title: Vitamin D and endothelial vasodilation in older individuals: data from the PIVUS study.
abstract: BACKGROUND
  Vitamin D plays a role in a wide range of extraskeletal processes, including vascular function. Endothelial dysfunction is a predictor of cardiovascular disease, especially in older subjects. However, the relationship between vitamin D levels and indexes of endothelial vasodilation has never been fully addressed in older individuals.
  
  
  OBJECTIVE
  The objective of this study was to examine the association between vitamin D and endothelial function in a large community-based sample of older subjects.
  
  
  METHODS
  This cross-sectional study involved 852 community-dwelling men and women aged 70 years from the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS), with complete data on vascular function and 25-hydroxyvitamin D. We evaluated endothelium-dependent vasodilation by an invasive forearm technique with acetylcholine, endothelium-independent vasodilation by sodium nitroprussiate, flow-mediated vasodilation, and the pulse wave analysis (reflectance index). Vitamin D levels were measured by chemiluminescence. We used multivariate regression models adjusted for body mass index (model 1) and for multiple confounders (high-sensitivity C-reactive protein, insulin, total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, smoking, sex hormones, season of blood collection, hypertension, diabetes, cardiovascular medications and diseases, statin usage, plasma calcium and calcium intake, PTH, physical exercise, liver and kidney function tests, albumin; model 2).
  
  
  RESULTS
  In women, but not in men, vitamin D levels were positively associated with endothelium-independent vasodilation in both model 1 (β ± SE = 1.41 ± 0.54; P = .001), and model 2 (β ± SE = 2.01 ± 0.68; P = .003).We found no significant relationship between vitamin D levels and endothelium-dependent vasodilation, flow-mediated vasodilation, and reflectance index in both sexes.
  
  
  CONCLUSIONS
  In older women, but not in men, vitamin D is positively and independently associated with EIDV.
authors.affiliation: Geriatric Rehabilitation Department (M.M., F.D.V., F.L., G.P.C.), University Hospital of Parma, 43126 Parma, Italy; Department of Clinical and Experimental Medicine (M.M., G.P.C.), Section of Geriatrics, University of Parma, 43126 Parma, Italy; Department of Internal Medicine (E.V.), Division of Geriatrics, and Sealy Center on Aging, University of Texas Medical Branch, Galveston, Galveston, Texas 77555-0264; Department of Clinical Medicine, Cardiovascular and Immunological Sciences (F.G.), University of Naples Federico II, 80138 Napoli, Italy; Cardiac Surgery Unit (G.D.C.), Community Hospital of Brescia, 25123 Brescia, Italy; Azienda USL Piacenza (C.C.), 23121 Piacenza, Italy; Department of Medical Sciences (H.M.), Uppsala University, 751 85 Uppsala, Sweden; Department of Surgical Sciences (K.M.), Uppsala University, 751 85 Uppsala, Sweden; Department of Medicine (T.C.), Uppsala University Hospital, 751 85 Uppsala, Sweden; and Department of Public Health and Caring Sciences (L.L.), Section of Clinical Nutrition and Metabolism, Uppsala University, 751 85 Uppsala, Sweden.
authors.forename: Marcello
authors.initials: M
authors.lastname: Maggio
authors.forename: Francesca
authors.initials: F
authors.lastname: De Vita
authors.forename: Fulvio
authors.initials: F
authors.lastname: Lauretani
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Ceda
authors.forename: Elena
authors.initials: E
authors.lastname: Volpi
authors.forename: Francesco
authors.initials: F
authors.lastname: Giallauria
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Cicco
authors.forename: Chiara
authors.initials: C
authors.lastname: Cattabiani
authors.forename: Håkan
authors.initials: H
authors.lastname: Melhus
authors.forename: Karl
authors.initials: K
authors.lastname: Michaëlsson
authors.forename: Tommy
authors.initials: T
authors.lastname: Cederholm
authors.forename: Lars
authors.initials: L
authors.lastname: Lind
mesh_terms: D000109:Acetylcholine / Q000008:administration & dosage; D000368:Aged; D000375:Aging / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000378:metabolism*; D005260:Female; D005542:Forearm / Q000098:blood supply; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000502:physiology; D018570:Risk Assessment; D012727:Sex Characteristics; D014652:Vascular Diseases / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology*; D014665:Vasodilator Agents / Q000008:administration & dosage; D014807:Vitamin D / Q000378:metabolism*; D014808:Vitamin D Deficiency / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D014665:Vasodilator Agents; D014807:Vitamin D; D000109:Acetylcholine