Vitamin D May Not Improve Lipid Levels: A Serial Clinical Laboratory Data Study.
Circulation. 2012 Jun 20.
Ponda MP, Huang XX, Odeh MA, Breslow JL, Kaufman HW.
The Rockefeller University, New York, NY;
BACKGROUND: Vitamin D deficiency is highly prevalent and associated with dyslipidemia and cardiovascular disease. The impact is unknown of correcting vitamin D deficiency on blood lipids, strong cardiovascular disease prognostic factors.
METHODS AND RESULTS: To determine relationships between 25-hydroxyvitamin D levels and lipids, we analyzed 4.06 million de-identified patient laboratory test results from September 2009 through February 2011.
We performed a cross-sectional study of this population to determine associations between 25-hydroxyvitamin D levels and lipids across clinically defined strata. We also conducted a retrospective cohort study of vitamin D deficient patients to investigate how changes in 25-hydroxyvitamin D levels relate to changes in lipid levels.
After exclusions, 108,711 patients with serial testing were selected for cross-sectional analysis.
Compared to vitamin D deficient patients (<20 ng/ml), those with optimal levels (?30 ng/ml) had *lower mean total cholesterol (-1.9 mg/dl [95% CI (-1.2, -2.7 mg/dl)]; p <.0001),
- lower LDL cholesterol (-5.2 mg/dl [95% CI (-4.5, -5.8 mg/dl)]; p <.0001),
- higher HDL cholesterol (4.8 mg/dl [95% CI (4.5, 5.0 mg/dl)]; p <.0001), and
- lower triglycerides (-7.5 mg/dl [95% CI (-6.2, -8.7 mg/dl)]; p <.0001).
For the retrospective cohort analysis, raising vitamin D levels from <20 ng/ml to ?30 ng/ml (n = 6,260), compared to those remaining <20 ng/ml (n = 2,332), was associated with a mean *increase in total cholesterol (0.77 mg/dl [95% CI (0.18, 1.36 mg/dl)]; p = .01)
- and HDL cholesterol (0.42 mg/dl [95% CI (0.08, 0.76 mg/dl)]; p = 0.02), but
- non-significant changes in LDL cholesterol (0.32 mg/dl [95% CI (-0.01, 0.66 mg/dl)]; p = .06) *and triglycerides (0.04 mg/dl [95% CI (-2.16, 2.23 mg/dl)]; p = .97)
While vitamin D deficiency is associated with an unfavorable lipid profile in cross-sectional analyses, correcting for a deficiency might not translate into clinically meaningful changes in lipid concentrations, although data from intervention trials is required to confirm these findings.
PDF Comment on this study by Heart.org is attached at the bottom of this page
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