Research Article: Association between vitamin D and risk of cardiovascular disease in Chinese rural population

Date Published: May 23, 2019

Publisher: Public Library of Science

Author(s): Teng Wang, Hualei Sun, Huina Ge, Xinxin Liu, Fei Yu, Han Han, Jun Wang, Wenjie Li, Ying-Mei Feng.


Previous studies have suggested that vitamin D is associated with cardiovascular disease (CVD), however, the relationship between vitamin D levels and CVD risk is still unclear. The purpose of this study was to assess the relationship of serum concentration of 25-hydroxyvitamin D (25(OH)D) with CVD in rural residents of Henan province of China. Basic information and medical history were gathered through face-to-face surveys from July 2013 to August 2015, and biochemical indicators were gathered in a laboratory setting. Logistic and restricted cubic splines regression analyses were used to estimate odd ratios (ORs) and 95% confidence intervals (95%CI) of CVD. A total of 1078 participants were included, the mean serum 25(OH)D concentration was determined to be 25 ± 18 ng/ml, with 54.45% of the participants presenting vitamin D deficiency [25(OH)D < 20 ng/mL]. Moreover, the prevalence of CVD was 59.28% in the vitamin D deficient group, which was higher than in the insufficient (48.55%) and sufficient groups (52.78%). After adjusting for potential confounders, compared with the deficient group, the ORs (95%CI) of CVDs were 0.68 (0.50, 0.91) in the insufficient group and 0.81 (0.56, 1.16) in the sufficient group. A nonlinear (U-shaped) association was observed between the risk of CVD and 25(OH)D concentration. Further research suggested that the risk of CVD was higher in males than in females. In conclusion, a U-shape association between serum levels of 25(OH)D and the risk of CVD was identified in our study, suggesting a nonlinear relationship between vitamin D with the prevalence of CVD.

Partial Text

Cardiovascular disease (CVD) is the leading cause of mortality in worldwide. Data from the World Health Organization (WHO) show that 17.7 million people died from CVD in 2015, representing 31% of all global deaths. Notably, out of all these deaths, 7.4 million people died from coronary heart disease and 6.7 million died from stroke[1]. Moreover, over three quarters of the deaths occur in developing countries[2].

Vitamin D deficiency is a severe public health problem[17]. Many studies have suggested that vitamin D deficiency is a risk factor for T2DM, hypertension, dyslipidemia, obesity and cardiovascular disease. However, previous vitamin D studies have mainly focused on particular subjects, such as children[19], pregnant women[20] middle-aged and elderly population[17]. Therefore, our study was conducted in the rural residents of the Henan province in China, aged 18 to 80 years, covering adults of all ages. Our results indicated that 54.45% of the participants had a vitamin D deficiency, 28.85% had a vitamin D insufficiency, only 16.70% of the subjects evaluated had sufficient levels of vitamin D. Notably, the prevalence of vitamin D deficiency was more severe than what was reported in other states[21].

Our study suggests that lower serum 25(OH)D levels are associated with an increased risk of CVD in the Chinese rural population, with a nonlinear (U-shape) association between 25(OH)D levels and CVD risk. Nonetheless, further studies are needed to verify these findings and follow-up work should focus on the clinical implications of vitamin D signals on CVD prevention and treatment.




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