title: Vitamin D status and functional performance in peripheral artery disease.
abstract: The clinical implications of low vitamin D in peripheral artery disease (PAD) are unknown. We hypothesized that among individuals with PAD, lower levels of 25-hydroxyvitamin D would be associated with poorer functional performance, more adverse calf muscle characteristics, and poorer peripheral nerve function. Participants were 402 men and women with PAD who underwent measurement of 25-hydroxyvitamin D (DiaSorin radioimmunoassay) along with 6-minute walk testing, measurement of walking velocity at usual and fastest pace, computed tomography-measured calf muscle density, and peripheral nerve conduction velocity (NCV). Among PAD participants, 20.4% had 25-hydroxyvitamin D levels < 30 nmol/L, consistent with deficient vitamin D status. Adjusting for age, sex, and race, lower 25-hydroxyvitamin D levels were associated with poorer 6-minute walk performance (p trend = 0.002), slower usual-paced 4-meter walking velocity (p trend = 0.031), slower fast-paced 4-meter walking velocity (p trend = 0.043), and lower calf muscle density (p trend = 0.031). After additional adjustment for body mass index (BMI) and diabetes, none of these associations remained statistically significant. However, lower levels of 25-hydroxyvitamin D were associated with poorer peroneal NCV (p trend = 0.013) and poorer sural NCV (p trend = 0.039), even after adjusting for age, sex, race, BMI, comorbidities, smoking, physical activity, and other confounders. In conclusion, vitamin D deficiency is common among people with PAD encountered in clinical settings. After adjusting for BMI and diabetes mellitus, we found no significant associations of lower levels of 25-hydroxyvitamin D with poorer functional performance or calf muscle characteristics. Associations of low vitamin D levels with poorer peripheral nerve function require further study.
authors: Department of Medicine, Northwestern University's Feinberg School of Medicine, Chicago, IL, USA. mdm608@northwestern.edu
authors: Mary M
authors: MM
authors: McDermott
authors: Kiang
authors: K
authors: Liu
authors: Luigi
authors: L
authors: Ferrucci
authors: Lu
authors: L
authors: Tian
authors: Jack
authors: J
authors: Guralnik
authors: Peter
authors: P
authors: Kopp
authors: Huimin
authors: H
authors: Tao
authors: Linda
authors: L
authors: Van Horn
authors: Yihua
authors: Y
authors: Liao
authors: David
authors: D
authors: Green
authors: Melina
authors: M
authors: Kibbe
authors: Michael H
authors: MH
authors: Criqui
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D002641:Chicago / Q000453:epidemiology; D003430:Cross-Sectional Studies; D015536:Down-Regulation; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009119:Muscle Contraction; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000294:innervation* / Q000503:physiopathology; D009431:Neural Conduction; D058729:Peripheral Arterial Disease / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D010543:Peroneal Nerve / Q000503:physiopathology*; D011237:Predictive Value of Tests; D015995:Prevalence; D011863:Radioimmunoassay; D012307:Risk Factors; D013497:Sural Nerve / Q000503:physiopathology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016138:Walking
chemical_list: D015415:Biomarkers; D014807:Vitamin D; C104450:25-hydroxyvitamin D