Association of C-reactive protein and vitamin D deficiency with cardiovascular disease: A nationwide cross-sectional study from National Health and Nutrition Examination Survey 2007 to 2008

Clin Cardiol. 2019 Jul;42(7):663-669. doi: 10.1002/clc.23189. Epub 2019 Apr 30.

Abstract

Objectives: The association of C-reactive protein (CRP) and serum 25-hydroxyvitamin D [25(OH)D] and cardiovascular disease (CVD) remains unknown.

Methods: We performed a cross-sectional analysis on 3848 participants by using the data from the National Health and Nutrition Examination Surveys (2007 to 2008). CVD was defined as a compromise of stroke, myocardial infarction, heart failure, and coronary heart disease. High CRP was defined as ≥0.2 mg/dL, and vitamin D status were categorized as severe deficiency, <25 nmol/mL; deficiency, 25 to 49.9 nmol/mL; insufficiency, 50 to 74.9 nmol/mL; and normal, ≥75 nmol/mL. Statistical analysis was performed using logistic regression models.

Results: We found that both high CRP and low 25(OH)D levels were associated with CVD. Participants with high CRP levels and severe vitamin D deficiency had a higher likelihood of having CVD than those with neither risk factor (odds ratio = 2.69, 95% confidence interval = 1.45-4.98, P = .0017). In stratified analysis, a significant positive association between vitamin D level and CVD was observed only in the high CRP group. However, in the absence of high CRP, even with severe vitamin D deficiency, no association was found with an increasing risk of CVD (P = .6416).

Conclusion: Within a cross-sectional, nationally representative sample, these findings suggest that vitamin D status evaluation, or vitamin D supplement may be especially important for individuals with high CRP levels.

Keywords: C-reactive protein; NHANES; cardiovascular disease; vitamin D.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • C-Reactive Protein / metabolism*
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • China / epidemiology
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Nutrition Surveys*
  • Prognosis
  • Retrospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / blood*
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / epidemiology
  • Young Adult

Substances

  • Vitamin D
  • C-Reactive Protein
  • 25-hydroxyvitamin D