Vitamin-D deficiency in coronary artery disease and peripheral artery disease

Vitamin-D deficiency has recently been implicated to play a major role in etiopathogenesis of atherosclerosis. We aimed to explore the relationship between coronary artery disease (CAD) and peripheral artery disease (PAD) and Vitamin-D levels in a large, nationally representative database of non-institutionalized US population.

Methods: Cross-sectional data from National Health and Nutrition Examination Survey (NHANES) 1999-2004 were used. Based on the serum Vitamin-D concentrations, five groups were identified: normal(>30ng/mL), mild deficiency(25-30ng/mL), moderate deficiency(20-25ng/mL), severe deficiency(15-20ng/mL) and very-severe deficiency(<15ng/mL). Multivariate logistic regression analysis was utilized to study the association between CAD / PAD with the Vitamin-D categories.

Results: Mean (SE) Vitamin-D level was 23.6(0.5)ng/mL, which was significantly higher than 21.6(0.8)ng/mL observed in the PAD group (p=0.004). A significantly higher proportion of individuals with PAD (87.5%) had evidence of Vitamin-D deficiency as compared to individuals with CAD (80.2%, p=0.03). 23.7% of individuals with PAD demonstrated very-severe Vitamin-D deficiency, which was significantly higher than 18.1% the CAD group demonstrating very-severe deficiency (p=0.02). Multivariate logistic regression analysis demonstrated the risk of CAD to be elevated only with very-severe Vitamin-D deficiency, whereas the risk of PAD increased in a dose-dependent manner, begining with mild deficiency. At the very-severe deficiency level, the risk of PAD was significantly higher [OR(95%CI):3.2(2.0-4.9)] than the risk of CAD [OR(95%CI):1.5(1.02-2.1)] (p:0.001).

Conclusions: Vitamin-D deficiency was associated with CAD and PAD. The risk of PAD appeared to be significantly higher than the risk of CAD with increasingly severe levels of Vitamin-D deficiency.