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J Clin Endocrinol Metab. 2018 Mar 23. doi: 10.1210/jc.2018-00136. [Epub ahead of print]

Association of Vitamin D deficiency with peripheral arterial disease: a meta-analysis of literature studies.

Author information

Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy.
Department of Translational Medical Sciences, Federico II University, Naples, Italy.



Vitamin D deficiency patients have an increased cardiovascular (CV) morbidity and mortality. Contrasting data are available about the association between peripheral arterial disease (PAD) and Vitamin D status.


To perform a meta-analysis of studies evaluating the association between Vitamin D status and PAD.

Data sources:

Studies were systematically searched in the PubMed, Web of Science, Scopus and EMBASE databases.


Ten studies with data on Vitamin D levels in 2,079 PAD patients and 18,233 non-PAD controls and 6 studies on the prevalence of PAD in 23,171 subjects with Vitamin D deficiency (<20 ng/ml), 48,311 subjects with Vitamin D insufficiency (20-30 ng/ml) and 27,910 with normal Vitamin D levels (>30 ng/ml) were included. Compared to controls, PAD patients showed significantly lower Vitamin D levels (MD: -2.24 ng/ml; 95%CI: -3.38, -1.10; p<0.001, I2=86.5%; p<0.001). Moreover, a higher prevalence of PAD was found both in subjects with Vitamin D insufficiency (OR: 1.098, 95%CI: 1.010-1.195, p=0.029, I2: 0%, p=0,600) and in subjects with Vitamin D deficiency (OR: 1.484, 95%CI: 1.348-1.635, p<0.001, I2: 7.65%, p=0,367) compared with controls with normal Vitamin D levels. Sensitivity analyses and the analysis of data on the cumulative risk of PAD according to Vitamin D levels derived from multivariate analysis consistently confirmed results.


PAD patients have lower vitamin D levels than controls and both Vitamin D deficiency and Vitamin D insufficiency are significantly associated with PAD. Reduced Vitamin D levels might represent an independent risk factor for PAD and, in turn, for CV events.


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