Cardiovascular Risk Factors and Their Association with Vitamin D Deficiency in Mexican Women of Reproductive Age

Abstract

Based on a nationally representative sample of young Mexican women aged 20 to 49 years (n = 3260), we sought to explore whether cardiovascular risk factors and acute myocardial infarction (AMI) were associated with vitamin D deficiency (VDD, defined as 25-OH-D <50 nmol/L). To this end, we obtained sociodemographic, serum and anthropometric data from the 2012 National Health and Nutrition Survey (ENSANUT 2012). Analyses were developed through logistic regression models adjusted for potential confounders. The prevalence of VDD was significantly higher in obese women (42.5%, 95% CI; 37.3-47.9) compared to women with a normal body mass index (29.9%, 95% CI; 23.5-37.1, p = 0.05), in those with high total cholesterol (TC) (45.6% 95% CI; 39.4-51.9) compared to those with normal TC levels (33.9%, 95% CI 30-38.1, p = 0.03), and in those with insulin resistance (IR) (44%, 95% CI; 36.9-51.7) or type 2 diabetes mellitus (T2DM) (58.6%, 95% CI 46.9-69.4) compared to those with normal glycemia (no insulin resistance: 34.7%, 95% CI; 30.9-38.8, p = 0.04 and no T2DM: 34.9%, 95% CI 31.4-38.6, p < 0.001). Utilizing individual models to estimate cardiovascular risk according to VDD, we found that the odds of being obese (odds ratio, OR: 1.53, 95% CI 1.02-2.32, p = 0.05), or having high TC levels (OR: 1.43, 95% CI; 1.05-2.01, p = 0.03), T2DM (OR: 2.64, 95% CI; 1.65-4.03, p < 0.001), or IR (OR: 1.48, 95% CI 1.04-2.10, p = 0.026) were significantly higher in women with VDD (p < 0.05). Odds were not statistically significant for overweight, high blood pressure, sedentarism, AMI, high serum concentration of triglycerides, homocysteine, or C-reactive protein models. In conclusion, our results indicate that young Mexican women with VDD show a higher prevalence of cardiovascular risk factors.

Keywords: 25-OH-D; T2DM; cardiovascular risk factors; obesity; vitamin D deficiency; women.

Figure 1

Adjusted prevalence (and 95% confidence interval) of vitamin D deficiency by age group and cardiovascular risk factor among Mexican women aged 20–49 years. BMI: body mass index; T2DM: type 2 diabetes mellitus; IR: insulin resistance; HBP: high blood pressure; TC: total cholesterol; HDL-C: high density lipoprotein; TG: triglycerides; AMI: acute myocardial infarction; Hcy: homocysteine; CRP: C-reactive protein. Horizontal bars indicate a statistical difference (p value < 0.05) among vitamin-D-deficiency prevalence rates in the subcategories. Reference subcategories are 20–29 years for age group; “Normal” for BMI, TC, HDL-C, TG, Hcy, and CRP; and “No” for sedentarism, T2DM, IR, HBP, and AMI. Logistic regression model was adjusted by area (urban/rurality), region of the country, Wellbeing index tertiles, ethnicity and all cardiovascular risk factors.

Figure 2

Odds ratios (OR) and 95% confidence interval adjusted for cardiovascular risk factors by vitamin D deficiency in Mexican women aged 20–49 years. BMI: body mass index; PA: physical activity; T2DM: type 2 diabetes mellitus; IR: insulin resistance; HBP: high blood pressure; TC: total cholesterol; HDL-C: high-density lipoprotein; TG: triglycerides; AMI: acute myocardial infarction; Hcy: homocysteine; CRP: C-reactive protein. (1) All models were adjusted by area (urban/rurality), region of the country, Wellbeing index tertiles, ethnicity and the following risk factor variables: HDL-C (<50 mg/dL), TG (<150 mg/dL), TC (<200 mg/dL), HBP, T2DM, CRP (<5 mg/dL), Hcy (<10 umol/L), sedentarism, overweight–obesity, IR, and AMI, except by the risk factor studied in the particular model. (2) Adjusted by all variables in model 1 excluding T2DM. (3) Adjusted by all variables in model 1 excluding TC. Black circle indicate a statistical difference (p value < 0.05)