Vitamin D deficiency and cardiovascular diseases: results from the Neyshabur Longitudinal Study on Ageing

Document Type : Original Article

Authors

1 Department of Epidemiology and statistics, Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran

2 Department of Basic Medical Sciences, Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran

3 Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

4 Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran AND Faculty of Medicine, Neyshabur University of Medical Sciences, Neyshabur, Iran

Abstract

Objectives: This study aimed to investigate the relationship between Vitamin D levels and Cardiovascular Diseases (CVDs) such as myocardial infarction (MI), stroke, and angina.
Methods: Data for this cross-sectional study were collected as part of the Neyshabur Longitudinal Study on Ageing (NeLSA) between 2016 and 2018. The effect of Vitamin D on CVDs was analyzed in conjunction with socioeconomic and medical history variables. Statistical analysis was conducted using the Chi-square test and logistic regression in the R.
Results: Vitamin D levels were evaluated in 3414 participants (1527 men and 1889 women), with over two-thirds of participants showing insufficiency or deficiency of Vitamin D. Among them, 362 participants had self-reported diagnosed CADs. The study did not find a significant association between serum 25OH Vitamin D levels and the risk of CADs. Adjusted logistic regression revealed that male gender was a risk factor for MI (OR=4.7; 95% CI: 3.125-6), stroke (OR=1.75; 95% CI: 1.08-2.85), and angina (OR=1.6; 95% CI: 1.03-2.7). Additionally, having one or more medical conditions other than hypertension and diabetes was associated with angina (OR=7.14; 95% CI: 3.7-14.7), MI (OR=5; 95% CI: 2.97-8.3), and stroke (OR=2.7; 95% CI: 1.2-4.7). Participants aged over 70 years were more likely to experience angina (OR=2.43; 95% CI: 1.36-4.5) and stroke (OR=2.5; 95% CI: 1.35-4.5).
Conclusions: The study revealed a high prevalence of Vitamin D deficiency and insufficiency. While the protective role of Vitamin D against CADs was not supported in this study, it does not discount the potential benefits of Vitamin D supplementation for overall health in older individuals.

Keywords

Main Subjects


  1. Buggio L, Roncella E, Somigliana E, Vercellini P. Vitamin D and benign gynaecological diseases: a critical analysis of the current evidence. Gynecol Endocrinol 2016;32(4):259-63. doi:10.3109/09513590.2015.1111329 PMid:26490176
  2. Judd SE, Tangpricha V. Vitamin D deficiency and risk for cardiovascular disease. Am J Med Sci 2009;338(1):40-4. doi:10.1097/MAJ.0b013e3181aaee91 PMid:19593102 PMCid:PMC2851242
  3. Jorge AJL, Cordeiro JR, Rosa MLG, Bianchi DBC. Vitamin D deficiency and cardiovascular diseases. Int J Cardiovasc Sci 2018; 31(4):422-32. doi:10.5935/2359-4802.20180025
  4. Kheiri B, Abdalla A, Osman M, Ahmed S, Hassan M, Bachuwa G. Vitamin D deficiency and risk of cardiovascular diseases: a narrative review. Clin Hypertens 2018;24(1):1-9. doi:10.1186/s40885-018-0094-4 PMid:30603100 PMCid:PMC6304770
  5. Thompson B, Waterhouse M, English DR, McLeod DS, Armstrong BK, Baxter C, et al. Vitamin D supplementation and major cardiovascular events: D-Health randomised controlled trial. BMJ 2023;381:e075230. doi:10.1136/bmj-2023-075230 PMid:37380191 PMCid:PMC10302209
  6. Barbarawi M, Kheiri B, Zayed Y, Barbarawi O, Dhillon H, Swaid B, et al. Vitamin D Supplementation and Cardiovascular Disease Risks in More Than 83 000 Individuals in 21 Randomized Clinical Trials: A Meta-analysis. JAMA Cardiol 2019;4(8): 765-76. doi:10.1001/jamacardio.2019.1870 PMid:31215980 PMCid:PMC6584896
  7. Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am College Cardiol 2017; 70(1):1-25. doi:10.1016/j.jacc.2017.04.052 PMid:28527533 PMCid:PMC5491406
  8. Yang B-Y, Guo Y, Morawska L, Bloom MS, Markevych I, Heinrich J, et al. Ambient PM1 air pollution and cardiovascular disease prevalence: Insights from the 33 Communities Chinese Health Study. Environ Int 2019;123:310-7 doi:10.1016/j.envint.2018.12.012 PMid:30557810
  9. He S, Hao X. The effect of vitamin D3 on blood pressure in people with vitamin D deficiency: A system review and meta-analysis. Medicine 2019;98(19). doi:10.1097/MD.0000000000015284 PMid:31083159 PMCid:PMC6531166
  10. Zittermann A, Schleithoff SS, Koerfer R. Vitamin D and vascular calcification. Curr Opin Lipidol 2007;18(1):41-6. doi:10.1097/MOL.0b013e328011c6fc PMid:17218831
  11. Fitzpatrick LA, Bilezikian JP, Silverberg SJ. Parathyroid hormone and the cardiovascular system. Curr Osteoporos Rep 2008; 6 (2): 77. doi:10.1007/s11914-008-0014-8 PMid:18778568
  12. Aminisani N, Azimi-Nezhad M, Shamshirgaran SM, Mirhafez SR, Borji A, Poustchi H, et al. Cohort Profile: The IRanian Longitudinal Study on Ageing (IRLSA): the first comprehensive study on ageing in Iran. Int J Epidemiol 2022. doi:10.1093/ije/dyab272 PMid:35137100
  13. Vatandost S, Jahani M, Afshari A, Amiri MR, Heidarimoghadam R, Mohammadi Y. Prevalence of vitamin D deficiency in Iran: a systematic review and meta-analysis. Nutr Health 2018; 24(4): 269-78. doi:10.1177/0260106018802968 PMid:30296903
  14. Papaioannou I, Pantazidou G, Kokkalis Z, Georgopoulos N, Jelastopulu E. Vitamin D deficiency in elderly with diabetes mellitus type 2: a review. Cureus 2021;13(1). doi:10.7759/cureus.12506
  15. Hoseinzadeh-Chahkandak F, Zeinali T, Salmani F, Moodi M, Sharifi F, Rahimlou M, et al. Prevalence of vitamin D deficiency and its association with metabolic syndrome among the elderly population of Birjand, Iran. J Diabetes Metabol Disord 2022;21 (1):475-81. doi:10.1007/s40200-022-00998-1 PMid:35673492 PMCid:PMC9167312
  16. Ghazizadeh H, Rezayi M, Emadzadeh M, Tayefi M, Abdollahi Z, Timar A, et al. Prevalence of Vitamin D Deficiency in Iran: A Systematic Review and Meta-Analysis. J Cardio-Thoracic Med 2022;10(2):945-73.
  17. Al Amiry A, Shahwan M. Vitamin D deficiency and associated factors among Ajman University students, United Arab Emirates. Obes Med 2020;17:100176. doi:10.1016/j.obmed.2019.100176
  18. Mousavi SM, Moradi EV, Yazdani A, Taghipour A, Rezaei Ardani A, Sadrzadeh SM. The Relation between Human Traffic Accident and Personality Traits. Arch Trauma Res 2021; 10(3): 161-164.
  19. Albatineh A, Sohrabi R, Baghi V, Ghanei Gheshlagh R. Effect of vitamin D on Helicobacter pylori infection and eradication: An updated systematic review and meta‐analysis. Novel Clin Med 2023; 2(3): 155-162. doi: 10.22034/ncm.2023.385278.1074
  20. Aspell N, Laird E, Healy M, Shannon T, Lawlor B, O'Sullivan M. The Prevalence and Determinants of Vitamin D Status in Community-Dwelling Older Adults: Results from the English Longitudinal Study of Ageing (ELSA). Nutrients 2019; 11 (6): 1253. doi:10.3390/nu11061253 PMid:31159411 PMCid:PMC6627050
  21. Del Valle HB, Yaktine AL, Taylor CL, Ross AC. Dietary reference intakes for calcium and vitamin D. 2011.
  22. Nudy M, Krakowski G, Ghahramani M, Ruzieh M, Foy AJ. Vitamin D supplementation, cardiac events and stroke: A systematic review and meta-regression analysis. Int J Cardiol Heart Vasc 2020;28:100537. doi:10.1016/j.ijcha.2020.100537 PMid:32462077 PMCid:PMC7240168
  23. Allai MS, Shah ZA, Changal KH, Raina MA, Bhat FA. Association of low levels of vitamin D with chronic stable angina: A prospective case-control study. N Am J Med Sci. 2016;8(3): 143. doi:10.4103/1947-2714.179130 PMid:27114971 PMCid:PMC4821093
  24. Triwedi D, Doll R, Khaw K. Effect of four monthly oral vitamin D 3 supplementation on fractures and mortality in men and women living in the community: Randomized double blind control trial. BMJ 2003;326:469. doi:10.1136/bmj.326.7387.469 PMid:12609940 PMCid:PMC150177
  25. Legarth C, Grimm D, Krüger M, Infanger M, Wehland M. Potential Beneficial Effects of Vitamin D in Coronary Artery Disease. Nutrients 2020;12(1):99. doi:10.3390/nu12010099 PMid:31905893 PMCid:PMC7019525
  26. Ruan Y, Guo Y, Zheng Y, Huang Z, Sun S, Kowal P, et al. Cardiovascular disease (CVD) and associated risk factors among older adults in six low-and middle-income countries: results from SAGE Wave 1. BMC Public Health 2018;18(1):778. doi:10.1186/s12889-018-5653-9 PMid:29925336 PMCid:PMC6011508
  27. Sumelahti M-L, Sumanen MS, Mattila KJ, Sillanmäki L, Sumanen M. Stroke and cardiovascular risk factors among working-aged Finnish migraineurs. BMC Public Health 2021; 21 (1):1088. doi:10.1186/s12889-021-11006-1 PMid:34098909 PMCid:PMC8186106
  28. Abbasi S, De Leon AP, Kassaian S, Karimi A, Sundin O, Soares J, et al. Gender differences in the risk of coronary artery disease in iran. Iran J Public Health 2012;41(3):36-47
  29. Ghayour-Mobarhan M, Moohebati M, Esmaily H, Ebrahimi M, Parizadeh SMR, Heidari-Bakavoli AR, et al. Mashhad stroke and heart atherosclerotic disorder (MASHAD) study: design, baseline characteristics and 10-year cardiovascular risk estimation. Int J Public Health 2015;60(5):561-72. doi:10.1007/s00038-015-0679-6 PMid:25943424
  30. de Jesús Llibre J, Valhuerdi A, Fernández O, Llibre JC, Porto R, López AM, et al. Prevalence of stroke and associated risk factors in older adults in Havana City and Matanzas Provinces, Cuba (10/66 population-based study). MEDICC review 2010;12(3):20-6. doi:10.37757/MR2010.V12.N3.6 PMid:20697334
  31. Markidan J, Cole JW, Cronin CA, Merino JG, Phipps MS, Wozniak MA, et al. Smoking and risk of ischemic stroke in young men. Stroke. 2018;49(5):1276-8. doi:10.1161/STROKEAHA.117.018859 PMid:29674522 PMCid:PMC5916531
  32. Schienkiewitz A, Mensink GBM, Scheidt-Nave C. Comorbidity of overweight and obesity in a nationally representative sample of German adults aged 18-79 years. BMC Public Health 2012; 12(1):658. doi:10.1186/1471-2458-12-658 PMid:22894173 PMCid:PMC3526457
  33. Opio J, Croker E, Odongo GS, Attia J, Wynne K, McEvoy M. Metabolically healthy overweight/obesity are associated with increased risk of cardiovascular disease in adults, even in the absence of metabolic risk factors: a systematic review and meta‐analysis of prospective cohort studies. Obes Rev 2020; 21(12): e13127. doi:10.1111/obr.13127 PMid:32869512
  34. Zhi X, Joas E, Waern M, Östling S, Börjesson-Hanson A, Skoog I. Prevalence of cardiovascular disorders and risk factors in two 75-year-old birth cohorts examined in 1976-1977 and 2005-2006. Aging Clin Exp Res 2013;25(4):377-83. doi:10.1007/s40520-013-0058-1 PMid:23740599