25-hydroxyvitamin D levels inversely associate with risk for developing coronary artery calcification

J Am Soc Nephrol. 2009 Aug;20(8):1805-12. doi: 10.1681/ASN.2008111157. Epub 2009 May 14.

Abstract

Vitamin D deficiency associates with increased risk for cardiovascular events and mortality, but the mechanism driving this association is unknown. Here, we tested whether circulating 25-hydroxyvitamin D concentration associates with coronary artery calcification (CAC), a measure of coronary atherosclerosis, in the Multi-Ethnic Study of Atherosclerosis. We included 1370 participants: 394 with and 976 without chronic kidney disease (estimated GFR <60 ml/min per 1.73 m(2)). At baseline, CAC was prevalent among 723 (53%) participants. Among participants free of CAC at baseline, 135 (21%) developed incident CAC during 3 yr of follow-up. Lower 25-hydroxyvitamin D concentration did not associate with prevalent CAC but did associate with increased risk for developing incident CAC, adjusting for age, gender, race/ethnicity, site, season, physical activity, smoking, body mass index, and kidney function. Further adjustment for BP, diabetes, C-reactive protein, and lipids did not alter this finding. The association of 25-hydroxyvitamin D with incident CAC seemed to be stronger among participants with lower estimated GFR. Circulating 1,25-dihydroxyvitamin D concentrations among participants with chronic kidney disease did not significantly associate with prevalent or incident CAC in adjusted models. In conclusion, lower 25-hydroxyvitamin D concentrations associate with increased risk for incident CAC. Accelerated development of atherosclerosis may underlie, in part, the increased cardiovascular risk associated with vitamin D deficiency.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Atherosclerosis / blood*
  • Atherosclerosis / diagnostic imaging
  • Atherosclerosis / etiology
  • Calcinosis / blood*
  • Calcinosis / diagnostic imaging
  • Calcitriol / blood
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Radiography
  • Renal Insufficiency, Chronic / complications
  • Risk Factors
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood

Substances

  • Vitamin D
  • 25-hydroxyvitamin D
  • Calcitriol