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Title: Vitamin D and atherosclerosis: A noteworthy link
Authors: Kartha, CC
Rajasree, S
Keywords: Cardiovascular System & Cardiology; Nutrition & Dietetics
Issue Date: 2003
Citation: 9 ,;261-270
Abstract: A number of studies indicate a possible relationship of vitamin D with atherosclerotic diseases. Jim Moon, Bandy and Davison in 1992 observed that the epidemic of ischemic heart disease in North America paralleled the increased use of vitamin D and decreased availability of dietary magnesium. Linden had earlier found a direct correlation of dietary intake of the vitamin with susceptibility for myocardial infarction and suspected that the known hypercholestrolemic effect of the vitamin may be the mechanism. Animal experiments suggest vitamin D to be arteriotoxic. Massive doses of vitamin D induce atherosclerotic lesions in a number of animal species. Lesions similar to those in humans are found when animals are fed hypercholestrolemic diet, given large doses of vitamin D and exposed to nicotine. The major source of vitamin D in adults is vitamin D synthesized in the skin through exposure to the sun. In tropical environment there is a possibility of high level of solar exposure and enhanced serum levels of vitamin D in the population. We explored the relation between serum level of 25-hydroxy vitamin D-3 and ischemic heart disease in a case-control study involving 143 patients with either angiographic evidence of coronary artery disease or patients with acute myocardial infarction and 70 controls, all men in the age group of 45-65 years. Serum levels of 25-hydroxy vitamin D-3, calcium, inorganic phosphate, cholesterol, low-density lipoprotein and triglycerides were elevated in a higher proportion of patients, compared to controls. Serum level of 25-OH-D-3 above 222.5 nmol/L (89 ng/ml) was observed in 59.4% of cases compared to 22.1% in controls (p < 0.001). Elevated serum 25 hydroxy vitamin D-3 levels (greater than or equal to222.5 nmol/L, greater than or equal to89 ng/ml) are associated with a 3.18 fold (95% confidence interval of Odds Ratio: 1.31-7.73) increased rate of ischemic heart disease. Considering the causal relation among calcium, vitamin D and arteriotoxicity, further investigations are warranted to probe whether the elevated serum levels of 25OH-vitamin D-3 observed in patients with ischemic heart disease in a tropical environment has any pathogenic significance.
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