title: Serum 25-hydroxyvitamin D levels and the prevalence of peripheral arterial disease: results from NHANES 2001 to 2004.
abstract: OBJECTIVE
  The purpose of this study was to determine the association between 25-hydroxyvitamin D (25(OH)D) levels and the prevalence of peripheral arterial disease (PAD) in the general United States population.
  
  
  RESULTS
  We analyzed data from 4839 participants of the National Health and Nutrition Examination Survey 2001 to 2004 to evaluate the relationship between 25(OH)D and PAD (defined as an ankle-brachial index < 0.9). Across quartiles of 25(OH)D, from lowest to highest, the prevalence of PAD was 8.1%, 5.4%, 4.9%, and 3.7% (P trend < 0.001). After multivariable adjustment for demographics, comorbidities, physical activity level, and laboratory measures, the prevalence ratio of PAD for the lowest, compared to the highest, 25(OH)D quartile (< 17.8 and > or = 29.2 ng/mL, respectively) was 1.80 (95% confidence interval: 1.19, 2.74). For each 10 ng/mL lower 25(OH)D level, the multivariable-adjusted prevalence ratio of PAD was 1.35 (95% confidence interval: 1.15, 1.59).
  
  
  CONCLUSIONS
  Low serum 25(OH)D levels are associated with a higher prevalence of PAD. Several mechanisms have been invoked in the literature to support a potential antiatherosclerotic activity of vitamin D. Prospective cohort and mechanistic studies should be designed to confirm this association.
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA. mmelamed@aecom.yu.edu
authors.forename: Michal L
authors.initials: ML
authors.lastname: Melamed
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: Erin D
authors.initials: ED
authors.lastname: Michos
authors.forename: Jaime
authors.initials: J
authors.lastname: Uribarri
authors.forename: Collin
authors.initials: C
authors.lastname: Weber
authors.forename: Jyotirmay
authors.initials: J
authors.lastname: Sharma
authors.forename: Paolo
authors.initials: P
authors.lastname: Raggi
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D010281:Parathyroid Hormone / Q000097:blood; D016491:Peripheral Vascular Diseases / Q000097:blood* / Q000175:diagnosis*; D010710:Phosphates / Q000097:blood; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D010710:Phosphates; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002118:Calcium