Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jan;98(1):389-97.
doi: 10.1210/jc.2012-3097. Epub 2012 Nov 8.

Vitamin D status and coronary flow reserve measured by positron emission tomography: a co-twin control study

Cristina Karohl  1 , Viola Vaccarino, Emir Veledar, Jack Goldberg, Vin Tangpricha, Antonio Bellasi, Paolo Raggi
Affiliations

Vitamin D status and coronary flow reserve measured by positron emission tomography: a co-twin control study

Cristina Karohl et al. J Clin Endocrinol Metab. 2013 Jan.

Abstract

Context: Vitamin D insufficiency is associated with increased cardiovascular events in the general population. Additionally, low serum 25-hydroxyvitamin D [25(OH)D] is associated with endothelial dysfunction and arterial stiffness. However, little is known about the association between serum 25(OH)D level and myocardial blood flow.

Objective: Our objective was to examine the association between serum 25(OH)D levels and coronary flow reserve (CFR) measured by (13)N-positron emission tomography in asymptomatic middle-aged male twins.

Design: The Emory Twin Study is a cross-sectional study of soldiers from the Vietnam Era Registry.

Setting: The study was conducted at the General Clinical Research Center, Emory University, Atlanta, GA.

Participants: A total of 368 middle-aged male twins were enrolled for the study. Serum 25(OH)D levels were measured in all subjects and classified as vitamin D insufficiency [25(OH)D <30 ng/ml] or sufficiency [25(OH)D ≥30 ng/ml]. Positron emission tomography with [(13)N]ammonia was used to evaluate myocardial blood flow at rest and after adenosine stress. CFR was measured as the ratio of maximum to rest myocardial blood flow.

Main outcome measure: Primary outcome was CFR measurement.

Results: Mean overall serum 25(OH)D concentration was 37.0 ± 21.4 ng/ml; 167 twins (45%) were vitamin D insufficient. CFR was significantly lower in subjects with vitamin D insufficiency compared with subjects with vitamin D sufficiency (2.41 vs. 2.64; P = 0.007), even after adjustment for traditional cardiovascular risk factors, serum PTH, calcium, and phosphorus levels, and season. An abnormal CFR (CFR <2) was more prevalent in subjects with vitamin D insufficiency than with vitamin D sufficiency (31 vs. 20%; P = 0.03). In addition, in vitamin D status-discordant twin pairs, CFR was significantly lower in the vitamin D-insufficient twin than in the vitamin D-sufficient co-twin (2.35 vs. 2.58; P = 0.037).

Conclusion: Vitamin D insufficiency is associated with lower CFR in men. This association may help explain some of the increased cardiovascular risk reported in individuals with vitamin D insufficiency.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
Vitamin D status and CFR. The horizontal thick lines indicate the median values; the upper and lower bounds represent the 75th and 25th percentile.
See this image and copyright information in PMC

References

    1. Melamed ML, Muntner P, Michos ED, Uribarri J, Weber C, Sharma J, Raggi P. 2008. Serum 25-hydroxyvitamin D levels and the prevalence of peripheral arterial disease: results from NHANES 2001 to 2004. Arterioscler Thromb Vasc Biol 28:1179–1185 - PMC - PubMed
    1. Dobnig H, Pilz S, Scharnagl H, Renner W, Seelhorst U, Wellnitz B, Kinkeldei J, Boehm BO, Weihrauch G, Maerz W. 2008. Independent association of low serum 25-hydroxyvitamin d and 1,25-dihydroxyvitamin D levels with all-cause and cardiovascular mortality. Arch Intern Med 168:1340–1349 - PubMed
    1. Pilz S, März W, Wellnitz B, Seelhorst U, Fahrleitner-Pammer A, Dimai HP, Boehm BO, Dobnig H. 2008. Association of vitamin D deficiency with heart failure and sudden cardiac death in a large cross-sectional study of patients referred for coronary angiography. J Clin Endocrinol Metab 93:3927–3935 - PubMed
    1. Kendrick J, Targher G, Smits G, Chonchol M. 2009. 25-Hydroxyvitamin D deficiency is independently associated with cardiovascular disease in the Third National Health and Nutrition Examination Survey. Atherosclerosis 205:255–260 - PubMed
    1. Burgaz A, Orsini N, Larsson SC, Wolk A. 2011. Blood 25-hydroxyvitamin D concentration and hypertension: a meta-analysis. J Hypertens 29:636–645 - PubMed

Publication types

MeSH terms