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J Clin Endocrinol Metab. 2013 Jan;98(1):389-97. doi: 10.1210/jc.2012-3097. Epub 2012 Nov 8.

Vitamin D status and coronary flow reserve measured by positron emission tomography: a co-twin control study.

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  • 1Division of Cardiology, Department of Medicine, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA.

Abstract

CONTEXT:

Vitamin D insufficiency is associated with increased cardiovascular events in the general population. Additionally, low serum 25-hydroxyvitamin D [25(OH)D] is associated with endothelial dysfunction and arterial stiffness. However, little is known about the association between serum 25(OH)D level and myocardial blood flow.

OBJECTIVE:

Our objective was to examine the association between serum 25(OH)D levels and coronary flow reserve (CFR) measured by (13)N-positron emission tomography in asymptomatic middle-aged male twins.

DESIGN:

The Emory Twin Study is a cross-sectional study of soldiers from the Vietnam Era Registry.

SETTING:

The study was conducted at the General Clinical Research Center, Emory University, Atlanta, GA.

PARTICIPANTS:

A total of 368 middle-aged male twins were enrolled for the study. Serum 25(OH)D levels were measured in all subjects and classified as vitamin D insufficiency [25(OH)D <30 ng/ml] or sufficiency [25(OH)D ≥30 ng/ml]. Positron emission tomography with [(13)N]ammonia was used to evaluate myocardial blood flow at rest and after adenosine stress. CFR was measured as the ratio of maximum to rest myocardial blood flow.

MAIN OUTCOME MEASURE:

Primary outcome was CFR measurement.

RESULTS:

Mean overall serum 25(OH)D concentration was 37.0 ± 21.4 ng/ml; 167 twins (45%) were vitamin D insufficient. CFR was significantly lower in subjects with vitamin D insufficiency compared with subjects with vitamin D sufficiency (2.41 vs. 2.64; P = 0.007), even after adjustment for traditional cardiovascular risk factors, serum PTH, calcium, and phosphorus levels, and season. An abnormal CFR (CFR <2) was more prevalent in subjects with vitamin D insufficiency than with vitamin D sufficiency (31 vs. 20%; P = 0.03). In addition, in vitamin D status-discordant twin pairs, CFR was significantly lower in the vitamin D-insufficient twin than in the vitamin D-sufficient co-twin (2.35 vs. 2.58; P = 0.037).

CONCLUSION:

Vitamin D insufficiency is associated with lower CFR in men. This association may help explain some of the increased cardiovascular risk reported in individuals with vitamin D insufficiency.

PMID:
23144471
[PubMed - indexed for MEDLINE]
PMCID:
PMC3537102
Free PMC Article

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