From the Department of Molecular Medicine and Surgery (A.D., S.G, C.-G.Ö., J.Ö., A.H.), Atherosclerosis Research Unit, Department of Medicine Solna (A.D., O.P., A.S., K.G., B.S., R.J.S., M.L.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine (K.L., B.G., U.d.F.), Karolinska Institutet, Stockholm, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano & Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.); Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland (J.K.); Foundation for Research in Health, Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland (R.R.); Department of Medicine, University Medical Center Groningen, Groningen, The Netherlands (A.J.S.); Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy (E.M.); Assistance Publique-Hopitaux de Paris, Service Endocrinologie-Metabolisme, Groupe Hôpitalier Pitie-Salpetriere, Unités de Prévention Cardiovasculaire, Paris, France (P.G.); and Centre for Cardiovascular Genetics, University College London, London, United Kingdom (S.E.H.).
Arterioscler Thromb Vasc Biol. 2013 Nov;33(11):2633-8. doi: 10.1161/ATVBAHA.113.301593. Epub 2013 Sep 26.
Vitamin D deficiency has been implicated in cardiovascular disease and is associated with multiple cardiovascular risk factors. We investigated the serum 25-hydroxyvitamin D (25(OH)D) concentration in relation to latitude, baseline carotid intima-media thickness (IMT), and IMT progression, the carotid IMT measures being surrogate markers of subclinical atherosclerosis and cardiovascular disease risk.
Serum 25(OH)D concentration was related to high-resolution carotid IMT measures in 3430 middle-aged and elderly subjects with high cardiovascular risk but no prevalent disease, who were recruited at 7 centers in Finland, Sweden, The Netherlands, France, and Italy. Participants underwent carotid ultrasound examination at baseline and at months 15 and 30 after entry into the study, whereas blood samples, clinical data, and information about lifestyle were collected at baseline. Serum 25(OH)D levels were positively associated with latitude (Jonckheere-Terpstra χ=166.643; P<0.001) and, as previously reported, associated with a range of cardiovascular risk factors. There were no independent relationships between 25(OH)D and segment-specific or composite IMT measures in the entire cohort. In analyses stratified by sex, diabetes mellitus, and statin treatment, weak associations with some baseline and progression measures of carotid IMT were observed in males, diabetics, and nonstatin-treated individuals.
Levels of 25(OH)D differed across Europe, were highest in the North, showed multiple associations with established and emerging cardiovascular risk factors but were not consistently, independently related to measures of carotid IMT. This argues against a protective role of vitamin D against subclinical atherosclerosis in high-risk individuals.
维生素 D 缺乏与心血管疾病有关，并与多种心血管危险因素相关。我们研究了血清 25-羟维生素 D（25(OH)D）浓度与纬度、基线颈动脉内膜中层厚度（IMT）以及 IMT 进展的关系，颈动脉 IMT 测量值是亚临床动脉粥样硬化和心血管疾病风险的替代标志物。
在芬兰、瑞典、荷兰、法国和意大利的 7 个中心招募了 3430 名具有高心血管风险但无现有疾病的中老年患者，这些患者接受了高分辨率颈动脉 IMT 检查。在进入研究后的第 15 个月和第 30 个月进行颈动脉超声检查，同时在基线时采集血液样本、临床数据和生活方式信息。血清 25(OH)D 水平与纬度呈正相关（Jonckheere-Terpstra χ=166.643；P<0.001），正如之前报道的那样，与一系列心血管危险因素相关。在整个队列中，25(OH)D 与节段特异性或复合 IMT 测量值之间没有独立的关系。在按性别、糖尿病和他汀类药物治疗分层的分析中，在男性、糖尿病患者和未接受他汀类药物治疗的个体中，观察到与颈动脉 IMT 的一些基线和进展测量值的弱相关性。
25(OH)D 水平在欧洲各地存在差异，在北部最高，与已确立和新兴的心血管危险因素有多种关联，但与颈动脉 IMT 的测量值并不一致且无独立关系。这表明维生素 D 对高危人群的亚临床动脉粥样硬化没有保护作用。
