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 journalArticlepeer-review

72 Scopus citations


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 (US)
Pages (from-to)2240-2245
Number of pages6
Issue number8
StatePublished - Aug 2011


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

ASJC Scopus subject areas

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


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