Serum 25(OH)D Concentration and Cardiovascular Disease Risk Markers Among Middle-Aged Healthy and Type 2 Diabetic Subjects

Abstract

Vitamin D deficiency is a major widespread health concern and is linked to a high risk of cardiovascular disease (CVD). Thus, we have investigated the association of vitamin D with various CVD risk markers. The present study comprises 90 control and 90 type 2 diabetes mellitus (T2DM) subjects of both sexes (age range, 30–50 years). The 25 hydroxyvitamin D [25(OH)D] and CVD risk markers including high sensitive C-reactive protein (hs-CRP), monocyte chemoattractant protein-1 (MCP-1), intact parathyroid hormone (I-PTH), fibroblast growth factor (FGF)-23, erythrocyte sedimentation rate (ESR), and fibrinogen were measured by using standard assays. Blood viscosity and atherogenic index of plasma calculated using standard formulae. The ten-year cardiovascular risk was assessed using the Framingham risk score (FRS). 25(OH)D, hs-CRP, MCP-1, FGF-23, ESR, fibrinogen, atherogenic index of plasma and FRS were significantly different between control and T2DM groups (p<0.05). 25(OH)D showed a significant negative correlation with MCP-1, ESR, blood viscosity, atherogenic index of plasma and FRS among total study subjects. Further, logistics regression analysis showed an association of 25(OH)D with MCP-1, hematocrit, fibrinogen, and blood viscosity. The association between 25(OH)D and various CVD risk markers suggests that 25(OH)D might help in the prediction of CVD risk.

Key words

cardiovascular risk markers - 25-hydroxyvitamin D - Framingham risk score - monocyte chemoattractant protein-1 - type 2 diabetes

Publikationsverlauf

Eingereicht: 11. Januar 2021

Angenommen nach Revision: 15. Juni 2021

Artikel online veröffentlicht:
25. August 2021

• References

• 1 Prabhakaran D, Jeemon P, Roy A. Cardiovascular diseases in India: current epidemiology and future directions. Circulation 2016; 133: 1605-1620
• 2 World Health Organization. Integrated management of cardiovascular risk: report of a WHO meeting. Geneva: 2002
• 3 Holick MF. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr 2004; 79: 362-371
• 4 Kim D, Sabour S, Sagar U. et al. Prevalence of hypovitaminosis D in cardiovascular diseases (from the National Health and nutrition examination survey 2001 to 2004). Am J Cardiol 2008; 102: 1540-1544
• 5 Kendrick J, Targher G, Smits G. et al. 25-Hydroxyvitamin D deficiency is independently associated with cardiovascular disease in the third National Health and nutrition examination survey. Atherosclerosis 2009; 205: 255-260
• 6 Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357: 266-281
• 7 Baz-hecht M, Goldfine AB. The impact of vitamin D deficiency on diabetes and cardiovascular risk. Curr Opin Endocrinol Diabetes Obes 2010; 17: 113-119
• 8 World Health Organization and International Diabetes Federation. Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycemia: Report of a WHO/IDF Consultation. Geneva, Switzerland: World Health Organization; 2006
• 9 Dhas Y, Banerjee J, Damle G. et al. Association of vitamin D deficiency with insulin resistance in middle-aged type 2 diabetics. Clin Chim Acta 2019; 492: 95-101
• 10 Varley H, Gowenlock AK, Bell M. Practical Clinical Biochemistry. Fifth ed. London: William Hienemann Medical Book Ltd,; 1980
• 11 Mishra N, Singh N. Blood viscosity, lipid profile, and lipid peroxidation in type-1 diabetic patients with good and poor glycemic control. N Am J Med Sci 2013; 5: 562-566
• 12 Wu TT, Gao Y, Zheng YY. et al. Atherogenic index of plasma (AIP): A novel predictive indicator for the coronary artery disease in postmenopausal women. Lipids Health Dis 2018; 17: 197
• 13 D’Agostino SrRB, Pencina MJ, Massaro JM. et al. Cardiovascular disease risk assessment: insights from Framingham. Glob Heart 2013; 8: 11-23
• 14 Akhtar T, Aggarwal R, Jain SK. Serum vitamin D level in patients with coronary artery disease and association with sun exposure: experience from a tertiary care, teaching hospital in India. Adv Med 2019; 2019: 1-4
• 15 Sarma D, Chauhan VS, Saikia KK. et al. Prevalence pattern of key polymorphisms in the vitamin D receptor gene among patients of type 2 diabetes mellitus in Northeast India. Indian J Endocr Metab 2018; 22: 229
• 16 Roy A, Lakshmy R, Tarik M. et al. Independent association of severe vitamin D deficiency as a risk of acute myocardial infarction in Indians. Indian Heart J 2015; 67: 27-32
• 17 Sahota O, Gaynor K, Harwood RH. et al. Hypovitaminosis D and 'functional hypoparathyroidism'-the NoNoF (Nottingham Neck of Femur) study. Age Ageing 2001; 30: 467-472
• 18 Sahota O, Mundey MK, San P. et al. Vitamin D insufficiency and the blunted PTH response in established osteoporosis: the role of magnesium deficiency. Osteoporos Int 2006; 17: 1013-1021
• 19 Patel S, Hyer S, Barron J. Glomerular filtration rate is a major determinant of the relationship between 25-hydroxyvitamin D and parathyroid hormone. Calcif Tissue Int 2007; 80: 221-226
• 20 Saliba W, Barnett O, Rennert HS. et al. The relationship between serum 25(OH)D and parathyroid hormone levels. Am J Med 2011; 124: 1165-1170
• 21 Syal SK, Kapoor A, Bhatia E. et al. Vitamin D deficiency, coronary artery disease, and Endothelial Dysfunction: Observations from a coronary angiographic study in Indian patients. J Invasive Cardiol 2012; 24: 385-389
• 22 Joergensen C, Reinhard H, Schmedes A. et al. Vitamin D levels and asymptomatic coronary artery disease in type 2 diabetic patients with elevated urinary albumin excretion rate. Diabetes Care 2012; 35: 168-172
• 23 Wang L, Song Y, Manson J. et al. Circulating 25-hydroxy-vitamin D and risk of cardiovascular disease: a meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes 2012; 5: 819-829
• 24 Adela R, Borkar RM, Bhandi MM. et al. Lower vitamin D metabolites levels were associated with increased coronary artery diseases in type 2 diabetes patients in India. Sci Rep 2016; 6: 37593
• 25 Wu-Wong JR, Nakane M, Ma J. et al. Effects of vitamin D analogs on gene expression profiling in human coronary artery smooth muscle cells. Atherosclerosis 2006; 186: 20-28
• 26 Rostand SG, Drueke TB. Parathyroid hormone, vitamin D, and cardiovascular disease in chronic renal failure. Kidney Int 1999; 56: 383-392
• 27 Tastan I, Schreckenberg R, Mufti S. et al. Parathyroid hormone improves contractile performance of adult rat ventricular cardiomyocytes at low concentrations in a non-acute way. Cardiovasc Res 2009; 82: 77-83
• 28 Dunlop TW, Vaisanen S, Frank C. et al. The human peroxisome proliferator-activated receptor delta gene is a primary target of 1alpha, 25-dihydroxyvitamin D3 and its nuclear receptor. J Mol Biol 2005; 349: 248-260
• 29 Li YC, Kong J, Wei M. et al. 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest 2002; 110: 229-238
• 30 Funakoshi Y, Ichiki T, Shimokawa H. et al. Rho-kinase mediates angiotensin II-induced monocyte chemoattractant protein-1 expression in rat vascular smooth muscle cells. Hypertension 2001; 38: 100-104