Circulating 25-hydroxy-vitamin D and the risk of cardiovascular diseases. Systematic review and meta-analysis of prospective cohort studies

Jani, Rati; Mhaskar, Kshemina; Tsiampalis, Thomas; Kassaw, Nigussie Assefa; González, Miguel Ángel Martínez; Panagiotakos, Demosthenes B.

doi:10.1016/j.numecd.2021.09.003

Cited by 24 publications

(16 citation statements)

References 120 publications

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“…These findings were consistent with those reported by Wan ( 5 ), Zhao ( 4 ), and Al-khalidi ( 35 ). Moreover, Jani et al ( 36 ) performed a meta-analysis, which showed that the lower level of circulating 25(OH)VD was dose-dependently associated with the higher risks of fatal, non-fatal and recurrent cardiovascular disease, while the thresholds varied for different outcomes. Heath et al ( 37 ) made another meta-analysis that showed an inverse relationship between circulating 25(OH)VD status and cancer-specific mortality with moderate evidence, while for cardiovascular mortality, there was weak evidence showing its association with 25(OH)VD.…”

Section: Discussionmentioning

confidence: 99%

Association of serum total 25-hydroxy-vitamin D concentration and risk of all-cause, cardiovascular and malignancies-specific mortality in patients with hyperlipidemia in the United States

et al. 2022

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BackgroundVitamin D (VD) plays an important role in decreasing the risk of adverse events for various metabolic diseases. However, for patients with hyperlipidemia, the relationship between the main VD storage within the body known as serum 25-hydroxy-VD [25(OH)VD] and the risk of all-cause, cardiovascular and malignancies-specific mortality is still unclear.Materials and methodsA total of 6740 participants above the age of 20 years with hyperlipidemia who completed the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016 and were followed up until 2019 were included in the study. The weighted Cox proportional hazards regression model and weighted competing risk regression model were used to evaluate the risk for all-cause, cardiovascular and malignancy-related mortality in relation to the serum 25(OH)VD. The model was adjusted according to age, gender, race, body mass index, lipids status, medication usage, the Charlson comorbidity index and healthy eating index. The last restricted cubic spline (RCS) method was used to present the relationship between hazard ratios (HR) associated with diverse cause-specified modalities and the serum 25(OH)VD levels.ResultsSerum 25(OH)VD was identified as an independent factor for mortality. Lower serum 25(OH)VD under the threshold of 25.6 and 25.2 ng/ml were significantly associated with a higher risk for all-cause and cardiovascular mortalities, respectively. However, no association was found between malignancy-specific mortality and serum 25(OH)VD.ConclusionSerum 25(OH)VD were identified as an independent factor associated with risks of all-cause and cardiovascular mortalities in patient with hyperlipidemia. Moreover, lower serum 25(OH)VD than 25.6 and 25.2 ng/mL were, respectively, associated with a gradual increase in a risk for all-cause and cardiovascular mortality in patients with hyperlipidemia, and therefore regular monitoring of VD levels and correction of VD deficiency is recommended in those patients.

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Section: Discussionmentioning

confidence: 99%

Association of serum total 25-hydroxy-vitamin D concentration and risk of all-cause, cardiovascular and malignancies-specific mortality in patients with hyperlipidemia in the United States

et al. 2022

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“…Additionally, there can be a cut-off level in vitamin D levels, under which an additive effect of vitamin D insufficiency on the risk for CVD mortality can be observed (37). Similarly, as for the all-cause mortality, with higher sequestration of vitamin D in adipose tissue, there will be much lower bioavailability of vitamin D for other tissues, which may have adverse effects on cardiovascular system, since vitamin D was shown as potent regulator of its components, despite some controversy on the particular mechanisms and outcomes (43)(44)(45)(46). Our results on the effect of vitamin D status on CVD mortality are in accordance with the data from the recent systematic review by Heat et al (47), which showed the evidence for the association in observational studies.…”

Section: Cardiovascular Diseases Mortalitymentioning

confidence: 99%

“…According to previous studies, vitamin D deficiency may be more significantly associated with cardiovascular diseases (CVD) and was also closely related to some carcinoma types (11)(12)(13). Low levels of circulating 25-hydroxy-vitamin D [25(OH)D] may be associated with an increased risk of CVD, especially recurrent CVD events and CVD mortality (14). Meanwhile, the global prevalence of obesity is also rising, and CVD is one of the main causes of death among the obese (15).…”

Section: Introductionmentioning

confidence: 99%

Additive effects of obesity and vitamin D insufficiency on all-cause and cause-specific mortality

et al. 2022

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Obesity and vitamin D deficiency are both considered risk factors for mortality, but the potential additive effects of vitamin D status and obesity on mortality has not been well-studied. We aimed to examine the possible additive effects of obesity and vitamin D status on all-cause and cause-specific mortality. The data from the NHANES III (1988–1994) and NHANES 2001–2014 surveys were used, and multivariate Cox regression models were performed to assess the additive effects of vitamin D status and overweight/obesity/abdominal obesity on the all-cause, cardiovascular and cancer mortality, by stratifying Cox Hazard Ratios (HRs) across different categories of vitamin D status and body mass index (BMI) and waist circumference (WC) categories. The models were adjusted for age, race/ethnicity, gender, educational level, family income to poverty ratio, leisure-time physical activity, smoking, and drinking. Across all BMI/WC categories, there was an additive effect of the vitamin D both insufficiency and deficiency on all mortality rates, with deficiency having much stronger effect than insufficiency. Interestingly, the effect of vitamin D deficiency overcame the effect of obesity on all mortality rates. The highest HRs for overall and cardiovascular mortality were observed among vitamin D deficient obese/abdominally obese subjects, while for cancer mortality among vitamin D deficient normal weight/non-abdominally obese subjects. In stratified analyses, regarding all-cause mortality, there was an additive effect of the vitamin D both insufficiency and deficiency in all BMI/WC categories. Regarding cardiovascular mortality, there was an additive effect of vitamin D deficiency in all BMI/WC categories, but the additive effect of vitamin D insufficiency reached significance only in normal weight subjects. Regarding cancer mortality, the effect did not reach significance among obese subjects for vitamin D deficiency, while for insufficiency, significance was reached only among non-abdominally obese subjects. Interestingly, vitamin D surplus was associated with increased risk for cancer mortality in obese subjects, but there was an inadequate number of subjects in this category to make proper judgment. In conclusion, vitamin D insufficiency and deficiency gradually increase risk for mortality across all BMI/WC categories. In our analyses, vitamin D deficiency overcame the effect of obesity on mortality rates.

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“…Primary prevention strategies have focused on the modifiable risk factors for stroke, including elevated systolic blood pressure, body-mass index and fasting plasma glucose, ambient particulate matter pollution, and smoking (1). Recently, 25-hydroxyvitamin D 25(OH)D, the main form of vitamin D in the body, is considered to be a potential modifiable risk factor of stroke (2)(3)(4)(5). Low 25(OH)D level is significantly related to higher risk of stroke (2,3,5,6).…”

Section: Introductionmentioning

confidence: 99%

Serum 25-hydroxyvitamin D is associated with stroke history in a reverse J-shape

Pan

et al. 2023

Front. Neurol.

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Background25-hydroxyvitamin D [25(OH)D], the major form of vitamin D in the body, has a non-linear association with stroke risk. However, the association is not fully understood. The specific shape of the association and the ideal value of 25(OH)D related to minimum risk of stroke remain unclear.AimWe conducted the study to establish the correlation between circulating 25(OH)D and stroke history and determine the ideal value of 25(OH)D in relation to the lowest stroke prevalence.MethodsData from the National Health and Nutrition Examination Survey (NHANES) were used for analyzes. We used multivariate logistic regression analysis with fitted smooth curves to explore the relationship between 25(OH)D and self-reported stroke history. Subsequently, 40,632 participants were enrolled in the study.ResultsA reverse J-shaped association between 25(OH)D and stroke history was determined, where the lowest stroke prevalence for the 25(OH)D level was about 60 nmol/L. After adjusting for confounding factors, prevalence of stroke showed an increasing trend below and above the middle quintile (53.2–65.4 nmol/L) of 25(OH)D. Participants with 25(OH)D levels in the lowest quintile (≤ 39.3 nmol/L) had a 38% increased prevalence of stroke (OR 1.38, 95 %CI 1.12–1.70), while those in the higher level range of 25(OH)D (65.5–80.8 nmol/L) had a 27% higher stroke prevalence (OR 1.27, 95 %CI 1.03–1.57).ConclusionUsing data from a large, cross-sectional cohort program, we found that circulating 25(OH)D was related to stroke history in a reverse J-shaped manner. Given how the causal relationship between circulating 25(OH)D and history of stroke has not been established, more high-quality evidence based on the reverse J-shaped feature is needed to elucidate the link between vitamin D and stroke risk, and the effect of vitamin D supplements on stroke prevention.

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Circulating 25-hydroxy-vitamin D and the risk of cardiovascular diseases. Systematic review and meta-analysis of prospective cohort studies

Cited by 24 publications

References 120 publications

Association of serum total 25-hydroxy-vitamin D concentration and risk of all-cause, cardiovascular and malignancies-specific mortality in patients with hyperlipidemia in the United States

Association of serum total 25-hydroxy-vitamin D concentration and risk of all-cause, cardiovascular and malignancies-specific mortality in patients with hyperlipidemia in the United States

Additive effects of obesity and vitamin D insufficiency on all-cause and cause-specific mortality

Serum 25-hydroxyvitamin D is associated with stroke history in a reverse J-shape

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