Abstract
Low vitamin D status is associated with increased risk of cardiovascular disease and may be involved in atherosclerosis. Our aim was to assess the association between vitamin D status and the progression of coronary artery disease (CAD). We measured 25-hydroxyvitamin D3 (25OHD3) by liquid chromatography tandem mass spectrometry (LC-MS/MS) in plasma from 348 participants with established CAD (84% males, mean ± standard deviation (SD) age 60 ± 10 years) of the Western Norway B-vitamin Intervention Trial (WENBIT, 1999-2006). The patients underwent invasive coronary angiography (CA) and percutaneous coronary intervention at baseline and a second CA after 302 ± 79 days of follow-up. From the angiograms, minimal lumen diameter (MLD) and diameter stenosis (DS) of atherosclerotic lesions were obtained. Significant CAD in non-intervened vessels was found in 309 coronary arteries from 183 participants either at baseline and/or at follow-up. To assess the association between levels of 25OHD3 and CAD progression in non-intervened vessels, we applied a linear quantile fitted mixed effects model with MLD or DS measured at follow-up as a function of continuous 25OHD3 concentrations. There were no statistically significant associations between plasma 25OHD3 concentrations (median: 63.9, 95% confidence interval (CI): 48.1-78.5 nmol/l) measured at baseline and the follow-up measures of either MLD (estimated effect per 10 nmol/l increase of 25OHD3 and 95% CI: -0.015 (-0.032-0.002) mm, p = 0.088) or DS (0.225 (-0.354-0.804) percentage points, p = 0.444). Multivariate adjustment did not alter these results. Plasma 25OHD3 levels were not associated with 'one-year' progression of CAD, assessed by CA in statin-treated patients.
Highlights
Nutrients are required by all organisms to perform the functions that constitute life
Seasonal variation has a strong influence on vitamin D status and researchers should consider cosinor models when adjusting for seasonality
Vitamin D status was inversely associated with a higher risk of all-cause and cardiovascular diseases (CVDs) mortality, but not associated with subclinical progression of atherosclerosis
Summary
Nutrients are required by all organisms to perform the functions that constitute life. Researchers discovered consequences of severe micronutrient deficiencies that caused clinical diseases like xerophthalmia, rickets, scurvy and beriberi. Today, they are attempting to discover consequences of milder deficiencies. To identify subtle differences in disease risk, researchers must be able to distinguish mild deficiency from sufficiency by the help of biomarkers that accurately reflect micronutrient status. They need to follow a large group of people over many years, as people vary in their requirement of micronutrients to sustain physiological functions. Vitamin D is required to maintain a healthy cardiovascular system, but it is unknown whether variation in vitamin D status in the general population is physiologically relevant to development of cardiovascular diseases (CVDs)
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