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Large abdominal aortic aneurysm 5.4X less frequent if have lots of vitamin D – June 2013

Is hypovitaminosis D associated with abdominal aortic aneurysm, and is there a dose-response relationship?

Eur J Vasc Endovasc Surg. 2013 Jun;45(6):657-64. doi: 10.1016/j.ejvs.2013.03.015. Epub 2013 Apr 19.
Wong YY, Flicker L, Yeap BB, McCaul KA, Hankey GJ, Norman PE.
Western Australian Centre for Health and Ageing, Centre for Medical Research, Western Australian Institute for Medical Research, Perth, Australia. ewong at meddent.uwa.edu.au

OBJECTIVE: This study aims to investigate the association between plasma 25-hydroxyvitamin D (25(OH)D) concentrations with the presence of abdominal aortic aneurysm (AAA) and aortic diameter.

DESIGN: An observational study of 4233 community-dwelling men aged 70-88 years, who participated in a randomised controlled trial of screening for AAA.

METHODS: Infrarenal aortic diameter measured by ultrasound and 25(OH)D by immunoassay.

RESULTS: A total of 311 men (7.4%) with AAA (defined as aortic diameter ≥ 30 mm) comprised the study. Multivariable models were adjusted for age, smoking, cardiovascular disease, hypertension, diabetes, dyslipidaemia, body mass index and serum creatinine concentration. Amongst men with the lowest 25(OH)D quartile of values compared with the highest quartile, the adjusted odds ratio of having an AAA increased in a graded fashion from 1.23 (95% confidence interval (CI) 0.87-1.73) for AAA ≥ 30 mm to 5.42 (95% CI 1.85-15.88) for AAA ≥ 40 mm. Similarly, there was a dose-response relationship between 25(OH)D concentrations and the size of the AAA: every 10-nmol l(-1) decrease in 25(OH)D levels was associated with 0.49 mm (95% CI 0.11-0.87) increase in mean aortic diameter.

CONCLUSIONS: Low vitamin D status is associated with the presence of larger AAA in older men, and there is a graded inverse relationship between 25(OH)D concentrations and AAA diameter. Further research is needed to clarify the mechanisms underlying these associations.

Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Comment in Commentary on 'is hypovitaminosis D associated with abdominal aortic aneurysm, and is there a dose response relationship?'. [Eur J Vasc Endovasc Surg. 2013]

PMID: 23602862


  1. Kim DH, Sabour S, Sagar UN, Adams S, Whellan DJ. Prevalence of hypovitaminosis D in cardiovascular diseases (from the National Health and Nutrition Examination Survey 2001 to 2004). Am J Cardiol. 2008;102:1540–1544
  2. Martins D, Wolf M, Pan D, Zadshir A, Tareen N, Thadhani R, et al. Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the United States: data from the third national health and nutrition examination survey. Arch Intern Med. 2007;167:1159–1165
  3. Grandi NC, Breitling LP, Brenner H. Vitamin D and cardiovascular disease: systematic review and meta-analysis of prospective studies. Prev Med. 2010;51:228–233
  4. Sugden JA, Davies JI, Witham MD, Morris AD, Struthers AD. Vitamin D improves endothelial function in patients with Type 2 diabetes mellitus and low vitamin D levels. Diabet Med. 2008;25:320–325
  5. Andrade J, Er L, Ignaszewski A, Levin A. Exploration of association of 1,25-OH2D3 with augmentation index, a composite measure of arterial stiffness. Clin J Am Soc Nephrol. 2008;3:1800–1806
  6. Momiyama Y, Ohmori R, Tanaka N, Kato R, Taniguchi H, Adachi T, et al. High plasma levels of matrix metalloproteinase-8 in patients with unstable angina. Atherosclerosis. 2010;209:206–210
  7. Secchiero P, Corallini F, Pandolfi A, Consoli A, Candido R, Fabris B, et al. An increased osteoprotegerin serum release characterizes the early onset of diabetes mellitus and may contribute to endothelial cell dysfunction. Am J Pathol. 2006;169:2236–2244
  8. Zhou C, Lu F, Cao K, Xu D, Goltzman D, Miao D. Calcium-independent and 1,25(OH)2D3-dependent regulation of the renin-angiotensin system in 1alpha-hydroxylase knockout mice. Kidney Int. 2008;74:170–179
  9. Elamin MB, Abu Elnour NO, Elamin KB, Fatourechi MM, Alkatib AA, Almandoz JP, et al. Vitamin D and cardiovascular outcomes: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2011;96:1931–1942
  10. Sakalihasan N, Limet R, Defawe OD. Abdominal aortic aneurysm. Lancet. 2005;365:1577–1589
  11. Jamrozik K, Norman PE, Spencer CA, Parsons RW, Tuohy R, Lawrence-Brown MM, et al. Screening for abdominal aortic aneurysm: lessons from a population-based study. Med J Aust. 2000;173:345–350
  12. Golledge J, Muller J, Daugherty A, Norman P. Abdominal aortic aneurysm: pathogenesis and implications for management. Arterioscler Thromb Vasc Biol. 2006;26:2605–2613
  13. Norman P, Le M, Pearce C, Jamrozik K. Infrarenal aortic diameter predicts all-cause mortality. Arterioscl Throm Vas. 2004;24:1278–1282
  14. Le MT, Jamrozik K, Davis TM, Norman PE. Negative association between infra-renal aortic diameter and glycaemia: the Health in Men Study. Eur J Vasc Endovasc Surg. 2007;33:599–604
  15. Norman PE, Powell JT. Vitamin D, shedding light on the development of disease in peripheral arteries. Arterioscler Thromb Vasc Biol. 2005;25:39–46
  16. Norman PE, Flicker L, Almeida OP, Hankey GJ, Hyde Z, Jamrozik K. Cohort profile: the Health in Men Study (HIMS). Int J Epidemiol. 2009;38:48–52
  17. Australian Bureau of Statistics (ABS) . 4399.0-National health survey: SF36 population norms. Australia 1995;
  18. Norman P, Spencer CA, Lawrence-Brown MM, Jamrozik K. C-reactive protein levels and the expansion of screen-detected abdominal aortic aneurysms in men. Circulation. 2004;110:862–866
  19. Norton K, Whittingham N, Carter L, Kerr D, Gore C, Marfell-Jones M. Measurement techniques in anthropometry. In: Norton K, Olds T editor. Anthropometrica. Sydney, Australia: UNSW Press; 2000;p. 27–75
  20. Holman CD, Bass AJ, Rouse IL, Hobbs MS. Population-based linkage of health records in Western Australia: development of a health services research linked database. Aust N Z J Public Health. 1999;23:453–459
  21. Forsdahl SH, Singh K, Solberg S, Jacobsen BK. Risk factors for abdominal aortic aneurysms: a 7-year prospective study: the Tromso Study, 1994-2001. Circulation. 2009;119:2202–2208
  22. van de Luijtgaarden KM, Voute MT, Hoeks SE, Bakker EJ, Chonchol M, Stolker RJ, et al. Vitamin D Deficiency may be an independent risk factor for arterial disease. Eur J Vasc Endovasc Surg. 2012;44:301–306
  23. Lanne T, Sonesson B, Bergqvist D, Bengtsson H, Gustafsson D. Diameter and compliance in the male human abdominal aorta: influence of age and aortic aneurysm. Eur J Vasc Surg. 1992;6:178–184
  24. Adji A, O'Rourke MF, Namasivayam M. Arterial stiffness, its assessment, prognostic value, and implications for treatment. Am J Hypertens. 2011;24:5–17
  25. London GM, Guerin AP, Verbeke FH, Pannier B, Boutouyrie P, Marchais SJ, et al. Mineral metabolism and arterial functions in end-stage renal disease: potential role of 25-hydroxyvitamin D deficiency. J Am Soc Nephrol. 2007;18:613–620
  26. Al Mheid I, Patel R, Murrow J, Morris A, Rahman A, Fike L, et al. Vitamin D status is associated with arterial stiffness and vascular dysfunction in healthy humans. J Am Coll Cardiol. 2011;58:186–192
  27. Mayer O, Filipovsky J, Seidlerova J, Vanek J, Dolejsova M, Vrzalova J, et al. The association between low 25-hydroxyvitamin D and increased aortic stiffness. J Hum Hypertens. 2011;26:650–655
  28. Giallauria F, Milaneschi Y, Tanaka T, Maggio M, Canepa M, Elango P, et al. Arterial stiffness and vitamin D levels: the baltimore longitudinal study of aging. J Clin Endocrinol Metab. 2012;97:3717–3723
  29. Melamed ML, Muntner P, Michos ED, Uribarri J, Weber C, Sharma J, et al. Serum 25-hydroxyvitamin D levels and the prevalence of peripheral arterial disease: results from NHANES 2001 to 2004. Arterioscler Thromb Vasc Biol. 2008;28:1179–1185
  30. Fahrleitner A, Dobnig H, Obernosterer A, Pilger E, Leb G, Weber K, et al. Vitamin D deficiency and secondary hyperparathyroidism are common complications in patients with peripheral arterial disease. J Gen Intern Med. 2002;17:663–669
  31. Fahrleitner-Pammer A, Obernosterer A, Pilger E, Dobnig H, Dimai HP, Leb G, et al. Hypovitaminosis D, impaired bone turnover and low bone mass are common in patients with peripheral arterial disease. Osteoporos Int. 2005;16:319–324
  32. Anderson JL, May HT, Horne BD, Bair TL, Hall NL, Carlquist JF, et al. Relation of vitamin D deficiency to cardiovascular risk factors, disease status, and incident events in a general healthcare population. Am J Cardiol. 2010;106:963–968
  33. Steinvil A, Leshem-Rubinow E, Berliner S, Justo D, Finn T, Ish-shalom M, et al. Vitamin D deficiency prevalence and cardiovascular risk in Israel. Eur J Clin Invest. 2011;41:263–268
  34. Carthy EP, Yamashita W, Hsu A, Ooi BS. 1,25-Dihydroxyvitamin D3 and rat vascular smooth muscle cell growth. Hypertension. 1989;13:954–959
  35. Mantell DJ, Owens PE, Bundred NJ, Mawer EB, Canfield AE. 1 alpha,25-dihydroxyvitamin D(3) inhibits angiogenesis in vitro and in vivo. Circ Res. 2000;87:214–220
  36. Kudo K, Hasegawa S, Suzuki Y, Hirano R, Wakiguchi H, Kittaka S, et al. 1alpha,25-Dihydroxyvitamin D(3) inhibits vascular cellular adhesion molecule-1 expression and interleukin-8 production in human coronary arterial endothelial cells. J Steroid Biochem Mol Biol. 2012;132:290–294
  37. Boonstra A, Barrat FJ, Crain C, Heath VL, Savelkoul HFJ, O'Garra A. 1 alpha,25-dihydroxyvitamin D3 has a direct effect on naive CD4(+) T cells to enhance the development of Th2 cells. J Immunol. 2001;167:4974–4980
  38. Schonbeck U, Sukhova GK, Gerdes N, Libby P. T(H)2 predominant immune responses prevail in human abdominal aortic aneurysm. Am J Pathol. 2002;161:499–506
  39. Chichester Aneurysm Screening GViborg Aneurysm Screening SWestern Australian Abdominal Aortic Aneurysm PMulticentre Aneurysm Screening S. A comparative study of the prevalence of abdominal aortic aneurysms in the United Kingdom, Denmark, and Australia. J Med Screen. 2001;8:46–50
  40. Lederle FA. The strange relationship between diabetes and abdominal aortic aneurysm. Eur J Vasc Endovasc Surg. 2012;43:254–256

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