Atherosclerosis
Volume 205, Issue 1 , Pages 255-260, July 2009

25-Hydroxyvitamin D deficiency is independently associated with cardiovascular disease in the Third National Health and Nutrition Examination Survey

  • Jessica Kendrick

      Affiliations

    • Division of Renal Diseases and Hypertension, University of Colorado Health Sciences Center, Denver, USA
    • ,
  • Giovanni Targher

      Affiliations

    • Section of Endocrinology, Department of Biomedical and Surgical Sciences, University of Verona, Verona, Italy
    • ,
  • Gerard Smits

      Affiliations

    • Division of Renal Diseases and Hypertension, University of Colorado Health Sciences Center, Denver, USA
    • ,
  • Michel Chonchol

      Affiliations

    • Division of Renal Diseases and Hypertension, University of Colorado Health Sciences Center, Denver, USA
    • Corresponding Author InformationCorresponding author at: University of Colorado Health Sciences Center, Division of Renal Diseases and Hypertension, Box C-281, Denver, CO 80262, USA. Tel.: +1 303 399 6997; fax: +1 303 399 3131.

Received 18 July 2008; received in revised form 12 September 2008; accepted 30 October 2008. published online 17 December 2008.

Abstract 

Objective

Serum 25-hydroxyvitamin D [25(OH)D] levels are inversely associated with important cardiovascular disease (CVD) risk factors. However, the association between 25(OH)D levels and prevalent CVD has not been extensively examined in the general population.

Methods

We performed a cross-sectional analysis of data from the Third National Health and Nutrition Examination Survey (1988–1994) and examined the association between serum 25(OH)D levels and prevalence of CVD in a representative population-based sample of 16,603 men and women aged 18 years or older. Prevalence of CVD was defined as a composite measure inclusive of self-reported angina, myocardial infarction or stroke.

Results

In the whole population, there were 1308 (8%) subjects with self-reported CVD. Participants with CVD had a greater frequency of 25(OH)D deficiency [defined as serum 25(OH)D levels <20ng/mL] than those without (29.3% vs. 21.4%; p<0.0001). After adjustment for age, gender, race/ethnicity, season of measurement, physical activity, body mass index, smoking status, hypertension, diabetes, elevated low-density lipoprotein cholesterol, hypertriglyceridemia, low high-density lipoprotein cholesterol, chronic kidney disease and vitamin D use, participants with 25(OH)D deficiency had an increased risk of prevalent CVD (odds ratio 1.20 [95% confidence interval (CI) 1.01–1.36; p=0.03]).

Conclusions

These results indicate a strong and independent relationship of 25(OH)D deficiency with prevalent CVD in a large sample representative of the US adult population.

Keywords: 25-Hydroxyvitamin D, Cardiovascular disease, Epidemiology

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PII: S0021-9150(08)00773-9

doi:10.1016/j.atherosclerosis.2008.10.033

Atherosclerosis
Volume 205, Issue 1 , Pages 255-260, July 2009

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