The effects of vitamin D repletion on endothelial function and inflammation in patients with coronary artery disease
Vasc Med December 2012 vol. 17 no. 6 394-404
Seth I Sokol1,2,3; Vankeepuram Srinivas1,2; Jill P Crandall4; Mimi Kim5; George Tellides6
Amir Lebastchi6; Yiting Yu5; Alok K Gupta7; Michael H Alderman2,5
1 Department of Medicine, Division of Cardiology, Jacobi Medical Center, Bronx, NY, USA
2 Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
3 Department of Medicine, Division of Cardiology, Montefiore Medical Center, Bronx, NY, USA
4 Department of Medicine, Division of Endocrinology, Albert Einstein College of Medicine, Bronx, NY, USA
5 Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
6 Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
7 Department of Clinical Research, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
Seth I Sokol Jacobi Medical Center 1400 Pelham Pkwy Building 1, 5W Bronx, NY 10461 USA Email: seth.sokol at nbhn.net
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.
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- Vitamin D2 has far less benefit than Vitamin D3 – even when given daily
- Vitamin D2 has even less benefit when given weekly
Have not seen studies still using Vitamin D2 for over a year now. Thought that such studies were not longer being performed. Wonder when this study was started?
- Lacking a loading dose, the repletion of the vitamin D, and thus the start of any possible benefits did not probably happen near the end of the trial
- The vitamin D levels need to be much more than just repletion for TREATMENT.
Even 40 ng level of vitamin D is needed for prevention, and more is needed for TREATMENT