title: Markers of subclinical atherosclerosis in premenopausal women with vitamin D deficiency and effect of vitamin D replacement.
abstract: BACKGROUND
  Recent studies have revealed a relationship between vitamin D deficiency and atherosclerosis. This study aims to investigate the impact of vitamin D deficiency and replacement on markers of subclinical atherosclerosis in young premenopausal women in whom vitamin D deficiency is prevalent.
  
  
  METHODS
  Thirty-one premenopausal vitamin D deficient women and 27 age and gender-matched control subjects were enrolled in this study. Markers of subclinical atherosclerosis including carotid intima-media thickness (cIMT), flow-mediated dilatation (FMD), endothelial progenitor cell (EPC) count and cytokine levels were determined at baseline. All measurements were repeated at 6-month follow-up in vitamin D-deficient subjects after vitamin D replacement.
  
  
  RESULTS
  Vitamin D deficient premenopausal women had lower FMD (9.9 ± 1.3 vs. 13.8 ± 1.7%, p < 0.001) and EPC counts at baseline. This population also had lower IL-10 and higher IL-17 levels. A 6-month vitamin D replacement therapy resulted in a significant increase in FMD (9.9 ± 1.3 vs. 11.4 ± 1.4%, p < 0.001) and EPC counts. Furthermore, cytokine profile shifted toward a more anti-inflammatory phenotype including elevated IL-10 and decreased IL-17 levels. cIMT was not different between patient and control groups and did not change following vitamin D replacement. Change in 25(OH)D and IL-17 levels were independent predictors of the change in FMD measurements following vitamin D replacement.
  
  
  CONCLUSIONS
  This study demonstrates that endothelial function is impaired in otherwise healthy vitamin D deficient young premenopausal women and improves with 6-month replacement therapy. Immune-modulatory effects of vitamin D may, at least partly, be responsible for its beneficial effects on vascular health.
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey. Electronic address: kmuratg@yahoo.com.
authors.forename: Kadri Murat
authors.initials: KM
authors.lastname: Gurses
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
authors.forename: Lale
authors.initials: L
authors.lastname: Tokgozoglu
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
authors.forename: Muhammed Ulvi
authors.initials: MU
authors.lastname: Yalcin
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
authors.forename: Duygu
authors.initials: D
authors.lastname: Kocyigit
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
authors.forename: Muhammet
authors.initials: M
authors.lastname: Dural
authors.affiliation: Cancer Institute Basic Oncology Department, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
authors.forename: Hande
authors.initials: H
authors.lastname: Canpinar
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
authors.forename: Hikmet
authors.initials: H
authors.lastname: Yorgun
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
authors.forename: Mehmet Levent
authors.initials: ML
authors.lastname: Sahiner
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
authors.forename: Ergun Baris
authors.initials: EB
authors.lastname: Kaya
authors.affiliation: Department of Internal Medicine, Section of Endocrinology and Metabolism, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
authors.forename: Safak
authors.initials: S
authors.lastname: Akin
authors.affiliation: Department of Internal Medicine, Section of Endocrinology and Metabolism, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Gurlek
authors.affiliation: Cancer Institute Basic Oncology Department, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
authors.forename: Dicle
authors.initials: D
authors.lastname: Guc
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000097:blood*; D015415:Biomarkers / Q000378:metabolism; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D002452:Cell Count; D016207:Cytokines / Q000097:blood; D042783:Endothelial Cells / Q000166:cytology; D004730:Endothelium, Vascular / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D006801:Humans; D007107:Immune System; D007249:Inflammation; D020381:Interleukin-17 / Q000378:metabolism; D017697:Premenopause; D013234:Stem Cells / Q000166:cytology; D014807:Vitamin D / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000097:blood* / Q000188:drug therapy
chemical_list: D015415:Biomarkers; D016207:Cytokines; D020381:Interleukin-17; D014807:Vitamin D
keywords: Endothelial function; Endothelial progenitor cell count; Inflammation; Subclinical atherosclerosis; Vitamin D