title: Independent association of severe vitamin D deficiency as a risk of acute myocardial infarction in Indians.
abstract: BACKGROUND
  Association of vitamin D deficiency with coronary heart disease (CHD) has been widely reported. Emerging data has shown high prevalence of vitamin D deficiency among Indians. However, this association has not been studied in Indians.
  
  
  METHODS
  A case-control study with 120 consecutive cases of first incident acute myocardial infarction (MI) and 120 age and gender matched healthy controls was conducted at All India Institute of Medical Sciences, New Delhi. The standard clinical and biochemical risk factors for MI were assessed for both cases and controls. Serum 25 (OH) vitamin D assay was performed from stored samples for cases and controls using radioimmunoassay.
  
  
  RESULTS
  Vitamin D deficiency [25(OH) D < 30 ng/ml] was highly prevalent in cases and controls (98.3% and 95.8% respectively) with median levels lower in cases (6 ng/ml and 11.1 ng/ml respectively; p < 0.001). The cases were more likely to have diabetes, hypertension and consume tobacco and alcohol. They had higher waist hip ratio, total and LDL cholesterol. Multivariate logistic regression analysis revealed severe vitamin D deficiency [25(OH) vitamin D < 10 ng/ml] was associated with a risk of MI with an odds ratio of 4.5 (95% CI 2.2-9.2).
  
  
  CONCLUSIONS
  This study reveals high prevalence of vitamin D deficiency among cases of acute MI and controls from India, with levels of 25 (OH)D being significantly lower among cases. Despite rampant hypovitaminosis, severe vitamin D deficiency was associated with acute MI after adjusting for conventional risk factors. This association needs to be tested in larger studies in different regions of the country.
authors.affiliation: Additional Professor, Dept. of Cardiology, Cardiothoracic Centre, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India. Electronic address: drambujroy@gmail.com.
authors.forename: Ambuj
authors.initials: A
authors.lastname: Roy
authors.affiliation: Dept. of Cardiac Biochemistry, Cardiothoracic Centre, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India.
authors.forename: Ramakrishnan
authors.initials: R
authors.lastname: Lakshmy
authors.affiliation: Dept. of Cardiac Biochemistry, Cardiothoracic Centre, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Tarik
authors.affiliation: Dept. of Endocrinology, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Tandon
authors.affiliation: Dept. of Cardiology, Cardiothoracic Centre, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India; President, Public Health Foundation of India Delhi, NCR, Plot No. 47, Sector 44, Institutional Area Gurgaon, Haryana 122003, India; Executive Director, Centre for Chronic Disease Control (CCDC) Professor, Chronic Disease Epidemiology, Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area Gurgaon, Haryana 122003, India.
authors.forename: K Srinath
authors.initials: KS
authors.lastname: Reddy
authors.affiliation: Dept. of Cardiology, Cardiothoracic Centre, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India.
authors.forename: Dorairaj
authors.initials: D
authors.lastname: Prabhakaran
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications* / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Indians; Myocardial infarction; Vitamin D
references.citation: Eur J Epidemiol. 2001;17(6):567-71
references.pmid: 11949730
references.citation: Am J Med Sci. 2009 Jul;338(1):40-4
references.pmid: 19593102
references.citation: Am J Physiol. 1997 Apr;272(4 Pt 2):H1751-8
references.pmid: 9139959
references.citation: Br J Nutr. 2005 Oct;94(4):483-92
references.pmid: 16197570
references.citation: Am J Cardiol. 2006 Apr 1;97(7):959-63
references.pmid: 16563894
references.citation: Prog Biophys Mol Biol. 2006 Sep;92(1):39-48
references.pmid: 16600341
references.citation: JAMA. 2007 Jan 17;297(3):286-94
references.pmid: 17227980
references.citation: J Clin Endocrinol Metab. 2007 Jun;92(6):2017-29
references.pmid: 17389701
references.citation: Indian J Med Res. 2008 Mar;127(3):211-8
references.pmid: 18497434
references.citation: Arch Intern Med. 2008 Jun 9;168(11):1174-80
references.pmid: 18541825
references.citation: Arch Intern Med. 2008 Jun 23;168(12):1340-9
references.pmid: 18574092
references.citation: Eur J Clin Invest. 2008 Nov;38(11):798-803
references.pmid: 19021696
references.citation: J Am Coll Cardiol. 2008 Dec 9;52(24):1949-56
references.pmid: 19055985
references.citation: Diabetes Educ. 2008 Nov-Dec;34(6):939-40, 942, 944 passim
references.pmid: 19075078
references.citation: J Assoc Physicians India. 2008 Oct;56:755-7
references.pmid: 19263699
references.citation: Int J Epidemiol. 1990 Sep;19(3):559-63
references.pmid: 2262248
references.citation: Nutr Cancer. 2010;62(1):51-7
references.pmid: 20043259
references.citation: Ann Intern Med. 2010 Mar 2;152(5):307-14
references.pmid: 20194237
references.citation: Ann Intern Med. 2010 Mar 2;152(5):315-23
references.pmid: 20194238
references.citation: Atherosclerosis. 2010 Jun;210(2):531-5
references.pmid: 20226461
references.citation: Prev Med. 2010 Sep-Oct;51(3-4):228-33
references.pmid: 20600257
references.citation: Am J Hypertens. 2011 Mar;24(3):253-62
references.pmid: 20847727
references.citation: JAMA. 2011 Jun 22;305(24):2565-6
references.pmid: 21693745
references.citation: J Am Coll Cardiol. 2011 Oct 4;58(15):1547-56
references.pmid: 21958881
references.citation: Kidney Blood Press Res. 2011;34(6):404-17
references.pmid: 21677437
references.citation: J Assoc Physicians India. 2011 Nov;59:706-9
references.pmid: 22616336
references.citation: J Invasive Cardiol. 2012 Aug;24(8):385-9
references.pmid: 22865308
references.citation: Arterioscler Thromb Vasc Biol. 2012 Nov;32(11):2794-802
references.pmid: 22936341
references.citation: Clin Chim Acta. 2013 Oct 21;425:192-5
references.pmid: 23954837
references.citation: Clin Endocrinol (Oxf). 2014 Jan;80(1):41-6
references.pmid: 23682759