Atherosclerosis
Volume 220, Issue 2 , Pages 563-568, February 2012

Study on the relationship between serum 25-hydroxyvitamin D levels and vascular calcification in hemodialysis patients with consideration of seasonal variation in vitamin D levels

  • Jae Hyun Chang

      Affiliations

    • Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Republic of Korea
  • ,
  • Han Ro

      Affiliations

    • Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Republic of Korea
  • ,
  • Sejoong Kim

      Affiliations

    • Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
  • ,
  • Hyun Hee Lee

      Affiliations

    • Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Republic of Korea
  • ,
  • Wookyung Chung

      Affiliations

    • Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Republic of Korea
  • ,
  • Ji Yong Jung

      Affiliations

    • Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Republic of Korea
    • Corresponding Author InformationCorresponding author at: Department of Internal Medicine, Gachon University of Medicine and Science, 1198 Guwol-Dong, Namdong-Gu, Incheon, 405-706, Republic of Korea. Tel.: +82 32 460 8912; fax: +82 32 460 3431.

Received 16 August 2011; received in revised form 28 October 2011; accepted 18 November 2011. published online 14 December 2011.

Abstract 

Background/aims

The aim of this study was to determine the prevalence of vitamin D deficiency in hemodialysis (HD) patients and the relationship between seasonal variations in vitamin D levels and vascular calcification.

Methods

As a prospective observational study, we analyzed 289 HD patients. We have assessed serum 25-hydroxyvitamin D (25D) levels at the end of the summer (September) and winter (March) and analyzed the data to reveal the association of serum 25D level with vascular calcification scores (VCS) at the end of the summer, when vitamin D levels were found to peak. Plan X-ray images of lateral lumbar spine from all subjects were studied for calculation of semiquantitative VCS as described by Kauppila.

Results

The prevalence of 25D deficiency was 86.2% at the end of the summer and increased to 96.2% at the end of the winter. Female gender and diabetes were associated with vitamin D deficiency. According to univariate analysis, 25D levels were inversely related to vascular calcification. However, after correcting for confounding factors, this relationship lost statistical significance. Multivariate analysis showed that age, systolic blood pressure, and LDL-cholesterol levels were directly associated with a higher VCS.

Conclusion

Vitamin D deficiency was highly prevalent in HD patients with marked seasonal variation. However, low 25D levels could not be identified as an independent predictor of vascular calcification in these patients.

Keywords: Vitamin D, Vascular calcification, Hemodialysis

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PII: S0021-9150(11)01099-9

doi:10.1016/j.atherosclerosis.2011.11.028

Atherosclerosis
Volume 220, Issue 2 , Pages 563-568, February 2012