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J Clin Endocrinol Metab. 2014 Sep;99(9):3382-9. doi: 10.1210/jc.2014-1536. Epub 2014 Jun 3.

Vitamin D and endothelial vasodilation in older individuals: data from the PIVUS study.

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  • 1Geriatric Rehabilitation Department (M.M., F.D.V., F.L., G.P.C.), University Hospital of Parma, 43126 Parma, Italy; Department of Clinical and Experimental Medicine (M.M., G.P.C.), Section of Geriatrics, University of Parma, 43126 Parma, Italy; Department of Internal Medicine (E.V.), Division of Geriatrics, and Sealy Center on Aging, University of Texas Medical Branch, Galveston, Galveston, Texas 77555-0264; Department of Clinical Medicine, Cardiovascular and Immunological Sciences (F.G.), University of Naples Federico II, 80138 Napoli, Italy; Cardiac Surgery Unit (G.D.C.), Community Hospital of Brescia, 25123 Brescia, Italy; Azienda USL Piacenza (C.C.), 23121 Piacenza, Italy; Department of Medical Sciences (H.M.), Uppsala University, 751 85 Uppsala, Sweden; Department of Surgical Sciences (K.M.), Uppsala University, 751 85 Uppsala, Sweden; Department of Medicine (T.C.), Uppsala University Hospital, 751 85 Uppsala, Sweden; and Department of Public Health and Caring Sciences (L.L.), Section of Clinical Nutrition and Metabolism, Uppsala University, 751 85 Uppsala, Sweden.



Vitamin D plays a role in a wide range of extraskeletal processes, including vascular function. Endothelial dysfunction is a predictor of cardiovascular disease, especially in older subjects. However, the relationship between vitamin D levels and indexes of endothelial vasodilation has never been fully addressed in older individuals.


The objective of this study was to examine the association between vitamin D and endothelial function in a large community-based sample of older subjects.


This cross-sectional study involved 852 community-dwelling men and women aged 70 years from the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS), with complete data on vascular function and 25-hydroxyvitamin D. We evaluated endothelium-dependent vasodilation by an invasive forearm technique with acetylcholine, endothelium-independent vasodilation by sodium nitroprussiate, flow-mediated vasodilation, and the pulse wave analysis (reflectance index). Vitamin D levels were measured by chemiluminescence. We used multivariate regression models adjusted for body mass index (model 1) and for multiple confounders (high-sensitivity C-reactive protein, insulin, total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, smoking, sex hormones, season of blood collection, hypertension, diabetes, cardiovascular medications and diseases, statin usage, plasma calcium and calcium intake, PTH, physical exercise, liver and kidney function tests, albumin; model 2).


In women, but not in men, vitamin D levels were positively associated with endothelium-independent vasodilation in both model 1 (β ± SE = 1.41 ± 0.54; P = .001), and model 2 (β ± SE = 2.01 ± 0.68; P = .003).We found no significant relationship between vitamin D levels and endothelium-dependent vasodilation, flow-mediated vasodilation, and reflectance index in both sexes.


In older women, but not in men, vitamin D is positively and independently associated with EIDV.

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