title: The relationship of vitamin D status to cardiovascular risk factors and amputation risk in veterans with peripheral arterial disease.
abstract: OBJECTIVE
  Peripheral arterial disease (PAD) is a common and often overlooked entity responsible for considerable morbidity and mortality. Recent evidence suggests that nontraditional risk factors such as vitamin D may contribute to atherosclerosis. We hypothesized that vitamin D status was associated with cardiovascular risk factors and that vitamin D deficiency (25(OH)D <20 ng/mL) enhanced the risk of amputation.
  
  
  METHODS
  We reviewed medical records of 1435 veterans between 2000 and 2008 in Tennessee via retrospective chart analysis using correlations, logistic regressions, t tests, and χ(2) analyses.
  
  
  RESULTS
  Vitamin D status was significantly and inversely correlated with body mass index (BMI), glucose, and triglyceride values. Hypertension and diabetes but not smoking also emerged as significantly associated. Of the sample population, 5.2% (n = 75) had an amputation performed. Those individuals who were vitamin D deficient had a significantly higher amputation rate (6.7%) compared with patients who were nondeficient (4.2%). BMI, triglyceride, total cholesterol, hypertension, and diabetes were found to account for 5.7% of the variation in amputation status. Vitamin D concentration and deficiency status accounted for a nonsignificant amount of additional variance.
  
  
  CONCLUSIONS
  We conclude that vitamin D deficiency is closely linked to increased adiposity, triglyceride, and glucose measurements. Vitamin D deficiency was associated with an increased amputation risk in veterans with PAD and appears to mediate its effects through traditional risk factors.
authors.affiliation: Quillen College of Medicine, Johnson City, TN, USA.
authors.forename: Vamsi C
authors.initials: VC
authors.lastname: Gaddipati
authors.forename: Beth A
authors.initials: BA
authors.lastname: Bailey
authors.forename: Reena
authors.initials: R
authors.lastname: Kuriacose
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Copeland
authors.forename: Todd
authors.initials: T
authors.lastname: Manning
authors.forename: Alan N
authors.initials: AN
authors.lastname: Peiris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D006801:Humans; D008485:Medical Audit; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013714:Tennessee; D014728:Veterans; D014808:Vitamin D Deficiency / Q000097:blood*