Vitamin D deficiency independent risk factor for abnormal carotid intima-media thickness: Study

Vitamin D deficiency has been linked to many health issues, including bone disorders and metabolic disturbances. This is not well documented with regard to cardiovascular health, particularly in obese children and adolescents. This study, therefore, sought to determine whether low levels of vitamin D are associated with increased carotid intima-media thickness, indicating predisposition to the development of diseases later in life.

This was a study of 440 children with obesity, all between the ages of 6-16 years. All anthropometric measures, blood pressure, blood lipids, blood glucose levels, and serum vitamin D concentrations were assessed. Carotid ultrasound was performed bilaterally to record carotid intima-media thickness. Vitamin D level is correlated with CIMT by a multivariate linear regression model using the method of generalized linear models with restricted cubic splines. Binary logistic regression analyses were also done to study the relationship of vitamin D status with the risk of abnormal CIMT.

Key Findings

• Vitamin D levels were inversely correlated with CIMT in subjects with serum 25-hydroxyvitamin D [25(OH)D] levels ≤50 nmol/L.

• Specifically, the beta coefficient was β = -0.147 (95% CI [-0.263, -0.030], p = 0.013), indicating that lower vitamin D levels were associated with greater CIMT.

• This correlation was not observed in subjects with serum 25(OH)D levels >50 nmol/L, suggesting a threshold effect.

• After adjusting for confounders, the risk of abnormal CIMT was significantly higher in those with vitamin D deficiency.

• The odds ratio for abnormal CIMT in the vitamin D deficiency group was OR = 2.080 (95% CI [1.112, 3.891], p = 0.022).

The results suggest that vitamin D deficiency could be one such potential cause for developing early atherosclerotic changes in obese children and adolescents. The vitamin D level was inversely related to CIMT, which further shows that keeping adequate levels of this vitamin might be important for cardiovascular health in such high-risk populations. The lack of significant correlation in those with higher vitamin D levels probably implies the existence of a threshold below which vitamin D turns detrimental to vascular health.

In obese children and adolescents, low vitamin D is an independent factor for abnormal CIMT. This research points out that the monitoring and need to treat vitamin D deficiency in cardiovascular risk management for obese youth should not be underrated. Further studies are required to investigate the detailed mechanisms of the actions of vitamin D on the atherosclerotic process and to define the optimal vitamin D levels for cardiovascular health.

Reference:

Liu C, Xia X, Zhu T, Gu W, Wang Z. Lower levels of vitamin D are associated with an increase in carotid intima-media thickness in children and adolescents with obesity. Nutr Hosp. 2024 Jul 10. English. doi: 10.20960/nh.05265. Epub ahead of print. PMID: 39037178. https://pubmed.ncbi.nlm.nih.gov/39037178/