Vitamin D deficiency and cardiovascular disease in postmenopausal women

Schnatz, Peter F.; Nudy, Matthew; Jiang, Xuezhi; Demko, John; Appt, Susan E.

doi:10.1097/gme.0000000000000399

Cited by 14 publications

(9 citation statements)

References 100 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Menopause may be considered a risk factor for VDD and, consequently, secondary hyperparathyroidism (25,36). It is also known that cardiovascular risk increases in menopause with hormonal changes (26,36). In postmenopausal women, Pirro M. et al showed that VitD insu ciency was associated with arterial stiffness weakly.…”

Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Vitamin D Deficiency in Premenopause: Endothelial and Diastolic Functions With Hyperparathyroidism

Akhan

Doğduş

2021

Preprint

View full text Add to dashboard Cite

Introduction: Vitamin D deficiency(VDD) is a common condition in all ages, especially in winter, and causes several adverse outcomes, including cardiovascular diseases. Although there is conflicting information about the causes of cardiac events in VDD, the commonly accepted cause is a pathogenic relationship with hyperparathyroidism.Aim: We aim to demonstrate the effects of hyperparathyroidism, if present, on endothelial and diastolic functions using echocardiography, carotid and brachial tissue Doppler imaging(tDi) in premenopausal women with VDD independent from other confounding risk factors.Methods: Our study is a cross-sectional, observational study investigating premenopausal women aged 18-50 who applied to internal medicine. The patients were divided into two groups according to their parathyroid hormone(PTH) levels. While PTH levels are within the normal range in 41 patients, it was high in 29 patients. Study groups are analyzed for basal characteristics, standard echocardiographic evaluation, carotid, and brachial artery tDi features.Results: There were no significant differences in age, height, weight, body mass index(BMI), and diastolic blood pressures(BP) between the groups(all p values>0.05). Systolic BPs were significantly higher in the secondary hyperparathyroidism, no patients diagnosed with hypertension(Mean systolic BP 124±8, p=0.020). The rate of severe VDD was 78%. In terms of diastolic parameters, prolongation of A wave durations and decreased E/A ratio were observed in the secondary hyperparathyroidism(p values are 0.043 and 0.031, respectively). Carotid and brachial tDi; carotid intima-media thickness(IMT) is significantly higher in secondary hyperparathyroidism(p=0.032).Conclusion: We showed that high PTH levels have adverse effects on diastolic functions(A wave, E/A ratio) and endothelial functions(carotid IMT) in premenopausal women with VDD, even in the absence of other confounding risk factors. We can state that our study's findings will contribute to the literature and are predictive for future studies.

show abstract

Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Vitamin D Deficiency in Premenopause: Endothelial and Diastolic Functions With Hyperparathyroidism

Akhan

Doğduş

2021

Preprint

View full text Add to dashboard Cite

show abstract

“…While there are data to suggest calcium + Vitamin D has some beneficial effects on cardiovascular disease risk factors 11,14,15 , this has not been well-established, and there is a paucity of prospective data regarding the effect of calcium + Vitamin D on cardiovascular disease outcomes 16,17 . More recent data have suggested that estrogen therapy alone, in younger women closer to the time of menopause (the timing hypothesis) could have beneficial cardiovascular disease outcomes, particularly lower rates of myocardial infarction 12,18-21 , but no significant reduction was observed with younger women randomized to estrogen plus progestogen therapy 9 .…”

Section: Discussionmentioning

confidence: 99%

Effects of Calcium, Vitamin D, and Hormone Therapy on Cardiovascular Disease Risk Factors in the Women's Health Initiative

Schnatz

Jiang

Aragaki

et al. 2017

Obstetrics &Amp; Gynecology

Self Cite

View full text Add to dashboard Cite

Objective To analyze the treatment effect of calcium + Vitamin D supplementation, hormone therapy, both, and neither on cardiovascular disease risk factors. Methods We conducted a prospective, randomized, double-blind, placebo controlled trial among Women's Health Initiative participants. The predefined primary outcome was low-density lipoprotein cholesterol (LDL-C). Results Between September 1993 to October 1998, a total of 68,132 women aged 50-79 were recruited and randomized to the WHI-Dietary Modification (WHI-DM) (n=48,835) and WHI-Hormone Therapy (WHI-HT) trials (n=27,347). Subsequently, 36,282 women from WHI-HT (16,089) and WHI-DM (n=25,210) trials were randomized in the WHI-calcium + Vitamin D (WHI-CaD) trial to 1,000 mg of elemental calcium carbonate plus 400 IU of vitamin D3 daily or placebo. Our study group included 1,521 women who participated in both the HT and CaD trials and were in the 6% subsample of trial participants with blood sample collections at baseline and years 1, 3, and 6. The average treatment effect with 95% confidence interval, for LDL-C, compared to placebo, was −1.6 ,(95th CI–5.5, 2.2) mg/dL for calcium + Vitamin D-alone, −9.0 (95th CI, −13.0, −5.1) mg/dL for hormone therapy alone, and −13.8 (95th CI,−17.8, −9.8) mg/dL for the combination. There was no evidence of a synergistic effect of calcium + Vitamin D + hormone therapy on LDL-C (p-value for interaction (p-int) = 0.26) except in those with low total intakes of vitamin D, for whom there was a significant synergistic effect on LDL (p-int = 0.03). Conclusion Reductions in LDL-C were greater among women randomized to both calcium + Vitamin D and hormone therapy than for those randomized to either intervention alone or to placebo. The treatment effect observed in the calcium + Vitamin D + hormone therapy combination group may be additive rather than synergistic. For clinicians and patients deciding to begin calcium + Vitamin D supplementation, current use of hormone therapy should not influence that decision.

show abstract

“…In skin 7-dehydrocholesterol can be converted to previtamin D 3 after absorbing solar ultraviolet B radiation and then sequentially hydroxylated into 25(OH)D and 1,25-dihydroxyvitamin D 3 (an active form) by hydroxylases in the liver and kidney. Vitamin D can be also ingested in the diet or by oral supplements [ 1 ]. Besides its classical physiological function of regulation of calcium and bone metabolism, vitamin D is suggested to have many other functions such as modulating immune function, anti-inflammatory activity, suppressing the rennin-angiotensin system and reducing insulin resistance [ 2 – 5 ].…”

Section: Introductionmentioning

confidence: 99%

The Associations of Serum Lipids with Vitamin D Status

et al. 2016

View full text Add to dashboard Cite

AimsVitamin D deficiency has been associated with some disorders including cardiovascular diseases. Dyslipidemia is a major risk factor for cardiovascular diseases. However, data about the relationships between vitamin D and lipids are inconsistent. The relationship of vitamin D and Atherogenic Index of Plasma (AIP), as an excellent predictor of level of small and dense LDL, has not been reported. The objective of this study was to investigate the effects of vitamin D status on serum lipids in Chinese adults.MethodsThe study was carried out using 1475 participants from the Center for Physical Examination, 306 Hospital of PLA in Beijing, China. Fasting blood samples were collected and serum concentrations of 25(OH)D, total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were measured. AIP was calculated based on the formula: log [TG/HDL-C]. Multiple linear regression analysis was used to estimate the associations between serum 25(OH)D and lipids. The association between the occurrences of dyslipidemias and vitamin D levels was assessed by multiple logistic regression analysis. Confounding factors, age and BMI, were used for the adjustment.ResultsThe median of serum 25(OH)D concentration was 47 (27–92.25) nmol/L in all subjects. The overall percentage of 25(OH)D ≦ 50 nmol/L was 58.5% (males 54.4%, females 63.7%). The serum 25(OH)D levels were inversely associated with TG (β coefficient = -0.24, p < 0.001) and LDL-C (β coefficient = -0.34, p < 0.001) and positively associated with TC (β coefficient = 0.35, p < 0.002) in men. The associations between serum 25(OH)D and LDL-C (β coefficient = -0.25, p = 0.01) and TC (β coefficient = 0.39, p = 0.001) also existed in women. The serum 25(OH)D concentrations were negatively associated with AIP in men (r = -0.111, p < 0.01) but not in women. In addition, vitamin D deficient men had higher AIP values than vitamin D sufficient men. Furthermore, the occurrences of dyslipidemias (reduced HDL-C, elevated TG and elevated AIP) correlated with lower 25(OH)D levels in men, whereas the higher TC and LDL-C associated with higher 25(OH)D levels in women.ConclusionIt seems that the serum 25(OH)D levels are closely associated with the serum lipids and AIP. Vitamin D deficiency may be associated with the increased risk of dyslipidemias, especially in men. The association between vitamin D status and serum lipids may differ by genders.

show abstract

Vitamin D deficiency and cardiovascular disease in postmenopausal women

Abstract: Well-designed research, with CVD as primary outcome, is needed to help bridge the gap in our knowledge on this topic. In the meantime, caution should be applied to avoid overdiagnosis and overtreatment of vitamin D deficiency.

Cited by 14 publications

References 100 publications

WITHDRAWN: Vitamin D Deficiency in Premenopause: Endothelial and Diastolic Functions With Hyperparathyroidism

WITHDRAWN: Vitamin D Deficiency in Premenopause: Endothelial and Diastolic Functions With Hyperparathyroidism

Effects of Calcium, Vitamin D, and Hormone Therapy on Cardiovascular Disease Risk Factors in the Women's Health Initiative

The Associations of Serum Lipids with Vitamin D Status

Contact Info

Product

Resources

About