Vitamin D and Cardiovascular Disease

Abstract

Vitamin D VD deficiency is a common health problem both in Turkey and worldwide. Today, it is known that vitamin D deficiency plays a role in the occurrence of autoimmune diseases, inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis, diabetes, cancer, psoriasis and cardiovascular diseases. In recent studies, it has been concluded that low VD levels are associated with cardiovascular risk factors age, obesity, diabetes mellitus, metabolic syndrome, chronic kidney disease . Furthermore, there are studies showing the correlation between VD deficiency, and increase in carotid intima-media thickness and subclinical cardiovascular diseases such as endothelial dysfunction and coronary artery calcification and increase in total mortality. We summarize the most recent studies evaluating the relationship between vitamin D and the presence of cardiovascular risk factors, including hypertension, obesity, type 2 diabetes mellitus, chronic kidney disease, dyslipidemia and endothelial dysfunction.

Keywords

• Vitamin D, cardiovascular diseases, cardiovascular risk factors

Vitamin D ve Kardiyovasküler Hastalık

Abstract

Vitamin D VD eksikliği dünyada ve Türkiye’de yaygın bir sağlık sorunudur. Günümüzde otoimmün hastalıklar, inflamatuar barsak hastalığı, romatoid artrit, multipl skleroz, diyabet, kanser, psoriasis ve kardiyovasküler hastalıkların oluşmasında D vitamini eksikliğinin rolü olduğu bilinmektedir. Son zamanlarda yapılan çalışmalarda düşük VD düzeylerinin kardiovasküler risk faktörleri yaş, obezite, diabetes mellitus, metabolik sendrom, kronik böbrek hastalığı ile ilişkili olduğu sonucuna varılmıştır. Dahası VD eksikliğinin karotis intima media kalınlığındaki artış, endotelyal disfonksiyonu ve koroner arter kalsifikasyonu gibi subklinik kardiyovasküler hastalıklar ve total mortalitedeki artış ile ilişkisini gösteren çalışmalar da vardır. Bu derlemede son çalışmalarda vitamin D ile hipertansiyon, obezite, tip 2 diyabet, kronik böbrek hastalığı, dislipidemi, ve endotelyal disfonksiyon gibi kardiyovasküler risk faktörleri arasındaki ilişkiyi özetledik.

Keywords

• Vitamin D,kardiyovasküler hastalıklar,kardiyovasküler risk faktörleri

References

1. 1. Holick MF. Vitamin D: important for prevention of osteoporosis, cardiovascular heart disease, type 1 diabetes, autoimmune diseases, and some cancers. South Med J 2005; 98: 1024- 7.
2. 2. Holick MF. Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol. 2009;19:73-8.
3. 3. TEMD Metabolik kemik hastalıkları kılavuzu. 2012
4. 4. Scragg R. Seasonality of cardiovascular disease mortality and the possible protective effect of ultraviolet radiation. Int. J. Epidemiol. 1981, 10, 337– 341.
5. 5. Burgaz A, Orsini N, Larsson S. Et al. Blood 25- hydroxyvitamin D concentration and hypertension: A meta-analysis. J. Hypertens. 2011, 29, 636–645.
6. 6. Wang L,Song Y, Manson J.E et al. Circulating 25- hydroxy-vitamin D and risk of cardiovascular disease: A metaanalysis of prospective studies. Circ. Cardiovasc. Qual. Outcomes 2012, 5, 819–829.
7. 7. Green JJ, Robinson DA, Wilson GE et al. Calcitriol modulation of cardiac contractile performance viaprotein kinase C. J Mol Cell Cardiol 2006;41:350- 359.
8. 8. Nibbelink KA, Tishkoff DX, Hershey SD et al. 1,25(OH)2Vitamin D3 actions on cell proliferation, size, gene expression, and receptor localisation, in the HL-1 cardiac myocyte. J Steroid Biochem Mol Biol 2007;103:533-537.

9. 9. O’Connell TD, Berry JE, Jarvis AK et al. 1,25-dihydroxyvitamin D3 regulation of cardiac myocyte proliferation and hypertrophy. Am J Physiol 1997;272:H1751- H1758
10. 10. Pilz S, Tomaschitz A, Drechsler C et al. Vitamin D deficiency and heart disease. Kidney Interna-tional Supplements 2011;1:111-115.
11. 11. De Zeeuw D, Agarwal R, Amdahl M, et al. Selective vitamin D receptor activation with paricalcitol for re- duction of albuminuria in patients with type 2 diabetes (VITAL study): a randomised controlled trial. Lancet 2010;376:1543- 1551.
12. 12. Pittas AG, Chung M, Trikalinos T et al. Systematic review: Vitamin D and cardiometabolic outcomes. Ann Intern Med 2010;152:307-314.
13. 13. Wang TJ, Pencina MJ, Booth SL et al. Vitamin D defi- ciency and risk of cardiovascular disease. Circulation 2008;117:503-511.
14. 14. Giovannucci E, Liu Y, Hollis BW et al. 25OHD and risk of myocardial infarction in men: a prospective study. Arch Intern Med 2008;168:1174-1180.
15. 15. Dobnig H, Pilz S, Scharnagl H et al. Independent association of low serum 25OHD and 1,25 D with all cause and cardiovascular mortality. Arch Intern Med 2008;168:1340-1349.
16. 16. Forman J.P, Williams J.S, Fisher N.D.L. Plasma 25-hydroxyvitamin D and regulation of the reninangiotensin system in humans. Hypertension 2010, 55, 1283–1288.
17. 17. Brewer L.C, Michos E.D, Reis J.P. Vitamin D in atherosclerosis, vascular disease, and endothelial function. Curr. Drug Targets 2011, 12, 54–60.
18. 18. Snijder, M.B, Lips P, Seidell J.C et al. Vitamin D status and parathyroid hormone levels in relation to blood pressure: A population-based study in older men and women. J. Intern. Med. 2007, 261, 558– 565.
19. 19. Kunutsor, S.K, Apekey, T.A, Steur M. Vitamin D and risk of future hypertension: Meta-analysis of 283,537 participants. Eur. J. Epidemiol. 2013, 28, 205–221.
20. 20. Larsen, T, Mose, F.H, Bech, J.Net al. Effect of cholecalciferol supplementation during winter months in patients with hypertension: A randomized, placebo-controlled trial. Am. J. Hypertens. 2012, 25, 1215–1222. 33.
21. 21. Forman, J.P, Scott J.B, Ng K et al. Effect of vitamin d supplementation on blood pressure in blacks. Hypertension 2013, 61, 779–785.
22. 22. Earthman, C.P, Beckman L.M, Masodkar K et al. The link between obesity and low 25- hydroxyvitamin D concentrations: Considerations and implications. Int. J. Obes. (Lond.) 2012, 36, 387– 396.
23. 23. Wortsman J, Matsuoka L.Y, Chen T.C et al. Decreased bioavailability of vitamin D in obesity. Am. J. Clin. Nutr. 2000, 72, 690–693.
24. 24. Foss Y.J. Vitamin D deficiency is the cause of common obesity. Med. Hypotheses 2009, 72, 314– 321.
25. 25. Parikh SJ, Edlman M, Uwaifo GI et al. The relationship between obesity and se- rum 1,25 dihydroxy vitamin D concentrations in healty adults. J Clin Endocrinol Metab 2004; 89:1196-9.
26. 26. Kremer R, Campbell PP, Reinhart T et al. Vitamin D status and its relationship to boy fat, final height and peak bone mass in young women. J Clin Endocrinol Metab 2009; 94:67-73.
27. 27. Yetley EA. Assessing the vitamin D status of the US population. Am J Clin Nutr 2008; 88:558-64.
28. 28. De Luis DA, Pacheco D, Izaola O et al. Clinical results and nutritional consequences of biliopancreatic diversion: three years of follow-up. Ann Nutr Metab 2008; 53:234-9.
29. 29. Adams JA, Hewison M. Update in vitamin D. J Clin Endoc- rinol Metab 2010; 95:471-8.
30. 30. Rosen CJ, Adams JS, Bikle DD et al. The Nonskeletal effects of Vitamin D: an Endocrine Society Scien- tific Statement. Endocrine Reviews 2012;33:456-492.
31. 31. Bouillon R, Carmeliet G, Verlinden L et al. Vitamin D and human health: lessons from vitamin D receptor null mice. Endocr Rev 2008;29:726-776.
32. 32.Narvaez CJ, Matthews D, Broun E et al. Lean pheno- type and resistance to diet-induced obesity invitamin D receptor knockout mice correlates with induction of uncoupling protein-1 in white adipose tissue. Endocri- nology 2009;150:651-661.
33. 33. Dutta D, Mondal SA, Choudhuri S et al. VitaminD supplementation in prediabetes reduced progression to type 2 diabetes and was associated with decreased insulin resistance and systemic inflammation: An open label randomized prospective study from Eastern India. Diabetes Res Clin Pract. 2014 Jan 6. pii: S0168-8227(13)00478-6. doi: 10.1016/j.diabres.2013.12.044. [Epub ahead of print]
34. 34. Deleskog A, Hilding A, Brismar K et all. Low serum 25-hydroxyvitamin-D level predicts progression to type-2 diabetes individuas with prediabetes but not normal glucose tolerance. Diabetologia 2012; 55: 1668-78.
35. 35. Devaraj S, Jialal G, Cook T et al. Low vitamin D levels in Northern American adults with the metabolic syn- drome. Horm Metab Res 2011;43:72-74.
36. 36.Nunlee-Bland G, Gambhir K, Abrams C et al. Vitamin D deficiency and insülin resistance in obese African- American adolescents. J Pediatr Endocrinol Metab 2011;24:29-33.
37. 37. De Boer IH, Tinker LF, Connelly S et al. Calcium plus vitamin D supplementation and the risk of incident dia- betes in the Women’s Health Initiative. Diabetes Care 2008;31:701-707.
38. 38. von Hurst PR, Stonehouse W, Coad J. Vitamin D supplementation reduces insulin resistance in South Asian women living in New Zealand who are insulin resistant and vitamin D deficient-a randomised, place- bo-controlled trial. Br J Nutr 2010;103:549- 555.
39. 39. Avenell A, Cook JA, MacLennan GS, McPherson GC. Vitamin D supplementation and type 2 diabetes: a substudy of a randomized placebo controlled trial in older people. Age Ageing 2009;38:606-609.
40. 40.Jorde R, Sneve M, Emaus N et al. Cross-sectional and longitudinal relation between serum 25- hydroxyvi- tamin D and body mass index: the Tromso study. Eur J Nutr 2010;49:401-407.
41. 41.Jorde R, Grimnes G. Vitamin D and metabolic health with special reference to the effect of vitamin D on serum lipids. Prog. Lipid Res. 2011, 50, 303–312.
42. 42.Jaimungal, S, Wehmeier, Mooradian A.D et al. The emerging evidence for vitamin D-mediated regulation of apolipoprotein AI synthesis. Nutr. Res. 2011, 31, 805–812.
43. 43. Skaaby T, Husemoen L.L.N, Pisinger C et al. Vitamin D status and changes in cardiovascular risk factors: A prospective study of a general population. Cardiology 2012, 123, 62–70.
44. 44. Schnatz PF, Jiang X, Vila-Wright S et al. Calcium/vitamin D supplementation, serum 25- hydroxyvitamin D concentrations, and cholesterol profiles in the Women's Health Initiative calcium/vitamin D randomized trial. Menopause. 2014 Mar 3. [Epub ahead of print]
45. 45. Ponda M.P, Dowd K, Finkielstein D et al. The short-term effects of vitamin D repletion on cholesterol: A randomized, placebo-controlled trial. Arterioscler. Thromb. Vasc. Biol. 2012, 32, 2510– 2515.
46. 46. Salehpour A, Shidfar F, Hosseinpanah F et al. Vitamin D3 and the risk of CVD in overweight and obese women: A randomised controlled trial. Br. J. Nutr. 2012, 108, 1866–1873.
47. 47. London GM, Guerin AP, Verbeke FH et al. Mineral metabolism and arterial functions in endstage renal disease: potential role of 25- hydroxyvitamin D defi- ciency. J Am Soc Nephrol 2007;18:613-620.
48. 48. Testa A, Mallamaci F, Benedetto FA et al. Vitamin D receptor (VDR) gene polymorphism is associated with left ventricular (LV) mass and predicts left ven- tricular hypertrophy (LVH) progression in end-stage renal disease (ESRD) patients. J Bone Miner Res 2010;25:313-319.
49. 49. Drechsler C, Pilz S, Obermayer-Pietsch B et al. Vitamin D deficiency is associated with sudden cardiac death, combined cardiovascular events, and mortality in haemodialysis patients. Eur Heart J 2010;31:2253- 2261.
50. 50. Molinari, C, Uberti F, Grossini E et al. 1α,25- Dihydroxycholecalciferol induces nitric oxide production in cultured endothelial cells. Cell. Physiol. Biochem. 2011, 27, 661–668.
51. 51. Tare M, Emmett S.J, Coleman et al. Vitamin D insufficiency is associated with impaired vascular endothelial and smooth muscle function and hypertension in young rats. J. Physiol. (Lond.) 2011, 589, 4777–4786.
52. 52. Pilz S, Tomaschitz A, März W et al. Vitamin D, cardiovascular disease and mortality. Clin. Endocrinol. (Oxf.) 2011, 75, 575–584.
53. 53. Harris R.A, Pedersen-White J, Guo, D.-H et al. Vitamin D3 supplementation for 16 weeks improves flow-mediated dilation in overweight AfricanAmerican adults. Am. J. Hypertens. 2011, 24, 557– 562.
54. 54. Gepner A.D, Ramamurthy R, Krueger D.C et al. A prospective randomized controlled trial of the effects of vitamin D supplementation on cardiovascular disease risk. PLoS One 2012, 7, e36617.
55. 55. Sokol S.I, Srinivas V, Crandall, J.P et al. The effects of vitamin D repletion on endothelial function and inflammation in patients with coronary artery disease. Vasc. Med. 2012, 17, 394–404.
56. 56. Wang L, Manson J.E, Song Y et al. Systematic review: Vitamin D and calcium supplementation in prevention of cardiovascular events. Ann. Intern. Med. 2010, 152, 315–323.
57. 57. Avenell A, MacLennan G.S, Jenkinson, D.J et al. Long-term follow-up for mortality and cancer in a randomized placebo-controlled trial of vitamin D(3) and/or calcium (RECORD trial). J. Clin. Endocrinol. Metab. 2012, 97, 614–622.
58. 58. Autier P, Gandini S. Vitamin D supplementation and total mortality: a meta-analysis of randomized con- trolled trials. Arch Intern Med 2007;167:1730- 1737.
59. 59. Trivedi DP, Doll R, Khaw KT. Effect of fourmonthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial. BMJ 2003;326:469- 473.
60. 60. LaCroix AZ, Kotchen J, Anderson G et al. Calcium plus vitamin D supplementation and mortality in postmenopausal women: the Women’s Health Initia- tive calcium-vitamin D randomized controlled trial. J Gerontol A Biol Sci Med Sci 2009;64:559-567.
61. 61. Bjelakovic G, Gluud L.L, Nikolova D et al. Vitamin D supplementation for prevention of mortality in adults. Cochrane Database Syst. Rev. 2011, doi:10.1002/14651858.CD007470.pub2.
62. 62. Bolland M.J, Grey A, Avenell A et al. Calcium supplements with or without vitamin D and risk of cardiovascular events: Reanalysis of the Women’s Health Initiative limited access dataset and metaanalysis. BMJ 2011, 342, d2040.
63. 63. Pilz, S, Dobnig H, Tomaschitz A et al. Low 25- hydroxyvitamin D is associated with increased mortality in female nursing home residents. J. Clin. Endocrinol. Metab. 2012, 97, E653–E657.
64. 64. Sanders K.M, Stuart A.L, Williamson E.J et al. Annual high-dose oral vitamin D and falls and fractures in older women: A randomized controlled trial. JAMA 2010, 303, 1815–1822.