The relationship of vitamin D with non-traditional risk factors for cardiovascular disease in subjects with metabolic syndrome

Stefania Makariou; Evangelos Liberopoulos; Matilda Florentin; Konstantinos Lagos; Irene Gazi; Anna Challa; Moses Elisaf

doi:10.5114/aoms.2012.29398

The relationship of vitamin D with non-traditional risk factors for cardiovascular disease in subjects with metabolic syndrome

Arch Med Sci. 2012 Jul 4;8(3):437-43. doi: 10.5114/aoms.2012.29398.

Authors

Stefania Makariou¹, Evangelos Liberopoulos, Matilda Florentin, Konstantinos Lagos, Irene Gazi, Anna Challa, Moses Elisaf

Affiliation

¹ Department of Child Health, Medical School, University of Ioannina, Greece.

Abstract

Introduction: Several studies implicate an inverse relationship between 25-hydroxy vitamin D (25(OH)Vit D) serum levels and metabolic syndrome (MetS). We sought to investigate a possible relationship between 25(OH)Vit D and emerging risk factors associated with MetS, such as small dense low-density lipoprotein cholesterol (sdLDL-C) concentration, lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) activity and high-sensitivity C-reactive protein (hsCRP) levels.

Material and methods: We studied 110 consecutive otherwise healthy individuals. Of these, 52 were diagnosed with MetS and 58 who did not meet the MetS criteria served as controls. Low-density lipoprotein (LDL) subclass analysis was performed by polyacrylamide gel electrophoresis. Lp-PLA(2) activity was determined in total plasma by the trichloroacetic acid precipitation procedure. Serum 25(OH)Vit D was determined quantitatively by an enzyme immunoassay method.

Results: Metabolic syndrome subjects had significantly lower 25(OH)Vit D levels (11.8 [0.6-48.3] ng/ml; 29.5 [1.5-120.75] nmol/l) compared with controls (17.2 [4.8-62.4] ng/ml; 43 [12-156] nmol/l, p = 0.027). Univariate regression analysis showed that 25(OH)Vit D concentration was inversely related to triglycerides (r= - 0.416, p = 0.003) and sdLDL-C (r= - 0.305, p = 0.004). There was no association of 25(OH)Vit D with waist circumference, blood pressure, high-density lipoprotein cholesterol (HDL-C), fasting glucose, Lp-PLA(2) and hsCRP. In multivariate regression analysis the relationship between 25(OH)Vit D and sdLDL-C became insignificant when triglycerides were included in the model.

Conclusions: Subjects with MetS exhibit lower 25(OH)Vit D serum levels compared with non-MetS individuals. Low 25(OH)Vit D is associated with higher sdLDL-C levels possibly through elevated triglycerides. No association between 25(OH)Vit D and Lp-PLA(2) or hsCRP was found.

Keywords: high-sensitivity C-reactive protein; lipoprotein-associated phospholipase A2 activity; metabolic syndrome; small dense low-density lipoprotein cholesterol; vitamin D.