title: Aortic stiffness and vitamin D are independent markers of aortic calcification in patients with peripheral arterial disease and in healthy subjects.
abstract: OBJECTIVE
  Arterial stiffness is a significant determinant of cardiovascular risk and is related to vascular calcification. Vitamin D may regulate arterial calcification and has been associated with cardiovascular survival benefits. However, data about the relationship between arterial stiffness, aortic calcification and vitamin D levels in patients with peripheral arterial disease (PAD) and in healthy subjects are limited. We examined the potential association between aortic calcification, arterial stiffness and vitamin D levels in patients with symptomatic PAD and in healthy individuals.
  
  
  METHODS
  We studied 78 men with PAD (aged 63 ± 7 years) and 74 healthy men (aged 61 ± 10 years). Aortic pulse wave velocity (aPWV) was determined by applanation tonometry using the Sphygmocor device. Aortic calcification score (ACS) was quantified by computed tomography. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured using a radioimmune assay.
  
  
  RESULTS
  ACS (4.9(2.3-8.9) vs. 0.2(0.03-1.6) (cm³); p < 0.01), aPWV (9.8 ± 2.4 vs. 8.2 ± 1.6 (m s⁻¹; p < 0.01) and 25(OH)D (15.1 ± 5.4 vs. 19.0 ± 5.9 (ng ml⁻¹); p < 0.01) were different in the patients compared with the controls. In multivariate analysis, ACS was independently determined by 25(OH)D, aPWV, calcium and age in patients with PAD (R² = 0.49; p < 0.001) and by 25(OH)D, aPWV, cholesterol/high-density lipoprotein (HDL) and age in the control group (R² = 0.55; p < 0.001). Increased aPWV and lower levels of 25(OH)D were associated with decreased ankle-brachial pressure index (p = 0.03).
  
  
  CONCLUSIONS
  These results indicate that calcification of the aorta is independently associated with aortic stiffness and serum 25(OH)D level in patients with PAD and in healthy subjects. Aortic stiffness and abnormal vitamin D level may contribute to vascular calcification and are related to higher severity grade of atherosclerotic disease.
authors.affiliation: Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu, Estonia; Endothelial Centre, University of Tartu, Tartu, Estonia. Maksim.Zagura@kliinikum.ee
authors.forename: M
authors.initials: M
authors.lastname: Zagura
authors.forename: M
authors.initials: M
authors.lastname: Serg
authors.forename: P
authors.initials: P
authors.lastname: Kampus
authors.forename: M
authors.initials: M
authors.lastname: Zilmer
authors.forename: J
authors.initials: J
authors.lastname: Eha
authors.forename: E
authors.initials: E
authors.lastname: Unt
authors.forename: J
authors.initials: J
authors.lastname: Lieberg
authors.forename: J R
authors.initials: JR
authors.lastname: Cockcroft
authors.forename: J
authors.initials: J
authors.lastname: Kals
mesh_terms: D000368:Aged; D001018:Aortic Diseases / Q000097:blood* / Q000209:etiology / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D016022:Case-Control Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000097:blood* / Q000209:etiology / Q000473:pathology; D061205:Vascular Calcification / Q000097:blood* / Q000209:etiology / Q000473:pathology; D059289:Vascular Stiffness; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D015415:Biomarkers; D014807:Vitamin D; C104450:25-hydroxyvitamin D