This Article Full Text Full Text (PDF) All Versions of this Article: 28/6/1179    most recent ATVBAHA.108.165886v1 Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Melamed, M. L. Articles by Raggi, P. Search for Related Content PubMed PubMed Citation Articles by Melamed, M. L. Articles by Raggi, P. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB CALCIUM COMPOUNDS CALCIUM, ELEMENTAL PARATHYROID HORMONE Medline Plus Health Information Peripheral Arterial Disease

(Arteriosclerosis, Thrombosis, and Vascular Biology. 2008;28:1179.)
© 2008 American Heart Association, Inc.

Clinical and Population Studies

Serum 25-Hydroxyvitamin D Levels and the Prevalence of Peripheral Arterial Disease

Results from NHANES 2001 to 2004

Michal L. Melamed; Paul Muntner; Erin D. Michos; Jaime Uribarri; Collin Weber; Jyotirmay Sharma; Paolo Raggi

From the Departments of Medicine and Epidemiology & Population Health (M.L.M.), Albert Einstein College of Medicine, Bronx, New York; the Department of Medicine (P.M., J.U.), Mount Sinai School of Medicine, New York, New York; the Division of Cardiology (E.D.M.), Johns Hopkins University School of Medicine, Baltimore, Md; and the Department of Surgery (C.W., J.S.) and the Division of Cardiology (P.R.), Emory University School of Medicine, Atlanta, Ga.

Correspondence to Michal L. Melamed, MD, MHS, 1300 Morris Park Avenue, Ullmann 615, Bronx, NY 10461. E-mail mmelamed{at}aecom.yu.edu

Objective— The purpose of this study was to determine the association between 25-hydroxyvitamin D (25(OH)D) levels and the prevalence of peripheral arterial disease (PAD) in the general United States population.

Methods and Results— We analyzed data from 4839 participants of the National Health and Nutrition Examination Survey 2001 to 2004 to evaluate the relationship between 25(OH)D and PAD (defined as an ankle-brachial index <0.9). Across quartiles of 25(OH)D, from lowest to highest, the prevalence of PAD was 8.1%, 5.4%, 4.9%, and 3.7% (P trend <0.001). After multivariable adjustment for demographics, comorbidities, physical activity level, and laboratory measures, the prevalence ratio of PAD for the lowest, compared to the highest, 25(OH)D quartile (<17.8 and 29.2 ng/mL, respectively) was 1.80 (95% confidence interval: 1.19, 2.74). For each 10 ng/mL lower 25(OH)D level, the multivariable-adjusted prevalence ratio of PAD was 1.35 (95% confidence interval: 1.15, 1.59).

Conclusions— Low serum 25(OH)D levels are associated with a higher prevalence of PAD. Several mechanisms have been invoked in the literature to support a potential antiatherosclerotic activity of vitamin D. Prospective cohort and mechanistic studies should be designed to confirm this association.

Vitamin D is an inhibitor of the renin–angiotensin system and has antiinflammatory and anticoagulant properties. Among 4839 NHANES 2001 to 2004 participants, low 25(OH)D levels were associated with a higher prevalence of PAD, after multivariate adjustment. To confirm this association, longitudinal cohort and mechanistic studies are needed.

Key Words: 25-hydroxyvitamin D • peripheral arterial disease • phosphate • PTH • cardiovascular disease

This article has been cited by other articles:

				A. Sayers, K. Tilling, B. J Boucher, K. Noonan, and J. H Tobias Predicting ambient ultraviolet from routine meteorological data; its potential use as an instrumental variable for vitamin D status in pregnancy in a longitudinal birth cohort in the UK Int. J. Epidemiol., June 29, 2009; (2009) dyp237v1. [Abstract] [Full Text] [PDF]

				A. H. Lichtenstein Nutrient supplements and cardiovascular disease: a heartbreaking story J. Lipid Res., April 1, 2009; 50(Supplement): S429 - S433. [Abstract] [Full Text] [PDF]

				J. H. Lee, J. H. O'Keefe, D. Bell, D. D. Hensrud, and M. F. Holick Vitamin D Deficiency: An Important, Common, and Easily Treatable Cardiovascular Risk Factor? J. Am. Coll. Cardiol., December 9, 2008; 52(24): 1949 - 1956. [Abstract] [Full Text] [PDF]

				J. P Reis, E. D Michos, D. von Muhlen, and E. R Miller III Differences in vitamin D status as a possible contributor to the racial disparity in peripheral arterial disease Am. J. Clinical Nutrition, December 1, 2008; 88(6): 1469 - 1477. [Abstract] [Full Text] [PDF]

				W. B. Grant Lower Vitamin D Status May Explain the Higher Prevalence of Peripheral Arterial Disease Among African Americans J. Am. Coll. Cardiol., October 21, 2008; 52(17): 1432 - 1432. [Full Text] [PDF]

				J. H. Ix and M. H. Criqui Reply J. Am. Coll. Cardiol., October 21, 2008; 52(17): 1432 - 1433. [Full Text] [PDF]