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Serum 25-Hydroxyvitamin D Levels Are Not Associated with Subclinical Vascular Disease or C-Reactive Protein in the Old Order Amish

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Abstract

The relationship between vitamin D metabolites and subclinical vascular disease is controversial. Because low serum levels of 25-hydroxyvitamin D (25(OH)D) have been associated with many cardiovascular disease (CVD) risk factors, we hypothesized that serum 25(OH)D levels would be inversely associated with inflammation as measured by C-reactive protein (CRP) and with subclinical vascular disease as measured by carotid intimal medial thickness (cIMT) and coronary artery calcification (CAC). We measured 25(OH)D levels in 650 Amish participants. CAC was measured by computed tomography and cIMT by ultrasound. The associations of 25(OH)D levels with natural log(CAC + 1), cIMT, and natural log(CRP) levels were estimated after adjustment for age, sex, family structure, and season of examination. Additional analyses were carried out adjusting for body mass index (BMI) and other CVD risk factors. 25(OH)D deficiency (<20 ng/ml) and insufficiency (21–30 ng/ml) were common among the Amish (38.2% and 47.7%, respectively). 25(OH)D levels were associated with season, age, BMI, and parathyroid hormone levels. In neither the minimally or fully adjusted analyses were significant correlations observed between 25(OH)D levels and CAC, cIMT, or CRP (R 2 < 0.01 for all). Contrary to our hypothesis, this study failed to detect a cross-sectional association between serum 25(OH)D levels and CAC, cIMT, or CRP. Either there is no causal relationship between 25(OH)D and CVD risk, or if there is, it may be mediated through mechanisms other than subclinical vascular disease severity.

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Acknowledgments

We acknowledge our Amish liaisons and field workers and the cooperation and support of the Amish community, without which these studies would not have been possible. This work was supported by research grants R01 HL088119, R01 AR046838, U01 HL72515, University of Maryland General Clinical Research Center (GCRC), grant M01 RR 16500, Johns Hopkins University GCRC, grant M01 RR 000052, GCRC, National Center for Research Resources, Maryland Clinical Nutrition and Research Unit, grant P30 DK072488, NIH; and Baltimore Veterans Administration Geriatric Research and Education Clinical Center. Dr. E.D.M. is funded by a Clinician Scientist Award at Johns Hopkins School of Medicine and a Career Development Award through American College of Cardiology Foundation in conjunction with Pfizer.

E.D.M. received a one-time minimal honorarium from Abbott pharmaceuticals. The other authors have no conflict of interest related to this article.

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Authors and Affiliations

  1. Division of Cardiology, Johns Hopkins University School of Medicine, Carneige 568, 600 N. Wolfe Street, Baltimore, MD, 21287, USA

    Erin D. Michos & Wendy Post

  2. Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA

    Elizabeth A. Streeten, Kathleen A. Ryan, Evadnie Rampersaud, Alan R. Shuldiner & Braxton D. Mitchell

  3. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA

    Patricia A. Peyser & Lawrence F. Bielak

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  1. Erin D. Michos
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  2. Elizabeth A. Streeten
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Correspondence to Erin D. Michos.

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Michos, E.D., Streeten, E.A., Ryan, K.A. et al. Serum 25-Hydroxyvitamin D Levels Are Not Associated with Subclinical Vascular Disease or C-Reactive Protein in the Old Order Amish. Calcif Tissue Int 84, 195–202 (2009). https://doi.org/10.1007/s00223-008-9209-3

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