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Scand J Rheumatol. 2017 May;46(3):198-205. doi: 10.3109/03009742.2016.1172664. Epub 2016 Jul 5.

Plasma vitamin D levels and inflammation in the aortic wall of patients with coronary artery disease with and without inflammatory rheumatic disease.

Author information

a Department of Pathology , Innlandet Hospital Trust , Lillehammer , Norway.
b Institute of Clinical Medicine , University of Oslo , Oslo , Norway.
c Department of Health, Technology and Society , Norwegian University of Science and Technology , Gjøvik , Norway.
d Department of Medical Biochemistry , Oslo University Hospital , Oslo , Norway.
e Department of Rheumatology, Dermatology and Infectious Diseases , University of Oslo , Oslo , Norway.
f Department of Medical Biochemistry , Innlandet Hospital Trust , Lillehammer , Norway.
g Oslo Centre for Biostatistics and Epidemiology, Research Support Services , Oslo University Hospital , Oslo , Norway.
h University of North Norway , Tromsø , Norway.
i Lillehammer Hospital for Rheumatic Diseases , Lillehammer , Norway.



Vitamin D modulates inflammation, and this may explain the observed associations between vitamin D status and disorders driven by systemic inflammation, such as coronary artery disease (CAD) and inflammatory rheumatic diseases (IRDs). The aims of this study were to assess vitamin D status in patients with CAD alone and in patients with CAD and IRD, and to explore potential associations between vitamin D status and the presence of mononuclear cell infiltrates (MCIs) in the aortic adventitia of these patients.


Plasma levels of 25-hydroxyvitamin D3 [(25(OH)D3] were determined by radioimmunoassay and 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] by enzyme immunoassay in the 121 patients from the Feiring Heart Biopsy Study (FHBS) who had available histology data on adventitial MCIs; 53 of these had CAD alone and 68 had CAD and IRD.


In the crude analysis, vitamin D levels were similar in CAD patients with and without IRD. After adjustment for potential confounders, IRD was associated with an increase of 8.8 nmol/L [95% confidence interval (CI) 1.0-16.6; p = 0.027] in 25(OH)D3 and an increase of 18.8 pmol/L (95% CI 4.3-33.3; p = 0.012) in 1,25(OH)2D3, while MCIs in the aortic adventitia were associated with lower levels of 1,25(OH)2D3 (β = -18.8, 95% CI -33.6 to -4.0; p = 0.014).


IRD was associated with higher levels of both 25(OH)D3 and 1,25(OH)2D3. These findings argue against the hypothesis that patients with high systemic inflammatory burden (CAD+IRD) should have lower vitamin D levels than those with less inflammation (CAD only). Of note, when controlled for potential confounders, low 1,25(OH)2D3 levels were associated with adventitial aortic inflammation.

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