|
 
 |
| ORIGINAL ARTICLE |
|
| Year : 2016 | Volume
: 8
| Issue : 7 | Page : 284-290 |
|
Associations between serum 25-hydroxyvitamin D and lipids, lipoprotein cholesterols, and homocysteine
Charles J Glueck, Vybhav Jetty, Matan Rothschild, Gregory Duhon, Parth Shah, Marloe Prince, Kevin Lee, Michael Goldenberg, Ashwin Kumar, Naila Goldenberg, Ping Wang
The Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Ohio, USA
| Date of Web Publication | 27-Jul-2016 |
Correspondence Address:
Charles J Glueck
Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Ohio
USA
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1947-2714.187137
Background: Serum 25(OH) vitamin D levels are inversely associated with cardiovascular disease (CVD) mortality, mediated in part by independent positive relationships with high-density lipoprotein cholesterol (HDLC) and inverse relationships with low-density lipoprotein cholesterol (LDLC), triglyceride, and homocysteine. Aims: In this study, we assessed relationships between fasting serum vitamin D and lipids, lipoprotein cholesterols, and homocysteine. Materials and Methods: We studied 1534 patients sequentially referred to our center from 2007 to 2016. Fasting serum total 25(OH) vitamin D, plasma cholesterol, triglyceride, HDLC, LDLC, and homocysteine were measured. Stepwise regression models were used with total cholesterol, triglyceride, HDLC, LDLC, and homocysteine as dependent variables and explanatory variables age, race, gender, body mass index (BMI), and serum vitamin D levels. Relationships between quintiles of serum vitamin D and triglycerides, HDLC, LDLC, and homocysteine were assessed after covariance adjusting for age, race, gender, and BMI. Results: Fasting serum vitamin D was positively correlated with age, HDLC, and White race, and was inversely correlated with BMI, total and LDL cholesterol, triglyceride, and fasting serum homocysteine (P ≤ 0.0001 for all). Serum vitamin D was a significant independent inverse explanatory variable for total cholesterol, triglyceride, and LDL cholesterol, and accounted for the largest amount of variance in serum total cholesterol (partial R 2 =3.6%), triglyceride (partial R 2 =3.1%), and LDLC (partial R 2 =2.9%) (P < 0.0001 for all). Serum vitamin D was a significant positive explanatory variable for HDLC (partial R 2 =1.4%, P < 0.0001), and a significant inverse explanatory variable for homocysteine (partial R 2 = 6.0-12.6%). Conclusions: In hyperlipidemic patients, serum vitamin D was a significant independent inverse determinant of total cholesterol, LDLC, triglyceride, and homocysteine, and a significant independent positive determinant of HDLC. Thus, serum vitamin D might be protective against CVD. Keywords: Cardiovascular disease, cholesterol, estimated glomerular filtration rate, high density lipoprotein cholesterol, homocysteine, low density lipoprotein cholesterol, myocardial infarction, triglycerides, Vitamin D
How to cite this article:
Glueck CJ, Jetty V, Rothschild M, Duhon G, Shah P, Prince M, Lee K, Goldenberg M, Kumar A, Goldenberg N, Wang P. Associations between serum 25-hydroxyvitamin D and lipids, lipoprotein cholesterols, and homocysteine. North Am J Med Sci 2016;8:284-90 |
How to cite this URL:
Glueck CJ, Jetty V, Rothschild M, Duhon G, Shah P, Prince M, Lee K, Goldenberg M, Kumar A, Goldenberg N, Wang P. Associations between serum 25-hydroxyvitamin D and lipids, lipoprotein cholesterols, and homocysteine. North Am J Med Sci [serial online] 2016 [cited 2023 Jun 4];8:284-90. Available from: https://www.najms.org/text.asp?2016/8/7/284/187137 |
| Introduction | |  |
Serum vitamin D levels are associated with adiposity, insulin resistance, and metabolic syndrome, [1],[2] and it is not surprising that low levels of serum vitamin D are significant independent predictors of cardiovascular disease (CVD). [3],[4] High levels of vitamin D and high density lipoprotein cholesterol (HDLC) are associated with a lower risk of CVD. [5] There are independent and significant positive correlations between serum vitamin D and apolipoprotein A1 and HDLC in adult men and women. [6] Vitamin D deficiency has been reported to be an independent predictor of elevated triglycerides in Spanish school children. [7] Vitamin D supplementation in Argentine school children increased HDLC and decreased triglyceride. [8] In women with polycystic ovary syndrome, vitamin D therapy decreased total cholesterol, triglyceride, and very low density lipoprotein cholesterol (LDLC), however, did not affect HDLC or apolipoprotein A1. [9]
In some studies, vitamin D supplementation has been reported to have no significant effect on CVD mortality [10] or on the incidence of myocardial infarction (MI) or stroke. [11] Wang et al. reported a nonsignificant reduction in CVD with moderate-to-high doses of vitamin D (risk ratio: 0.90; 95% confidence interval (CI): 0.77-1.05). [12] Vitamin D supplementation may protect against cardiac failure in older people, however, in a meta-analysis, it did not appear to protect against MI or stroke. [13]
In 1534 patients referred to our Cholesterol Center from 2007 to 2016, we assessed pretreatment entry relationships between fasting serum vitamin D and lipids, lipoprotein cholesterols, and homocysteine to better understand the independent relationships of serum vitamin D to CVD risk factors.
| Materials and Methods | | |
The study was carried out following protocol #12-03 approved by the Jewish Hospital Institutional Review Board.
Participants
We evaluated routine lipid, lipoprotein, homocysteine, and serum vitamin D determinations drawn at study entry after an overnight fast as part of our standard clinical initial evaluation of referred patients, following a protocol approved by the Institutional Review Board of the Jewish Hospital of Cincinnati. We studied 1534 patients in the consecutive order of their referral from 2007 to 2016.
Laboratory determinations
At the initial visit, after an overnight fast, blood was drawn for serum total 25(OH) vitamin D levels quantitated by two-dimensional high performance liquid chromatography (HPLC) with tandem mass spectrometry detection after protein precipitation. [14] The laboratory lower normal limit for total 25(OH) vitamin D was 32 ng/ml. [14] Additional measures included plasma cholesterol, triglyceride, HDLC, LDLC, and in some patients, fasting serum homocysteine and estimated glomerular filtration rate (eGFR).
Statistical analysis
Because the data was not normally distributed, Spearman correlation coefficients were calculated between serum vitamin D and other variables. Stepwise regression models were used with total cholesterol, triglyceride, HDLC, LDLC, and homocysteine as dependent variables, and explanatory variables such as age, race, gender, body mass index (BMI), and serum vitamin D levels.
To assess whether the association between serum vitamin D and homocysteine (or lipids) might be nonlinear, a spline second-degree function of vitamin D with a single knot at the cohort median of serum vitamin D (27.6 ng/ml) [Figure 1] was included in the linear regression model [15] to test the hypothesis that the association between serum vitamin D and homocysteine (or lipids) existed up to the median of serum vitamin D, but not above it. | Figure 1: Curvilinear relationship between serum vitamin D and homocysteine. A splined function of vitamin D was used in regression models, knot = 27.6 ng/ml (cohort median for serum vitamin D), and degree = 2
Click here to view |
We categorized serum vitamin D in quintiles, and assessed least square mean triglyceride, HDLC, LDLC, and homocysteine by D quintiles, after covariance adjusting for age, race, gender, and BMI [Figure 2], [Figure 3], [Figure 4] and [Figure 5]. | Figure 2: Unadjusted triglyceride (mean ± SD) in the lowest, middle, and highest vitamin D (VD) quintiles exhibited. Significant differences between groups are shown, with P values taken from comparisons of least squares means after adjustment for age, race, gender, and body mass index
Click here to view |
 | Figure 3: Unadjusted high density lipoprotein cholesterol (mean ± SD) in the lowest, middle, and highest vitamin D quintiles exhibited. Significant differences between groups are shown, with P values taken from comparisons of least squares means after adjustment for age, race, gender, and body mass index
Click here to view |
 | Figure 4: Unadjusted low density lipoprotein cholesterol (mean ± SD) in the lowest, middle, and highest vitamin D quintiles exhibited. Significant differences between groups are shown, with P values taken from comparisons of least squares means after adjustment for age, race, gender, and body mass index
Click here to view |
 | Figure 5: Unadjusted serum homocysteine (mean ± SD) in the lowest, middle, and highest vitamin D quintiles exhibited. Significant differences between groups are shown, with P values taken from comparisons of least squares means after adjustment for age, race, gender, and body mass index
Click here to view |
| Results | | |
As displayed in [Table 1], fasting serum vitamin D was positively correlated with age, HDLC, and White race (P < 0.0001 for all). Serum vitamin D was inversely correlated with BMI, total cholesterol and LDLC, triglyceride, eGFR, and fasting serum homocysteine (P ≤ 0.0001 for all) [Table 1]. | Table 1: Vitamin D, lipids, lipoprotein cholesterols, glomerular filtration rate (eGFR), 1MTHFR genotype, 1and homocysteine1 in 1534 patients at study entry
Click here to view |
Homocysteine was positively correlated with age, BMI, total cholesterol, LDLC, and was inversely correlated with HDLC, eGFR, female gender, and White race [Table 1].
Vitamin D, as a significant negative independent determinant, accounted for the largest amount of variance in serum total cholesterol (partial R 2 =3.6%), triglyceride (partial R 2 =3.1%), and LDLC (partial R 2 =2.9%) [Table 2]. Serum vitamin D was also a significant positive independent predictor for HDLC (partial R 2 =1.4%) [Table 2]. | Table 2: Significant predictors for lipids, lipoprotein cholesterols, and homocysteine with explanatory variables race, gender, age, body mass index, serum vitamin D level (VD), and spline function1 of VD
Click here to view |
Vitamin D was a significant negative independent determinant of triglyceride, with a linear term and a splined quadratic term [[Table 2], panel 2]. The spline quadratic term of vitamin D (with a positive coefficient) was significant for triglyceride in addition to the linear term [[Table 2], panel 2]. The spline quadratic term for vitamin D accounted for an extra decrement in triglyceride up to the cohort mean of vitamin D, 26.7 ng/ml with no further decrements above the median.
Vitamin D was a significant negative independent determinant of LDLC [[Table 2], panel 4] as a linear term, whereas the spline function for vitamin D provided a reduced decrement in LDLC up to the cohort vitamin D median, 26.7 ng/ml.
The curvilinear relationship between homocysteine and vitamin D is displayed in three regression models, which included the splined quadratic function of vitamin D [Table 2], panel 5 and [[Table 3], panels 1 and 2] [Figure 1]. The spline vitamin D quadratic term was a significant predictor of homocysteine; homocysteine decreased when vitamin D increased from low levels up to the cohort median (27.6 ng/ml), however, it did not decrease further as vitamin D increased above 27.6 ng/ml [Figure 1]. | Table 3: Homocysteine 193 observations: Regression model of homocysteine, stepwise selection of explanatory variables: Age, gender, race, BMI, eGFR, TG, HDL, Vitamin D (VD), and spline function of VD
Click here to view |
As displayed in [Table 3], beyond the spline function of vitamin D, other significant explanatory variables for homocysteine included eGFR (inverse) and gender (female lower). Removing the MTHFR genotype, a nonsignificant explanatory variable, allowed an increase in the size of the model [[Table 3], panel 2], and the resultant model was similar. Of the 3 regression models for homocysteine [bottom panel [[Table 2] and 3], the spline function of vitamin D was an important explanatory variable, partial R 2 =6.0-12.6%.
After covariance adjusting for age, race, gender, and BMI, least square (LS) mean triglyceride was highest in patients with the lowest quintile serum vitamin D versus patients in both the middle and top quintiles [Figure 2]. Covariance adjusted HDLC was lowest in patients with lowest quintile serum vitamin D versus those with middle and top quintile vitamin D, and was lower in patients with middle quintile vitamin D than those with top quintile vitamin D [Figure 3]. Covariance adjusted LDLC was highest in patients with the lowest quintile serum vitamin D, lower in patients with middle quintile vitamin D, and was lowest in patients with highest quintile vitamin D [Figure 4]. Covariance adjusted fasting serum homocysteine was highest in patients with the lowest quintile serum vitamin D, and lower in patients with both middle and top quintile serum vitamin D levels [Figure 5].
| Discussion | | |
Our data is congruent with previous studies that reported that higher serum vitamin D levels are associated with lower CVD risk lipid profiles. [16],[17] In our current study of patients referred for the diagnosis and treatment of hyperlipidemia and CVD, serum vitamin D was a significant independent inverse determinant of total cholesterol, LDLC, triglyceride, and homocysteine, and a significant independent positive determinant of HDLC. Within this frame of reference, if vitamin D supplementation lowered total cholesterol, LDLC, and triglyceride, as well as serum homocysteine, and elevated HDLC, it should be antiatherogenic.
Significant independent positive correlations between serum vitamin D and apolipoprotein A1 and HDLC have been reported in adult men and women. [6] In a database of 20360 participants, [18] serum vitamin D was positively associated with HDLC and inversely associated with triglyceride and LDLC. Low serum vitamin D was associated with high LDLC and triglyceride in diabetic and nondiabetic patients with stable CVD. [19] Low vitamin D levels were associated independently with reduced left ventricular ejection fraction. [19] In early childhood, serum vitamin D was inversely associated with nonHDLC, total cholesterol, and triglyceride. [20] Vitamin D deficiency was an independent predictor of elevated triglycerides in Spanish school children. [7]
Several mechanisms have been identified that might partially explain the effects of vitamin D on lipids and lipoproteins. In vitro, vitamin D metabolites can upregulate lipoprotein lipase, [21] increasing HDLC and lowering triglyceride. Vitamin D has anti-inflammatory effects, and might, speculatively, reduce insulin resistance by reducing low-grade chronic inflammation, [22],[23] thus lowering triglycerides and increasing HDLC.
In placebo-controlled vitamin D intervention studies in adults, effects on LDLC, HDLC, and triglyceride have been varied and inconclusive. [24],[25] In the Women's Health Initiative, where 1 g calcium-400 IU vitamin D were given in a double-blind randomized trial, LDLC reduced significantly (P = 0.03), and higher serum concentrations of vitamin D were associated with higher HDLC levels (P = 0.003), along with lower LDLC (P = 0.02) and triglyceride levels (P < 0.001). [26] In a placebo-controlled trial of vitamin D in patients with type 2 diabetes, [27] vitamin D reduced serum total cholesterol, but not triglyceride or HDLC. Although most vitamin D supplementation trials have not demonstrated reduction in CVD, they have used relatively low doses of vitamin D supplementation, emphasizing the important of future trials with higher levels of vitamin D intervention, with focus on cardiovascular events. [25]
Inverse associations between serum vitamin D and homocysteine have been reported in Chinese [28] and North American (NHANES) [15] studies, but not in a Canadian [29] study. An curvilinear inverse association between serum vitamin D and homocysteine has been reported by Amer et al. in individuals with serum vitamin D below the group median (≤21 ng/ml), [15] however, in those with vitamin D levels >21 ng/ml, homocysteine did not fall as serum vitamin D increased. In our study, congruent with the report by Amer et al., [15] vitamin D supplementation should lower homocysteine in subjects with serum vitamin D below the cohort median (27.6 ng/ml-our study), but may not be of benefit for those with serum vitamin D above 27.6 ng/ml. Overall, in the current report, with the spline term [15] in the model, vitamin D independently accounted for 6.0-12.6% of the variance of homocysteine, and, as such, vitamin D supplementation for subjects with serum vitamin D below the median should, speculatively, reduce the homocysteine-mediated risk of ischemic stroke. [30],[31]
Risk factors for CVD including blood pressure, [32] smoking, [23] obesity, [33],[34] physical inactivity, [35] and advanced age [36] are associated with lower serum vitamin D, making it difficult to ascribe an independent role of vitamin D in the development of CVD. However, there is an inverse association between vitamin D and all-cause mortality, [37] and Shotker et al. reported consistent inverse associations between vitamin D quintiles and both cardiovascular and all-cause mortality. [38] We speculate that the relationships between serum vitamin D and both lipoprotein cholesterols and homocysteine underlie the reported [38] inverse association of vitamin D with cardiovascular mortality. Placebo-controlled clinical trials of vitamin D supplementation in hyperlipidemic and hyperhomocysteinemic cohorts will be required to cross the bridge from correlation to causation.
| Conclusion | | |
In hyperlipidemic patients, serum vitamin D is a significant independent inverse determinant of total cholesterol, LDLC, triglyceride, and homocysteine, and a significant independent positive determinant of HDLC. We speculate that through these relationships, serum vitamin D might be protective against CVD.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Ford ES, Ajani UA, McGuire LC, Liu S. Concentrations of serum vitamin D and the metabolic syndrome among U.S. adults. Diabetes Care 2005;28:1228-30.  |
| 2. | Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr 2004;79:820-5. [ PUBMED] |
| 3. | Anderson JL, May HT, Horne BD, Bair TL, Hall NL, Carlquist JF, et al. Relation of vitamin D deficiency to cardiovascular risk factors, disease status, and incident events in a general healthcare population. Am J Cardiol 2010;106:963-8. [ PUBMED] |
| 4. | Beveridge LA, Witham MD. Vitamin D and the cardiovascular system. Osteoporos Int 2013;24:2167-80. [ PUBMED] |
| 5. | Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation 2008;117:503-11. [ PUBMED] |
| 6. | Auwerx J, Bouillon R, Kesteloot H. Relation between 25-hydroxyvitamin D3, apolipoprotein A-I, and high density lipoprotein cholesterol. Arterioscler Thromb 1992;12:671-4. [ PUBMED] |
| 7. | Rodriguez-Rodriguez E, Aparicio A, Lopez-Sobaler AM, Ortega RM. Vitamin D status in a group of Spanish schoolchildren. Minerva Pediatr 2011;63:11-8. |
| 8. | Hirschler V, Maccallini G, Tamborenea MI, Gonzalez C, Sanchez M, Molinari C, et al. Improvement in lipid profile after vitamin D supplementation in indigenous argentine school children. Cardiovasc Hematol Agents Med Chem 2014;12:42-9. |
| 9. | Rahimi-Ardabili H, Pourghassem Gargari B, Farzadi L. Effects of vitamin D on cardiovascular disease risk factors in polycystic ovary syndrome women with vitamin D deficiency. J Endocrinol Invest 2013;36:28-32. |
| 10. | Bjelakovic G, Gluud LL, Nikolova D, Whitfield K, Krstic G, Wetterslev J, et al. Vitamin D supplementation for prevention of cancer in adults. Cochrane Database Syst Rev 2014;6:CD007469. [ PUBMED] |
| 11. | Elamin MB, Abu Elnour NO, Elamin KB, Fatourechi MM, Alkatib AA, Almandoz JP, et al. Vitamin D and cardiovascular outcomes: A systematic review and meta-analysis. J Clin Endocrinol Metab 2011;96:1931-42. [ PUBMED] |
| 12. | Wang L, Manson JE, Song Y, Sesso HD. Systematic review: Vitamin D and calcium supplementation in prevention of cardiovascular events. Ann Intern Med 2010;152:315-23. [ PUBMED] |
| 13. | Ford JA, MacLennan GS, Avenell A, Bolland M, Grey A, Witham M. Cardiovascular disease and vitamin D supplementation: Trial analysis, systematic review, and meta-analysis. Am J Clin Nutr 2014;100:746-55. |
| 14. | Tsugawa N, Suhara Y, Kamao M, Okano T. Determination of 25-hydroxyvitamin D in human plasma using high-performance liquid chromatography--Tandem mass spectrometry. Anal Chem 2005;77:3001-7. [ PUBMED] |
| 15. | Amer M, Qayyum R. The relationship between 25-hydroxyvitamin D and homocysteine in asymptomatic adults. J Clin Endocrinol Metab 2014;99:633-8. [ PUBMED] |
| 16. | Martins D, Wolf M, Pan D, Zadshir A, Tareen N, Thadhani R, et al. Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the United States: Data from the Third National Health and Nutrition Examination Survey. Arch Intern Med 2007;167:1159-65. [ PUBMED] |
| 17. | Cheng S1, Massaro JM, Fox CS, Larson MG, Keyes MJ, McCabe EL, et al. Adiposity, cardiometabolic risk, and vitamin D status: The Framingham Heart Study. Diabetes 2010;59:242-8. |
| 18. | Lupton JR, Faridi KF, Martin SS, Sharma S, Kulkarni K, Jones SR, et al. Deficient serum 25-hydroxyvitamin D is associated with an atherogenic lipid profile: The Very Large Database of Lipids (VLDL-3) study. J Clin Lipidol 2016;10:72-81 e1. |
| 19. | Pekkanen MP, Ukkola O, Hedberg P, Piira OP, Lepojärvi S, Lumme J, et al. Serum 25-hydroxyvitamin D is associated with major cardiovascular risk factors and cardiac structure and function in patients with coronary artery disease. Nutr Metab Cardiovasc Dis 2015;25:471-8. |
| 20. | Birken CS, Lebovic G, Anderson LN, McCrindle BW, Mamdani M, Kandasamy S, et al. Association between Vitamin D and Circulating Lipids in Early Childhood. PLoS One 2015;10:e0131938. |
| 21. | Querfeld U, Hoffmann MM, Klaus G, Eifinger F, Ackerschott M, Michalk D, et al. Antagonistic effects of vitamin D and parathyroid hormone on lipoprotein lipase in cultured adipocytes. J Am Soc Nephrol 1999;10:2158-64. |
| 22. | Hewison M. An update on vitamin D and human immunity. Clin Endocrinol 2012;76:315-25. |
| 23. | Chagas CE, Borges MC, Martini LA, Rogero MM. Focus on vitamin D, inflammation and type 2 diabetes. Nutrients 2012;4:52-67. [ PUBMED] |
| 24. | Jorde R, Grimnes G. Vitamin D and metabolic health with special reference to the effect of vitamin D on serum lipids. Prog Lipid Res 2011;50:303-12. [ PUBMED] |
| 25. | Schnatz PF, Manson JE. Vitamin D and cardiovascular disease: An appraisal of the evidence. Clin Chem 2014;60:600-9. [ PUBMED] |
| 26. | Schnatz PF, Jiang X, Vila-Wright S, Aragaki AK, Nudy M, O'Sullivan DM, et al. Calcium/vitamin D supplementation, serum 25-hydroxyvitamin D concentrations, and cholesterol profiles in the Women's Health Initiative calcium/vitamin D randomized trial. Menopause 2014;21:823-33. [ PUBMED] |
| 27. | Jafari T, Fallah AA, Barani A. Effects of vitamin D on serum lipid profile in patients with type 2 diabetes: A meta-analysis of randomized controlled trials. Clin Nutr 2016 [Epub ahead of print]. |
| 28. | Mao X, Xing X, Xu R, Gong Q, He Y, Li S, et al. Folic Acid and Vitamins D and B12 Correlate With Homocysteine in Chinese Patients With Type-2 Diabetes Mellitus, Hypertension, or Cardiovascular Disease. Medicine 2016;95:e2652. [ PUBMED] |
| 29. | Garcia-Bailo B, Da Costa LA, Arora P, Karmali M, El-Sohemy A, Badawi A. Plasma vitamin D and biomarkers of cardiometabolic disease risk in adult Canadians, 2007-2009. Prev Chronic Dis 2013;10:E91. |
| 30. | Spence JD, Bang H, Chambless LE, Stampfer MJ. Vitamin Intervention For Stroke Prevention trial: An efficacy analysis. Stroke 2005;36:2404-9. [ PUBMED] |
| 31. | Toole JF, Malinow MR, Chambless LE, Spence JD, Pettigrew LC, Howard VJ, et al. Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death: The Vitamin Intervention for Stroke Prevention (VISP) randomized controlled trial. JAMA 2004;291:565-75. [ PUBMED] |
| 32. | Witham MD, Nadir MA, Struthers AD. Effect of vitamin D on blood pressure: A systematic review and meta-analysis. J Hypertens 2009;27:1948-54. [ PUBMED] |
| 33. | Oliai Araghi S, van Dijk SC, Ham AC, Brouwer-Brolsma EM, Enneman AW, Sohl E, et al. BMI and Body Fat Mass Is Inversely Associated with Vitamin D Levels in Older Individuals. J Nutr Health Aging 2015;19:980-5. [ PUBMED] |
| 34. | Ren W, Gu Y, Zhu L, Wang L, Chang Y, Yan M, et al. The effect of cigarette smoking on vitamin D level and depression in male patients with acute ischemic stroke. Compr Psychiatry 2016;65:9-14. |
| 35. | Baker CP, Kulkarni B, Radhakrishna KV, Charyulu MS, Gregson J, Matsuzaki M, et al. Is the Association between Vitamin D and Cardiovascular Disease Risk Confounded by Obesity? Evidence from the Andhra Pradesh Children and Parents Study (APCAPS). PLoS One 2015;10:e0129468. [ PUBMED] |
| 36. | Savji N, Rockman CB, Skolnick AH, Guo Y, Adelman MA, Riles T, et al. Association between advanced age and vascular disease in different arterial territories: A population database of over 3.6 million subjects. J Am Coll Cardiol 2013;61:1736-43. [ PUBMED] |
| 37. | Chien KL, Hsu HC, Chen PC, Lin HJ, Su TC, Chen MF, et al. Total 25-hydroxyvitamin D concentration as a predictor for all-cause death and cardiovascular event risk among ethnic Chinese adults: A cohort study in a Taiwan community. PLoS One 2015;10:e0123097. [ PUBMED] |
| 38. | Schottker B, Jorde R, Peasey A, Thorand B, Jansen EH, Groot LD, et al. Vitamin D and mortality: Meta-analysis of individual participant data from a large consortium of cohort studies from Europe and the United States. BMJ 2014;348:g3656. |
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]
[Table 1], [Table 2], [Table 3]
| This article has been cited by | | 1 |
Correlation of Vitamin 25(OH)D, Liver Enzymes, Potassium, and Oxidative Stress Markers with Lipid Profile and Atheromatic Index: A Pilot Study |
|
| Stavroula Ioannidou, Konstantina Kazeli, Hristos Ventouris, Dionysia Amanatidou, Argyrios Gkinoudis, Evgenia Lymperaki | | Journal of Xenobiotics. 2023; 13(2): 193 | | [Pubmed] | [DOI] | | | 2 |
No Vitamin D Deficiency in Patients with Parkinson’s Disease |
|
| Wilfried Kuhn, Georg Karp, Thomas Müller | | Degenerative Neurological and Neuromuscular Disease. 2022; Volume 12: 127 | | [Pubmed] | [DOI] | | | 3 |
Longitudinal Analysis of 1a,25-dihidroxyvitamin D3 and Homocysteine Changes in Colorectal Cancer |
|
| Dorottya Mühl, Magdolna Herold, Zoltan Herold, Lilla Hornyák, Attila Marcell Szasz, Magdolna Dank | | Cancers. 2022; 14(3): 658 | | [Pubmed] | [DOI] | | | 4 |
Serum 25-hydroxyvitamin D3 is associated with homocysteine more than with apolipoprotein B |
|
| Nam-Kyu Kim, Min-Ah Jung, Beom-hee Choi, Nam-Seok Joo | | Nutrition Research and Practice. 2022; 16(6): 745 | | [Pubmed] | [DOI] | | | 5 |
Vitamin D: Not Just Bone Metabolism but a Key Player in Cardiovascular Diseases |
|
| Marcello Izzo,Albino Carrizzo,Carmine Izzo,Enrico Cappello,Domenico Cecere,Michele Ciccarelli,Patrizia Iannece,Antonio Damato,Carmine Vecchione,Francesco Pompeo | | Life. 2021; 11(5): 452 | | [Pubmed] | [DOI] | | | 6 |
Vitamin D and Blood Parameters |
|
| Thomas Müller,Lutz Lohse,Andreas Blodau,Katja Frommholz | | Biomolecules. 2021; 11(7): 1017 | | [Pubmed] | [DOI] | | | 7 |
ASSO?IATION BETWEEN VITAMIN D STATUS AND METABOLIC DISORDERS IN PREMENOPAUSAL WOMEN WITH AUTOIMMUNE HYPOTHYROID DISEASE |
|
| Oksana O. Chukur,Nadiya V. Pasyechko,Anzhela O. Bob,Iryna V. Smachylo,Liudmyla V. Radetska | | Wiadomosci Lekarskie. 2021; 74(7): 1612 | | [Pubmed] | [DOI] | | | 8 |
Association between vitamin D deficiency and serum Homocysteine levels and its relationship with coronary artery disease |
|
| Monica Verdoia,Matteo Nardin,Rocco Gioscia,Arraa Maddalena Saghir Afifeh,Filippo Viglione,Federica Negro,Marco Marcolongo,Giuseppe De Luca | | Journal of Thrombosis and Thrombolysis. 2021; | | [Pubmed] | [DOI] | | | 9 |
Effect of Yogurt Consumption on Metabolic Syndrome Risk Factors: a Narrative Review |
|
| Leila Khorraminezhad,Iwona Rudkowska | | Current Nutrition Reports. 2021; | | [Pubmed] | [DOI] | | | 10 |
Vitamin D in pediatric patients with obesity and arterial hypertension |
|
| Živa Radulovic,Zarja Polak Zupan,Aljoša Tomazini,Nataša Marcun Varda | | Scientific Reports. 2021; 11(1) | | [Pubmed] | [DOI] | | | 11 |
Risk of falls in 4 years of follow-up among Chinese adults with diabetes: findings from the China Health and Retirement Longitudinal Study |
|
| Yue Wen,Jing Liao,Yiqiong Yin,Chunjuan Liu,Renrong Gong,Dongmei Wu | | BMJ Open. 2021; 11(6): e043349 | | [Pubmed] | [DOI] | | | 12 |
Associations between hyperhomocysteinemia and the presence and severity of acute coronary syndrome in young adults?=?35 years of age |
|
| Jiayin Sun,Wei Han,Sijing Wu,Shuo Jia,Zhenxian Yan,Yonghe Guo,Yingxin Zhao,Yujie Zhou,Wei Liu | | BMC Cardiovascular Disorders. 2021; 21(1) | | [Pubmed] | [DOI] | | | 13 |
Metabolic Signatures of Genetically Elevated Vitamin D Among Chinese: Observational and Mendelian Randomization Study |
|
| Zhenhuang Zhuang,Canqing Yu,Yu Guo,Zheng Bian,Ling Yang,Iona Y Millwood,Robin G Walters,Yiping Chen,Qinai Xu,Mingyuan Zou,Junshi Chen,Zhengming Chen,Jun Lv,Tao Huang,Liming Li | | The Journal of Clinical Endocrinology & Metabolism. 2021; | | [Pubmed] | [DOI] | | | 14 |
Indicators of mineral metabolism and dental status of young rats born from female with methionine-induced hyperhomocysteinemia |
|
| O. Kutelmakh, R. Lesyk, Yu. Chumakova | | The Ukrainian Biochemical Journal. 2021; 93(6): 93 | | [Pubmed] | [DOI] | | | 15 |
Association Between Cardiovascular Risk Factors and 25(OH)D Levels in Obese Patients |
|
| Karine L. Curvello-Silva,Nataly A. Oliveira,Thalane S.S. Silva,Cláudia D. Sousa,Carla Daltro | | Metabolic Syndrome and Related Disorders. 2020; | | [Pubmed] | [DOI] | | | 16 |
Plasma metabolomic profiles associated with infant food allergy with further consideration of other early life factors |
|
| Susan Ellul,Wolfgang Marx,Fiona Collier,Richard Saffery,Mimi Tang,David Burgner,John Carlin,Peter Vuillermin,Anne-Louise Ponsonby | | Prostaglandins, Leukotrienes and Essential Fatty Acids. 2020; : 102099 | | [Pubmed] | [DOI] | | | 17 |
Independent and Interactive Influences of Environmental UVR, Vitamin D Levels, and Folate Variant MTHFD1-rs2236225 on Homocysteine Levels |
|
| Patrice Jones,Mark Lucock,Charlotte Martin,Rohith Thota,Manohar Garg,Zoe Yates,Christopher J. Scarlett,Martin Veysey,Emma Beckett | | Nutrients. 2020; 12(5): 1455 | | [Pubmed] | [DOI] | | | 18 |
Environmental UVR Levels and Skin Pigmentation Gene Variants Associated with Folate and Homocysteine Levels in an Elderly Cohort |
|
| Patrice Jones,Mark Lucock,Christopher J. Scarlett,Martin Veysey,Emma Beckett | | International Journal of Environmental Research and Public Health. 2020; 17(5): 1545 | | [Pubmed] | [DOI] | | | 19 |
Lipid status association with 25-hydroxy vitamin D: Cross sectional study of end stage renal disease patients |
|
| Neda Milinkovic,Marija Saric,Snežana Jovicic,Duško Mirkovic,Višnja Ležaic,Svetlana Ignjatovic | | Journal of Medical Biochemistry. 2019; 0(0) | | [Pubmed] | [DOI] | | | 20 |
Effect of Experimental Hypergomocysteinemia and its Correction by Choline and Vitamin D on the Reproductive Function and Dental Status of Rates of Rats |
|
| O. KUTELMAKH | | Experimental and Clinical Physiology and Biochemistry. 2019; 2019(3): 37 | | [Pubmed] | [DOI] | | | 21 |
Comparison of free and total 25-hydroxyvitamin D in normal human pregnancy |
|
| Oleg Tsuprykov,Claudia Buse,Roman Skoblo,Berthold Hocher | | The Journal of Steroid Biochemistry and Molecular Biology. 2019; 190: 29 | | [Pubmed] | [DOI] | | | 22 |
Effect of calcium and vitamin D co-supplementation on lipid profile of overweight/obese subjects: A systematic review and meta-analysis of the randomized clinical trials |
|
| Omid asbaghi,Sara Kashkooli,Razieh Choghakhori,Amin Hasanvand,Amir Abbasnezhad | | Obesity Medicine. 2019; 15: 100124 | | [Pubmed] | [DOI] | | | 23 |
Vitamin D rise enhances blood perfusion in patients with multiple sclerosis |
|
| Thomas Müller,Lutz Lohse,Andreas Blodau,Katja Frommholz | | Journal of Neural Transmission. 2019; | | [Pubmed] | [DOI] | | | 24 |
FEATURES OF LIPID METABOLISM IN OVERWEIGHT AND OBESE ADOLESCENTS DEPENDING ON THE VARIOUS LEVELS OF VITAMIN D |
|
| A-M. A. Shulhai,H. A. Pavlyshyn | | ???????? ????????? ? ????????????????? ????????. 2019; (2): 37 | | [Pubmed] | [DOI] | | | 25 |
Homocysteine and homocysteine-related compounds: an overview of the roles in the pathology of the cardiovascular and nervous systems |
|
| Dragan Djuric,Vladimir Jakovljevic,Vladimir Zivkovic,Ivan Srejovic | | Canadian Journal of Physiology and Pharmacology. 2018; 96(10): 991 | | [Pubmed] | [DOI] | | | 26 |
Association between baseline vitamin D metabolite levels and long-term cardiovascular events in patients with rheumatoid arthritis from the CIMESTRA trial: protocol for a cohort study with patient-record evaluated outcomes |
|
| M Herly,K Stengaard-Pedersen,K Hřrslev-Petersen,M L Hetland,M Řstergaard,R Christensen,B B Lřgstrup,P Vestergaard,J Přdenphant,P Junker,T Ellingsen | | BMJ Open. 2017; 7(4): e014816 | | [Pubmed] | [DOI] | | | 27 |
Vitamin D intake and risk of CVD and all-cause mortality: evidence from the Caerphilly Prospective Cohort Study |
|
| Jing Guo,John R Cockcroft,Peter C Elwood,Janet E Pickering,Julie A Lovegrove,David I Givens | | Public Health Nutrition. 2017; : 1 | | [Pubmed] | [DOI] | | | 28 |
Impact of metabolic status on the association of serum vitamin D with hypogonadism and lower urinary tract symptoms/benign prostatic hyperplasia |
|
| Sun Gu Park,Jeong Kyun Yeo,Dae Yeon Cho,Min Gu Park | | The Aging Male. 2017; : 1 | | [Pubmed] | [DOI] | | | 29 |
High Prevalence of Vitamin D Deficiency and Correlation of Serum Vitamin D with Cardiovascular Risk in Patients with Metabolic Syndrome |
|
| Mohammad J. Alkhatatbeh,Khalid K. Abdul-Razzak,Lubna Q. Khasawneh,Nesreen A. Saadeh | | Metabolic Syndrome and Related Disorders. 2017; | | [Pubmed] | [DOI] | |
|
 |
|
|
|
Search Pubmed for