Vol 14, No 6 (2018):254-259

The association between the serum 25-hydroxyvitamin D level and cardiovascular events in individuals with and without metabolic syndrome

Keivan Kiani, Hamidreza Roohafza, Mojgan Gharipour, Minoo Dianatkhah, Mohammad Talaei, Shahram Oveisgharan, Nizal Sarrafzadegan, Masoumeh Sadeghi

DOI: http://dx.doi.org/10.22122/arya.v14i6.1703


BACKGROUND: Previous studies revealed that the level of 25-hydroxyvitamin D [25(OH)D] could be consider as one the risk factors for the occurrence of cardiovascular diseases (CVDs). This study aimed to evaluate the relationship between serum 25(OH)D level and CVD events in individuals with and without metabolic syndrome (MetS) in an Iranian population.

METHODS: In this nested case-control study conducted as a part of the Isfahan Cohort Study (ISC), 55 patients with CVD events were selected as case group, and 55 sex- and age-matched individuals without CVD events as control group. These participants were divided into the two main groups based on the presence of MetS at baseline.

RESULTS: The level of 25(OH)D in individuals with and without MetS was significantly lower among patients with CVD compared to those without CVD events at the baseline of study and after the follow-up (P = 0.036 and P = 0.039, respectively). The level of 25(OH)D significantly decreased risk of incidence of CVD events in individuals without MetS after adjusting for age, sex, nutrition, and exposure to sunlight [0.19 (0.05-0.73); P = 0.016]. There was not any significant relationship between the amount of 25(OH)D at the baseline and CVD events in individuals with MetS.

CONCLUSION: In individuals with MetS, the level of 25(OH)D is not related to CVD events; as MetS directly influence the pathophysiology of mechanisms which are responsible for CVD events, and maybe this effect obscure the effect of 25(OH)D.


Cardiovascular diseases; Metabolic syndrome; 25-hydroxyvitamin D

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Teo K, Chow CK, Vaz M, Rangarajan S, Yusuf S. The prospective urban rural epidemiology (pure) study: Examining the impact of societal influences on chronic noncommunicable diseases in low-, middle-, and high-income countries. Am Heart J 2009; 158(1): 1-7.

Sarrafzadegan N, Kelishadi R, Sadri G, Malekafzali H, Pourmoghaddas M, Heidari K, et al. Outcomes of a comprehensive healthy lifestyle program on cardiometabolic risk factors in a developing country: The Isfahan Healthy Heart Program. Arch Iran Med 2013; 16(1): 4-11.

Institute of Medicine, Board on Population Health and Public Health Practice. A nationwide framework for surveillance of cardiovascular and chronic lung diseases. Washington, DC: National Academies Press; 2011.

El Bilbeisi AH, Shab-Bidar S, Jackson D, Djafarian K. The prevalence of metabolic syndrome and its related factors among adults in Palestine: A meta-analysis. Ethiop J Health Sci 2017; 27(1): 77-84.

Gharipour M, Sarrafzadegan N, Sadeghi M, Khosravi A, Hoseini M, Khosravi-Boroujeni H, et al. The metabolic syndrome and associated lifestyle factors among the Iranian population. Adv Biomed Res 2015; 4: 84.

Mandarino NR, Junior F, Salgado JV, Lages JS, Filho NS. Is vitamin d deficiency a new risk factor for cardiovascular disease? Open Cardiovasc Med J 2015; 9: 40-9.

Mozos I, Marginean O. Links between Vitamin D Deficiency and Cardiovascular Diseases. Biomed Res Int 2015; 2015: 109275.

Motiwala SR, Wang TJ. Vitamin D and cardiovascular disease. Curr Opin Nephrol Hypertens 2011; 20(4): 345-53.

Hovsepian S, Amini M, Aminorroaya A, Amini P, Iraj B. Prevalence of vitamin D deficiency among adult population of Isfahan City, Iran. J Health Popul Nutr 2011; 29(2): 149-55.

Talaei M, Sarrafzadegan N, Sadeghi M, Oveisgharan S, Marshall T, Thomas GN, et al. Incidence of cardiovascular diseases in an Iranian population: The Isfahan Cohort Study. Arch Iran Med 2013; 16(3): 138-44.

Sarrafzadegan N, Talaei M, Sadeghi M, Kelishadi R, Oveisgharan S, Mohammadifard N, et al. The Isfahan cohort study: Rationale, methods and main findings. J Hum Hypertens 2011; 25(9): 545-53.

Huang PL. A comprehensive definition for metabolic syndrome. Dis Model Mech 2009; 2(5-6): 231-7.

Faxon DP, Creager MA, Smith SC Jr, Pasternak RC, Olin JW, Bettmann MA, et al. Atherosclerotic vascular disease conference: executive summary: Atherosclerotic vascular disease conference proceeding for healthcare professionals from a special writing group of the american heart association. Circulation 2004; 109(21): 2595-604.

McNeill AM, Rosamond WD, Girman CJ, Golden SH, Schmidt MI, East HE, et al. The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study. Diabetes Care 2005; 28(2): 385-90.

Awad AB, Alappat L, Valerio M. Vitamin d and metabolic syndrome risk factors: Evidence and mechanisms. Crit Rev Food Sci Nutr 2012; 52(2): 103-12.

Ajabshir S, Asif A, Nayer A. The effects of vitamin D on the renin-angiotensin system. J Nephropathol 2014; 3(2): 41-3.

Judd SE, Tangpricha V. Vitamin D deficiency and risk for cardiovascular disease. Am J Med Sci 2009; 338(1): 40-4.

Kayaniyil S, Harris SB, Retnakaran R, Vieth R, Knight JA, Gerstein HC, et al. Prospective association of 25(OH)D with metabolic syndrome. Clin Endocrinol (Oxf) 2014; 80(4): 502-7.

Gagnon C, Lu ZX, Magliano DJ, Dunstan DW, Shaw JE, Zimmet PZ, et al. Serum 25-hydroxyvitamin D, calcium intake, and risk of type 2 diabetes after 5 years: Results from a national, population-based prospective study (the Australian Diabetes, Obesity and Lifestyle study). Diabetes Care 2011; 34(5): 1133-8.

Rostand SG. Ultraviolet light may contribute to geographic and racial blood pressure differences. Hypertension 1997; 30(2 Pt 1): 150-6.

Hintzpeter B, Mensink GB, Thierfelder W, Muller MJ, Scheidt-Nave C. Vitamin D status and health correlates among German adults. Eur J Clin Nutr 2008; 62(9): 1079-89.

Rajasree S, Rajpal K, Kartha CC, Sarma PS, Kutty VR, Iyer CS, et al. Serum 25-hydroxyvitamin D3 levels are elevated in South Indian patients with ischemic heart disease. Eur J Epidemiol 2001; 17(6): 567-71.


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