Background Vitamin D is involved in immune reactions, and vitamin D deficiency is associated with autoimmune diseases and with cardiovascular diseases (CVDs). In Feiring Heart Biopsy Study (FHBS), we previously demonstrated a high occurrence of mononuclear cell infiltrates (MCIs) in subintimal layers of the aorta, related to inflammatory rheumatic disease (IRD). In theory, vitamin D deficiency might contribute to vascular inflammation involved in the pathogenesis of CVD along with the accelerated CVD in IRD.
To look for differences in plasma levels of 25(OH)D3 and 1,25(OH)2D3 in patients with coronary artery disease (CAD) with and without IRD.
To search for relationships between inflammation in subintimal aortic layers (in terms of MCIs) and plasma levels of 25(OH)D3 and 1,25(OH)2D3.
Methods Plasma levels of 25(OH)D3 were examined by radioimmunoassay and 1,25(OH)2D3 by immunoassay in 53 patients with CAD and 68 patients with CAD and IRD from FHBS. The D vitamin levels were then related to the number of MCI previously identified in the subintimal aortic layers of these patients1.
Results In crude analysis, we observed no significant differences in 25(OH)D3 and 1,25(OH)2D3 levels between patients with CAD and IRD and patients with CAD only (see Table). Nor did we observe any significant crude associations between vitamin D levels and occurrence of MCIs in the subintimal aortic layers. However, after adjustment for age, sex, CRP, glucocorticosteroids, daily vitamin and mineral supplementation, and IRD status, patients with MCIs in the subintimal aortic layers had lower levels of 1,25(OH)2D3 than patients without (inter-group difference = 17.0 pmol/l (95%CI: 2.8 to 31.3), p=0.019).
Conclusions Our study does not support the hypothesis that patients with CVD and IRD have lower levels of vitamin D than patients with CVD only. Interestingly, based on multivariate analyses, low 1,25(OH)2D3 levels were associated with subintimal aortic inflammation. This finding should be explored in future studies. If a causal relationship exists, vitamin D supplementation could reduce vascular inflammation and thereby have potential therapeutic effect in CVD.
I. Hollan et al., Arthritis Rheum, 56 (2007), 2072-9.
Disclosure of Interest None Declared