Vitamin D has been the source of some controversy for some time now. Years ago there was debate about whether we should measure it at all (still some camps out there holding to that) because it wasn’t shown to relate to any clear diseases, increased risk, or if supplementing it made a difference. More recently, COVID demonstrated that those with low vitamin D levels were more likely to end up in the Intensive Care Unit (86% of ICU COVID patients had low levels – under 29), and thus more likely to die. Lots of people argued that supplementing vitamin D as prophylaxis against serious illness (including myself) was a good idea, but conventional evaluations of that didn’t yield confirmatory results (some studies were poorly done, but others were done well). It makes for a bit of a morass when you’re trying to decide what to do. For the record, my normal vitamin D level (25-OH to be specific) tends toward the low side, so I supplement daily.

Now we have a review of small group of sedentary, nonsmoking Spaniards who had a bunch of metabolic parameters measured and compared. What it showed was an inverse relationship between Vitamin D levels and virtually every cardiovascular risk factor you can think of . In other words, Vitamin D goes down, everything else bad goes up. Their argument is that we could measure Vitamin D levels as an easy way to monitor cardiovascular risk. Of course, in the US, to have the Vitamin D levels paid for by insurance companies, you have to be diagnosed with a Vitamin D disorder! Ahhh, the beauty of American medicine.

By the way, I measure Vitamin D in everyone regularly. It’s inexpensive to supplement, easy to avoid the virtually unheard of problems associated with excessive Vitamin D, and it just might avoid problems in the 300 or so mechanisms for which Vitamin D is essential.

Concerned about your cardiovascular risks? We have cutting edge approaches to evaluating and managing those risks, and establishing the presence of real issues before they become problems. Let’s discuss your situation – first conversation is complementary.

From medscape / by Shrabasti Bhattacharya

Low Vitamin D Levels May Signal CVD Risk in Young Adults

TOPLINE:

Circulating levels of serum 25-hydroxyvitamin D (25[OH]D) may be a marker of cardiovascular disease (CVD) risk in healthy young adults, small study finds.

METHODOLOGY:

A secondary analysis of the Activating Brown Adipose Tissue Through Exercise (ACTIBATE) trial assessed the association between serum 25(OH)D levels and CVD risk factors.
The cross-sectional study used baseline data of in 177 healthy sedentary adults ages 18-25 years (65% women; all White individuals), who were recruited between October 2015 and December 2016 from Granada, a region in the south of Spain.
Study participants were nonsmokers, led a sedentary lifestyle, and did not have a prior history of CVD or chronic illnesses.
The CVD risk factors included anthropometrical and body composition profiles, glucose and lipid metabolism, liver, and pro- and anti-inflammatory biomarkers.
25(OH)D serum concentrations were measured with a competitive chemiluminescence immunoassay and defined as deficient (< 20 ng/mL), insufficient (21-29 ng/mL), or normal (> 30 ng/mL).

TAKEAWAY:

The vitamin D levels correlated inversely with body mass index (BMI; standardized regression coefficient [β], −0.177; P = .018), fat mass index (β, −0.195; P = .011), and systolic blood pressure (β, −0.137; P = .038), after adjusting for sex.
Glucose metabolism markers (serum glucose and insulin concentrations, insulin/glucose ratio, and homeostatic model assessment of insulin resistance index) also correlated inversely with vitamin D levels.
The trend was similar for liver markers serum γ-glutamyl transferase and alkaline phosphatase) and the anti-inflammatory marker interleukin-4.
BMI, waist/hip ratio, fat mass index, blood pressure, and levels of glucose, insulin, triglycerides, and liver markers were higher in the 44 participants with vitamin D deficiency vs 41 participants with normal vitamin D levels.

IN PRACTICE:

"Collectively, these findings support the idea that 25(OH)D concentrations may be used as a useful marker of CVD status, which can be easily monitored in young individuals," the authors wrote.

SOURCE:

This study was led by first author Francisco J. Amaro‑Gahete, MD, PhD, from the Department of Physiology, Faculty of Medicine, University of Granada, Spain, who also holds positions in other institutions. It was published online on January 4, 2024, in the Journal of Endocrinological Investigation.

LIMITATIONS:

This study could not establish causal relationships due to its cross-sectional design. The results might not apply to younger or older people from different locations and ethnic backgrounds. The gold standard method for analyzing vitamin D levels, liquid chromatography–mass spectrometry, was not used in this study.

DISCLOSURES:

This study was supported by the Spanish Ministry of Economy and Competitiveness, Spanish Ministry of Education, AstraZeneca HealthCare Foundation, and other sources. The authors declared no conflicts of interest.