title: The effects of vitamin D repletion on endothelial function and inflammation in patients with coronary artery disease.
abstract: Adequate vitamin D levels may promote cardiovascular health by improving endothelial function and down-regulating inflammation. The objective of this pilot trial was to investigate the effects of vitamin D repletion on endothelial function and inflammation in patients with coronary artery disease (CAD). Using a double-blind placebo wait-list control design, 90 subjects with CAD and vitamin D deficiency (< 20 ng/ml) were randomized 1:1 to 50,000 IU of oral ergocalciferol or placebo weekly for 12 weeks. Endothelial function (reactive hyperemia peripheral arterial tonometry, RH-PAT), circulating adhesion molecules, and pro-inflammatory cytokines were measured at baseline and 12 weeks. The median increase in serum 25-vitamin D from baseline was 26 ± 17 ng/ml in the active group and 4 ± 8 ng/ml in the placebo group (between-group difference = 22 ng/ml, p < 0.001). The median within-subject change in RH-PAT score was 0.13 ± 0.73 with active treatment and -0.04 ± 0.63 with placebo (between-group difference = 0.17, p = 0.44). Within-group and between-group differences in intercellular adhesion molecule levels were greater with placebo (between-group difference = 6 ng/ml, p = 0.048). Vascular cell adhesion molecule levels decreased in both groups by a similar magnitude (median difference between groups = 8.5 ng/ml, p = 0.79). There was no difference between groups in magnitude of reduction in interleukin (IL)-12 (-8.6 ng/ml, p = 0.72) and interferon-gamma (0.52 ng/ml, p = 0.88). No significant differences in blood pressure, e-selectin, high-sensitivity c-reactive protein, IL-6 or the chemokine CXCL-10 were found with treatment. In conclusion, repleting vitamin D levels in subjects with CAD failed to demonstrate any benefits on surrogate markers of cardiovascular health. These results question the role of vitamin D supplementation in modifying cardiovascular disease.
authors.affiliation: Department of Medicine, Division of Cardiology, Jacobi Medical Center, Bronx, NY 10461, USA. seth.sokol@nbhn.net
authors.forename: Seth I
authors.initials: SI
authors.lastname: Sokol
authors.forename: Vankeepuram
authors.initials: V
authors.lastname: Srinivas
authors.forename: Jill P
authors.initials: JP
authors.lastname: Crandall
authors.forename: Mimi
authors.initials: M
authors.lastname: Kim
authors.forename: George
authors.initials: G
authors.lastname: Tellides
authors.forename: Amir H
authors.initials: AH
authors.lastname: Lebastchi
authors.forename: Amir
authors.initials: A
authors.lastname: Lebastchi
authors.forename: Yiting
authors.initials: Y
authors.lastname: Yu
authors.forename: Alok K
authors.initials: AK
authors.lastname: Gupta
authors.forename: Michael H
authors.initials: MH
authors.lastname: Alderman
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015815:Cell Adhesion Molecules / Q000378:metabolism; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy*; D019587:Dietary Supplements / Q000009:adverse effects; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000187:drug effects*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000378:metabolism; D007249:Inflammation / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D014807:Vitamin D / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000188:drug therapy*
chemical_list: D015415:Biomarkers; D015815:Cell Adhesion Molecules; D014807:Vitamin D