deficiency ◽

Plasma Vitamin ◽

Inverse Association ◽

Hormone Levels ◽

Increased Risk

Background: In majority of the studies inverse association between vitamin D and parathyroid hormone levels is documented. Objective: The rationale of the current study was to investigate whether this inverse association is agedependent and whether it has any role in modulating renal function and insulin resistance. Methods: To test this hypothesis, we have carried out a hospital based study enrolling 848 subjects (558 men and 290 women) with the mean age of 50.9 ± 15.9 y. Chemiluminometric competitive immune assays were performed using commercial kits to determine 25-OH vitamin D and Parathyroid Hormone (PTH) levels. Fasting glucose levels and serum creatinine were used to evaluate diabetes and renal function. Results: Vitamin D deficiency was predominant irrespective of age group (p = 0.21) and gender (p = 0.12). An inverse association between vitamin D and PTH was observed (r = -0.24) in middle age subjects (p = 0.02). The data segregation based on plasma vitamin D levels which were <20 ng/ml, 20.1- 30 ng/ml and >30 ng/ml confirmed the inverse association between vitamin D and PTH levels (ptrend: 0.007). Subjects with low plasma vitamin D and increased PTH exhibited elevated blood urea, serum creatinine and blood glucose. Subjects with 25-OHD deficiency showed a 3.03-folds (95% CI: 2.26- 4.07) and 2.09-fold (1.41-3.10) increased risk for diabetes and renal disease, respectively. Conclusion: Based on the results of the present study, it is suggested that those with vitamin D deficiency need to be evaluated for possible presence of renal dysfunction, diabetes/insulin resistance in addition to assessing their PTH status.

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Monocyte-to-HDL Ratio (MHR) Predicts Vitamin D Deficiency in Healthy and Metabolic Women: A Cross-Sectional Study in 1048 Subjects

Nutrients ◽

10.3390/nu14020347 ◽

2022 ◽

Vol 14 (2) ◽

pp. 347

Author(s):

Carlo De Matteis ◽

Lucilla Crudele ◽

Marica Cariello ◽

Stefano Battaglia ◽

Giuseppina Piazzolla ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Density Lipoprotein ◽

Cross Sectional Study ◽

Inverse Association ◽

Sectional Study ◽

Cross Sectional ◽

Inflammatory Status ◽

Vitamin D Levels ◽

25 Oh Vitamin D

Vitamin D deficiency is often linked with Metabolic Syndrome, both being more frequent with ageing and associated with an increase inflammatory state. Recently, monocytes-to-high density lipoprotein (HDL) ratio (MHR) has emerged as a powerful index to predict systemic inflammation. In this cross-sectional study, we investigated the association between circulating vitamin D level (25-OH vitamin D) and inflammatory status in a population of 1048 adult individuals. Our study reveals an inverse association between 25-OH vitamin D levels and MHR in the overall population. When the population is stratified by gender, waist circumference, and body mass index (BMI), we observed that while in men this relation is strongly significative only in condition of central obesity, in women a lifelong negative correlation exists between circulating 25-OH vitamin D and MHR and it is independent of the metabolic status. These observations underscore the relevance of circulating biomarkers such as MHR in the prediction of systemic inflammatory conditions sustained by vitamin D deficiency also in healthy and young women.

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