Vitamin D deficiency is associated with subclinical carotid atherosclerosis: The Northern Manhattan Study

Angela L. Carrelli, Marcella D. Walker, Hyesoo Lowe, Don J. McMahon, Tatjana Rundek, Ralph L Sacco, Shonni J. Silverberg

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Background and Purpose-The purpose of this study was to assess the association of vitamin D deficiency and indices of mineral metabolism with subclinical carotid markers that predict cardiovascular events. Methods-Two hundred three community-dwelling adults (Northern Manhattan Study; age, 68±11; age range, 50 to 93 years) had serum measurements (calcium, phosphorus, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, parathyroid hormone) and carotid ultrasound (plaque presence, number, maximal carotid plaque thickness, intima-media thickness). Results-Adjusting for cardiovascular risk factors, plaque number was associated with phosphorus levels (β=0.39 per 1-mg/dL increase; P=0.02) and calcium-phosphorus product (β=0.36 per 10-U increase; P=0.03). In those with plaque (N=116 [57%]), the association of plaque number with phosphorus and calcium-phosphorus product persisted. In addition, 25-hydroxyvitamin D was inversely associated with both intima-media thickness (β=-0.01 per 10-ng/mL increase; P=0.05) and maximal carotid plaque thickness (β=-0.10 per 10-ng/mL increase; P=0.03). In a model containing traditional cardiac risk factors and indices of mineral metabolism, 25-hydroxyvitamin D accounted for 13% of the variance in both intima-media thickness and maximal carotid plaque thickness. Calcium, parathyroid hormone, and 1,25-dihydroxyvitamin D levels were not associated with carotid measures. Conclusions-After adjusting for cardiovascular risk factors and renal function, serum phosphorus and calcium-phosphorus product were associated with a greater burden of subclinical carotid atherosclerosis. Low 25-hydroxyvitamin D levels were associated with increased intima-media thickness and maximal carotid plaque thickness in those with plaque, and 25-hydroxyvitamin D contributed in a robust manner to the variance in both. These results confirm and extend data on the association of low vitamin D levels with subclinical carotid atherosclerosis. The precise nature of this association and the optimum levels of vitamin D for vascular health remain to be elucidated.

Original languageEnglish
Pages (from-to)2240-2245
Number of pages6
JournalStroke
Volume42
Issue number8
DOIs
StatePublished - Aug 1 2011

Fingerprint

Carotid Artery Diseases
Vitamin D Deficiency
Phosphorus
Carotid Intima-Media Thickness
Calcium
Parathyroid Hormone
Vitamin D
Minerals
Independent Living
Serum
Blood Vessels
25-hydroxyvitamin D
Kidney
Health

Keywords

  • atherosclerosis
  • carotid intimal medial thickness
  • carotid ultrasound
  • endocrinology
  • vitamin D

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Vitamin D deficiency is associated with subclinical carotid atherosclerosis : The Northern Manhattan Study. / Carrelli, Angela L.; Walker, Marcella D.; Lowe, Hyesoo; McMahon, Don J.; Rundek, Tatjana; Sacco, Ralph L; Silverberg, Shonni J.

In: Stroke, Vol. 42, No. 8, 01.08.2011, p. 2240-2245.

Research output: Contribution to journalArticle

Carrelli, Angela L. ; Walker, Marcella D. ; Lowe, Hyesoo ; McMahon, Don J. ; Rundek, Tatjana ; Sacco, Ralph L ; Silverberg, Shonni J. / Vitamin D deficiency is associated with subclinical carotid atherosclerosis : The Northern Manhattan Study. In: Stroke. 2011 ; Vol. 42, No. 8. pp. 2240-2245.
@article{f225c8f8862f447db8e49c5c90f139f2,
title = "Vitamin D deficiency is associated with subclinical carotid atherosclerosis: The Northern Manhattan Study",
abstract = "Background and Purpose-The purpose of this study was to assess the association of vitamin D deficiency and indices of mineral metabolism with subclinical carotid markers that predict cardiovascular events. Methods-Two hundred three community-dwelling adults (Northern Manhattan Study; age, 68±11; age range, 50 to 93 years) had serum measurements (calcium, phosphorus, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, parathyroid hormone) and carotid ultrasound (plaque presence, number, maximal carotid plaque thickness, intima-media thickness). Results-Adjusting for cardiovascular risk factors, plaque number was associated with phosphorus levels (β=0.39 per 1-mg/dL increase; P=0.02) and calcium-phosphorus product (β=0.36 per 10-U increase; P=0.03). In those with plaque (N=116 [57{\%}]), the association of plaque number with phosphorus and calcium-phosphorus product persisted. In addition, 25-hydroxyvitamin D was inversely associated with both intima-media thickness (β=-0.01 per 10-ng/mL increase; P=0.05) and maximal carotid plaque thickness (β=-0.10 per 10-ng/mL increase; P=0.03). In a model containing traditional cardiac risk factors and indices of mineral metabolism, 25-hydroxyvitamin D accounted for 13{\%} of the variance in both intima-media thickness and maximal carotid plaque thickness. Calcium, parathyroid hormone, and 1,25-dihydroxyvitamin D levels were not associated with carotid measures. Conclusions-After adjusting for cardiovascular risk factors and renal function, serum phosphorus and calcium-phosphorus product were associated with a greater burden of subclinical carotid atherosclerosis. Low 25-hydroxyvitamin D levels were associated with increased intima-media thickness and maximal carotid plaque thickness in those with plaque, and 25-hydroxyvitamin D contributed in a robust manner to the variance in both. These results confirm and extend data on the association of low vitamin D levels with subclinical carotid atherosclerosis. The precise nature of this association and the optimum levels of vitamin D for vascular health remain to be elucidated.",
keywords = "atherosclerosis, carotid intimal medial thickness, carotid ultrasound, endocrinology, vitamin D",
author = "Carrelli, {Angela L.} and Walker, {Marcella D.} and Hyesoo Lowe and McMahon, {Don J.} and Tatjana Rundek and Sacco, {Ralph L} and Silverberg, {Shonni J.}",
year = "2011",
month = "8",
day = "1",
doi = "10.1161/STROKEAHA.110.608539",
language = "English",
volume = "42",
pages = "2240--2245",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

TY - JOUR

T1 - Vitamin D deficiency is associated with subclinical carotid atherosclerosis

T2 - The Northern Manhattan Study

AU - Carrelli, Angela L.

AU - Walker, Marcella D.

AU - Lowe, Hyesoo

AU - McMahon, Don J.

AU - Rundek, Tatjana

AU - Sacco, Ralph L

AU - Silverberg, Shonni J.

PY - 2011/8/1

Y1 - 2011/8/1

N2 - Background and Purpose-The purpose of this study was to assess the association of vitamin D deficiency and indices of mineral metabolism with subclinical carotid markers that predict cardiovascular events. Methods-Two hundred three community-dwelling adults (Northern Manhattan Study; age, 68±11; age range, 50 to 93 years) had serum measurements (calcium, phosphorus, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, parathyroid hormone) and carotid ultrasound (plaque presence, number, maximal carotid plaque thickness, intima-media thickness). Results-Adjusting for cardiovascular risk factors, plaque number was associated with phosphorus levels (β=0.39 per 1-mg/dL increase; P=0.02) and calcium-phosphorus product (β=0.36 per 10-U increase; P=0.03). In those with plaque (N=116 [57%]), the association of plaque number with phosphorus and calcium-phosphorus product persisted. In addition, 25-hydroxyvitamin D was inversely associated with both intima-media thickness (β=-0.01 per 10-ng/mL increase; P=0.05) and maximal carotid plaque thickness (β=-0.10 per 10-ng/mL increase; P=0.03). In a model containing traditional cardiac risk factors and indices of mineral metabolism, 25-hydroxyvitamin D accounted for 13% of the variance in both intima-media thickness and maximal carotid plaque thickness. Calcium, parathyroid hormone, and 1,25-dihydroxyvitamin D levels were not associated with carotid measures. Conclusions-After adjusting for cardiovascular risk factors and renal function, serum phosphorus and calcium-phosphorus product were associated with a greater burden of subclinical carotid atherosclerosis. Low 25-hydroxyvitamin D levels were associated with increased intima-media thickness and maximal carotid plaque thickness in those with plaque, and 25-hydroxyvitamin D contributed in a robust manner to the variance in both. These results confirm and extend data on the association of low vitamin D levels with subclinical carotid atherosclerosis. The precise nature of this association and the optimum levels of vitamin D for vascular health remain to be elucidated.

AB - Background and Purpose-The purpose of this study was to assess the association of vitamin D deficiency and indices of mineral metabolism with subclinical carotid markers that predict cardiovascular events. Methods-Two hundred three community-dwelling adults (Northern Manhattan Study; age, 68±11; age range, 50 to 93 years) had serum measurements (calcium, phosphorus, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, parathyroid hormone) and carotid ultrasound (plaque presence, number, maximal carotid plaque thickness, intima-media thickness). Results-Adjusting for cardiovascular risk factors, plaque number was associated with phosphorus levels (β=0.39 per 1-mg/dL increase; P=0.02) and calcium-phosphorus product (β=0.36 per 10-U increase; P=0.03). In those with plaque (N=116 [57%]), the association of plaque number with phosphorus and calcium-phosphorus product persisted. In addition, 25-hydroxyvitamin D was inversely associated with both intima-media thickness (β=-0.01 per 10-ng/mL increase; P=0.05) and maximal carotid plaque thickness (β=-0.10 per 10-ng/mL increase; P=0.03). In a model containing traditional cardiac risk factors and indices of mineral metabolism, 25-hydroxyvitamin D accounted for 13% of the variance in both intima-media thickness and maximal carotid plaque thickness. Calcium, parathyroid hormone, and 1,25-dihydroxyvitamin D levels were not associated with carotid measures. Conclusions-After adjusting for cardiovascular risk factors and renal function, serum phosphorus and calcium-phosphorus product were associated with a greater burden of subclinical carotid atherosclerosis. Low 25-hydroxyvitamin D levels were associated with increased intima-media thickness and maximal carotid plaque thickness in those with plaque, and 25-hydroxyvitamin D contributed in a robust manner to the variance in both. These results confirm and extend data on the association of low vitamin D levels with subclinical carotid atherosclerosis. The precise nature of this association and the optimum levels of vitamin D for vascular health remain to be elucidated.

KW - atherosclerosis

KW - carotid intimal medial thickness

KW - carotid ultrasound

KW - endocrinology

KW - vitamin D

UR - http://www.scopus.com/inward/record.url?scp=79961206833&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79961206833&partnerID=8YFLogxK

U2 - 10.1161/STROKEAHA.110.608539

DO - 10.1161/STROKEAHA.110.608539

M3 - Article

C2 - 21719770

AN - SCOPUS:79961206833

VL - 42

SP - 2240

EP - 2245

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 8

ER -