Vitamin D and vascular calcification.
OBJECTIVE
Vascular calcification is frequently found in patients with osteoporosis, atherosclerosis and chronic kidney disease, leading to high morbidity and mortality rates. The effects of vitamin D excess and deficiency on vascular calcification are reviewed in this article.


RESULTS
There is evidence from experimental studies that mediacalcinosis induced by vitamin D excess is an active and reversible process. Vitamin D excess, however, is rarely seen in the general human population. Experimental data also demonstrate that physiologic vitamin D actions include the inhibition of processes that are important for intimal and medial artery calcification such as pro-inflammatory cytokine release, adhesion molecule release, and proliferation and migration of vascular smooth muscle cells. In uremic rats, low levels of the vitamin D hormone calcitriol are associated with massive vascular and soft tissue calcifications. Whereas retrospective studies already indicate a beneficial effect of active vitamin D on mortality rates in chronic kidney disease, little is yet known about the effect of vitamin D deficiency on cardiovascular morbidity and mortality in the general population.


CONCLUSIONS
Available data indicate that vitamin D exerts a biphasic 'dose response' curve on vascular calcification with deleterious consequences not only of vitamin D excess but also of vitamin D deficiency.
Zittermann
Armin
A
Department of Cardiothoracic Surgery, Northrhine Westfalia Heart Center, Ruhr University Bochum, Bad Oeynhausen, Germany. azittermann@hdz-nrw.de
Schleithoff
Stefanie S
SS
Koerfer
Reiner
R
D000818:Animals; D002114:Calcinosis / Q000503:physiopathology* / Q000517:prevention & control; D004195:Disease Models, Animal; D006706:Homeostasis; D006801:Humans; D008954:Models, Biological; D014652:Vascular Diseases / Q000503:physiopathology* / Q000517:prevention & control; D014807:Vitamin D / Q000502:physiology*; D014808:Vitamin D Deficiency
D014807:Vitamin D