Serum 25-hydroxyvitamin D concentration in subclinical carotid atherosclerosis.
OBJECTIVE
Vitamin D deficiency has been implicated in cardiovascular disease and is associated with multiple cardiovascular risk factors. We investigated the serum 25-hydroxyvitamin D (25(OH)D) concentration in relation to latitude, baseline carotid intima-media thickness (IMT), and IMT progression, the carotid IMT measures being surrogate markers of subclinical atherosclerosis and cardiovascular disease risk.


RESULTS
Serum 25(OH)D concentration was related to high-resolution carotid IMT measures in 3430 middle-aged and elderly subjects with high cardiovascular risk but no prevalent disease, who were recruited at 7 centers in Finland, Sweden, The Netherlands, France, and Italy. Participants underwent carotid ultrasound examination at baseline and at months 15 and 30 after entry into the study, whereas blood samples, clinical data, and information about lifestyle were collected at baseline. Serum 25(OH)D levels were positively associated with latitude (Jonckheere-Terpstra χ=166.643; P<0.001) and, as previously reported, associated with a range of cardiovascular risk factors. There were no independent relationships between 25(OH)D and segment-specific or composite IMT measures in the entire cohort. In analyses stratified by sex, diabetes mellitus, and statin treatment, weak associations with some baseline and progression measures of carotid IMT were observed in males, diabetics, and nonstatin-treated individuals.


CONCLUSIONS
Levels of 25(OH)D differed across Europe, were highest in the North, showed multiple associations with established and emerging cardiovascular risk factors but were not consistently, independently related to measures of carotid IMT. This argues against a protective role of vitamin D against subclinical atherosclerosis in high-risk individuals.
From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland (J.K.); Foundation for Research in Health, Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland (R.R.); Department of Medicine, University Medical Center Groningen, Groningen, The Netherlands (A.J.S.); Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy (E.M.); Assistance Publique-Hopitaux de Paris, Service Endocrinologie-Metabolisme, Groupe Hôpitalier Pitie-Salpetriere, Unités de Prévention Cardiovasculaire, Paris, France (P.G.); and Centre for Cardiovascular Genetics, University College London, London, United Kingdom (S.E.H.).
Anna
A
Deleskog
Olga
O
Piksasova
Angela
A
Silveira
Karl
K
Gertow
Damiano
D
Baldassarre
Fabrizio
F
Veglia
Bengt
B
Sennblad
Rona J
RJ
Strawbridge
Malin
M
Larsson
Karin
K
Leander
Bruna
B
Gigante
Jussi
J
Kauhanen
Rainer
R
Rauramaa
Andries J
AJ
Smit
Elmo
E
Mannarino
Philippe
P
Giral
Sven
S
Gustafsson
Claes-Göran
CG
Östenson
Steve E
SE
Humphries
Elena
E
Tremoli
Ulf
U
de Faire
John
J
Öhrvik
Anders
A
Hamsten
D000368:Aged; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000378:metabolism*; D059168:Carotid Intima-Media Thickness; D018450:Disease Progression; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
D014807:Vitamin D; C104450:25-hydroxyvitamin D
25-hydroxyvitamin D; cardiovascular diseases; carotid intimal medial thickness 1; risk factors; vitamin D