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J Clin Endocrinol Metab. 2017 May 9. doi: 10.1210/jc.2017-00342. [Epub ahead of print]

Impact of Vitamin D deficiency on subclinical carotid atherosclerosis: a pooled analysis of cohort studies.

Author information

1
Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
2
Centro Cardiologico Monzino, IRCCS, Milan, Italy
3
Department of Advanced Biomedical Sciences, Division of Cardiology, Federico II University, Naples, Italy

Abstract

Context:

Vitamin D deficiency patients have an increased cardiovascular (CV) morbidity and mortality. Carotid intima-media thickness (IMT) and carotid plaques are markers of subclinical atherosclerosis and predictors of CV events.

Objective:

To perform a meta-analysis of studies evaluating the impact of Vitamin D deficiency on common carotid artery IMT (CCA-IMT) and on the prevalence of carotid plaques.

Data Sources:

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

Results:

Twenty-one studies (3,777 Vitamin D deficiency patients and 4,792 controls) with data on CCA-IMT and 6 studies (1,889 Vitamin D deficiency patients and 2,883 controls) on the prevalence of carotid plaques were included. Compared to controls, Vitamin D deficiency patients showed a significantly higher CCA-IMT (mean difference [MD]: 0.043 mm; 95%CI: 0.030, 0.056; P<0.001), and an increased prevalence of carotid plaques (Odds Ratio [OR]: 2.29, 95%CI: 1.03-5.11; P=0.043) with an attributable risk of 35.9%. When selecting studies specifically including patients with diabetes, the prevalence of carotid plaques in Vitamin D deficiency patients than in controls resulted higher (OR: 3.27; 95%CI: 1,62-6.62; P=0.001). A significant difference in CCA-IMT was confirmed when comparing patients with Vitamin D insufficiency to controls (MD: 0.011; 95%CI: 0.010-0.012, P<0.001). Sensitivity analyses substantially confirmed results and regression models showed that with the exception of LDL-cholesterol, HDL-cholesterol, triglycerides and the prevalence of hypercholesterolemia, all the other clinical and demographic co-variates significantly impacted on the difference in CCA-IMT between Vitamin D deficiency patients and controls.

Conclusions:

Both Vitamin D deficiency and Vitamin D insufficiency are associated with subclinical atherosclerosis, potentially suggesting an increased CV risk in these clinical settings.

KEYWORDS:

atherosclerosis; ldl cholesterol lipoproteins; high density lipoprotein cholesterol; triglycerides; hypercholesterolemia; diabetes mellitus; vitamin d deficiency; cardiovascular disease risk factors; carotid atherosclerosis; diabetes mellitus, type 2; cardiovascular system; carotid artery, common; demography; morbidity; mortality; cardiovascular event; attributable; sensitivity analysis; carotid intima-media thickness; embase

PMID:
28609831
DOI:
10.1210/jc.2017-00342

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