Vitamin D Deficiency Is Associated With Subclinical Carotid Atherosclerosis: The Northern Manhattan Study.
Stroke. 2011 Jun 30.
Carrelli AL, Walker MD, Lowe H, McMahon DJ, Rundek T, Sacco RL, Silverberg SJ.
Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY; and the Department of Neurology, University of Miami Miller School of Medicine, Miami, FL.
BACKGROUND AND PURPOSE:
The purpose of this study was to assess the association of vitamin D deficiency and indices of mineral metabolism with subclinical carotid markers that predict cardiovascular events.
Two hundred three community-dwelling adults (Northern Manhattan Study; age, 68±11; age range, 50 to 93 years) had serum measurements (calcium, phosphorus, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, parathyroid hormone) and carotid ultrasound (plaque presence, number, maximal carotid plaque thickness, intima-media thickness).
Adjusting for cardiovascular risk factors, plaque number was associated with phosphorus levels (?=0.39 per 1-mg/dL increase; P=0.02) and calcium-phosphorus product (?=0.36 per 10-U increase; P=0.03).
In those with plaque (N=116 57%), the association of plaque number with phosphorus and calcium-phosphorus product persisted.
In addition, 25-hydroxyvitamin D was inversely associated with both
(intima-media thickness (?=-0.01 per 10-ng/mL increase; P=0.05) and
- maximal carotid plaque thickness (?=-0.10 per 10-ng/mL increase; P=0.03).
In a model containing traditional cardiac risk factors and indices of mineral metabolism, 25-hydroxyvitamin D accounted for 13% of the variance in both intima-media thickness and maximal carotid plaque thickness.
Calcium, parathyroid hormone, and 1,25-dihydroxyvitamin D levels were not associated with carotid measures.
After adjusting for cardiovascular risk factors and renal function, serum phosphorus and calcium-phosphorus product were associated with a greater burden of subclinical carotid atherosclerosis. Low 25-hydroxyvitamin D levels were associated with increased intima-media thickness and maximal carotid plaque thickness in those with plaque, and 25-hydroxyvitamin D contributed in a robust manner to the variance in both. These results confirm and extend data on the association of low vitamin D levels with subclinical carotid atherosclerosis. The precise nature of this association and the optimum levels of vitamin D for vascular health remain to be elucidated.
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