The correlation of cardiovascular risk factors and angiographic findings with serum vitamin D levels in patients undergoing coronary angiography

Authors

  • Tripathy S. K. Department of Medicine, SCB Medical College, Cuttack, Odisha, India
  • Dhal N. Department of Medicine, SCB Medical College, Cuttack, Odisha, India
  • Pattnaik S. Department of Medicine, Student in Neurology, Bangur Institute of Neurosciences, Kolkata, West Bengal, India
  • Routray S. N. Department of Cardiology, SCB Medical College, Cuttack, Odisha, India
  • Das S. Department of Medicine, SCB Medical College, Cuttack, Odisha, India
  • Mishra S. K. Department of Medicine, SCB Medical College, Cuttack, Odisha, India
  • Panigrahi M. Department of Ophthalmology, District Headquarter Hospital, Kendrapada, Odisha, India
  • Mohanty B. Department of Medicine, SCB Medical College, Cuttack, Odisha, India
  • Behera M. R. Department of Medicine, SCB Medical College, Cuttack, Odisha, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20175535

Keywords:

Coronary artery disease, Coronary angiogram, Vit-D insufficiency, 25-(OH)D

Abstract

Background: Studies regarding correlation of various conventional risks factors for Coronary Artery Disease (CAD) are many. Keeping in mind the scarcity of studies regarding Vit-D Deficiency (VDD), a new risk factor in CAD, present study was conducted to correlate Vit-D level with conventional risk factors and Coronary Angiography (CAG).

Methods: Hundred adult patients admitted to Medicine and Cardiology undergoing CAG with suspected or established CAD were kept in study. Patients having renal, hepatic, parathyroid disease, osteomalacia and patients taking drugs interfering with Vitamin D (Vit-D) metabolism were excluded. After detailed history and thorough clinical examination, routine investigations and 25-(OH) D level was estimated. Subsequently patients underwent CAG. Statistical analysis by Mann Whitey test and Chi-square Test was done and inference was drawn.

Results: 100 patients in different age groups had hypertension (HTN) in 53, diabetics mellitus (DM) 39, dyslipidemia 62, smokers 38 and family history of CAD 19. CAG showed normal coronaries in 4, Single Vessel Disease (SVD) in 30, double vessel diseases (DVD) 43 and triple vessel disease (TVD) 22. Vit-D level <20ng/ml i.e. Vit-D deficiency (VDD) in 68, 20-30ng/ml i.e. Vit-D insufficiency (VDI) in 22 and >30ng/ml (normal) in 10. VDD was profound in 51-60 and 61-70 years age groups. Statistical correlation of VDD was not significant with conventional risk factors, but statistically significant correlation of VDD was observed with dyslipidemia and CAG findings in our study.

Conclusions: Like earlier studies we observed significant correlation of Vit-D levels with CAD. Though dyslipidemia was significantly correlated with VDD, correlation of other conventional risk factors like age, sex, HTN, DM, smoking and family history was not found. We conclude from this study presence of significant association of VDD with severe CAD. DVD and TVD by CAG were common with low Vit-D levels.

References

World Health Organisation. World Health Statistics. Department of Measurement and Health Information Systems of the Information, Evidence and Research Cluster. Geneva: WHO Press; 2008:29-31.

Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, et al. Prevalence of Vitamin D insufficiency in an adult normal population. Osteoporosis Int. 1997;7(5):439-43.

Ginde AA, Liu MC, Camargo CA. Demographic differences and trends of Vitamin D insufficiency in the US population, 1988-2004. Arch Med. 2009;169(6):626-32.

Harinarayan CV, Ramalakshmi T, Prasad UV, Sudhakar D. Vitamin D Status in Andhra Pradesh: A population based study. Indian J Med Res. 2008;127:211-8.

Goswami R, Gupta N, Goswami D, Marwaha RK, Tandon N, Kochupillai N. Prevalence and significance of low 25-hydroxy Vitamin D concentrations in healthy subjects in Delhi. Am J Clinic Nut. 2000;72(2):472-5.

Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, et al. Global Vitamin D Status and determinants of hypovitaminosis D. Osteo Int. 2009;20(11):1807-20.

Forman JP, Giovannucci E, Holmes MD, Bischoff-Ferrari HA, Tworoger SS, Willett WC, et al. Plasma 25-hydroxy Vitamin D levels and risk of incident hypertension. Hypertension. 2007;49(5):1063-9.

Li YC. Molecular mechanism of Vitamin D in the Cardiovascular system. J Invest Med. 2011;59(6):868-71.

Fitzpatrick LA, Bilezikian JP, Silverberg SJ. Parathyroid hormone and the Cardiovascular system. Current Osteoporosis Report. 2008;6(2):77-83.

Goel R.K, Lal H. Role of Vitamin D Supplementation in Hypertension. Indian J clinic Biochem. 2011;26(1):88-90.

Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of Vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J clinic Endocrinol Metabol. 2007;92(6):2017-29.

Isaia G, Giorgino R, Adami S. High Prevalence of Hypovitaminosis D in Female Type 2 Diabetic population Seasonal Variation of glycemic control in type 2 diabetic patients. Diabetes Care. 2001;24:1503.

Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin Resistance and beta cell dysfunction. Am J Clinic Nut. 2004;79(5):820-25.

Kelishadi R, Farajzadegan Z, Bahreynian M. Association between vitamin D status and lipid profile in children and adolescents: a systematic review and meta-analysis. Int J Food Sci Nut. 2014;65(4):404-10.

Ford ES, Ajani UA, McGuire LC, Liu S. Concentrations of serum Vitamin D and the Metabolic Syndrome Among U.S Adults. Diabet Care. 2005;28(5):1228-30.

Uh ST, Koo SM, Kim YK, Kim KU, Park SW, Jang AS, et al. Inhibition of Vitamin D receptor translocation by cigarette smoking Extracts. Tuberculosis Respiratory Disease. 2012;73(5):258-65.

Siadat ZD, Shariat AS, Sadeghi M, Kiani K, Farajzadegan Z, Kheirmand M. Vitamin D deficiency and coronary artery disease. J Res Med Sci. 2012;17:190-93.

Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-hydroxyVitamin D and risk of Myocardial infarction in men: a prospective study. Archives Internal Medicine. 2008;168(11):1174-80.

Bair TL, Horne B, Anderson J, May H, Lappe D, Muhlestein J. Do levels of Vitamin D differ among patients with coronary artery disease based on Initial clinical presentation. J Am Col Cardiol. 2012;59(13):1386.

Young KA, Snell-Bergeon JK, Nail RG, Hokanson JE, Tarullo D, Gottlieb PA, et al. Vitamin D deficiency and coronary artery Calcification in subjects with type 1 diabetes. Diabet care. 2011;34(2):454-8.

Syal Sk, Kapoor A, Bhatia E, Sinha A, Kumar S, Tewari S, et al. Vitamin D deficiency and coronary artery disease, and endothelial dysfunction: observations from a coronary angiographic study in Indian patients. J Invasive Cardiol. 2012;24(8):385-9.

Shojaeifard M, Rahmanpour HR, Effatpanah M, Omidi N. Association between 25-hydroxy Vitamin D deficiency and severity of coronary artery involvement. Ann Bri Med Sci. 2015;1(1):10-3.

Verdoia M, Schaffer A, Barbieri L, Di Giovine G, Marino P, Suryapranata H, De Luca G, Novara Atherosclerosis Study Group. Impact of gender difference on vitamin D status and its relationship with the extent of coronary artery disease. Nutrition, Metabolism and Cardiovascular Diseases. 2015;25(5):464-70.

Van Ballegooijen AJ, Kestenbaum B, Sachs MC, De Boer IH, Siscovick DS, Hoofnagle AN, Ix JH, Visser M, Brouwer IA. Association of 25-hydroxyvitamin D and parathyroid hormone with incident hypertension: MESA (Multi-Ethnic Study of Atherosclerosis). Journal of the American College of Cardiology. 2014;63(12):1214-22.

Scragg R, Sowers M, Bell C. Serum 25-HydroxyVitamin D, Diabetes, and Ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care. 2004;27:2813-8.

Brot C, Jorgensen NR. Sorensen OH. The influence of smoking on Vitamin D status and calcium metabolism. Eur J Clinic Nutrition. 1999;53(12):920-6.

Entezari-Maleki T, Talasaz AH, Salarifar M, Hadjibabaie M, Javadi MR, Bozorgi A, et al. Plasma vitamin D status and its correlation with risk factors of thrombosis, P-selectin and hs-CRP level in patients with venous thromboembolism; the first study of iranian population. IJPR. 2014;13(1):319.

Schildkraut JM, Myers RH, Cupples LA, Kiely DK, Kannel WB. Coronary risk associated with age and sex of parental heart disease in the Framingham study. Am J Cardiol. 1989;64(10):555-9.

Karhapää P, Pihlajamäki J, Pörsti I, Kastarinen M, Mustonen J, Niemelä O, Kuusisto J. Diverse associations of 25‐hydroxyvitamin D and 1, 25‐dihydroxy‐vitamin D with dyslipidaemias. J Med. 2010;268(6):604-10.

Wang H, Xia N, Yang Y, Peng DQ. Influence of vitamin D supplementation on plasma lipid profiles: a meta-analysis of randomized controlled trials. Lipids in health and disease. 2012;11(1):42.

Downloads

Published

2017-12-23

How to Cite

S. K., T., N., D., S., P., S. N., R., S., D., S. K., M., M., P., B., M., & M. R., B. (2017). The correlation of cardiovascular risk factors and angiographic findings with serum vitamin D levels in patients undergoing coronary angiography. International Journal of Basic & Clinical Pharmacology, 7(1), 32–37. https://doi.org/10.18203/2319-2003.ijbcp20175535

Issue

Section

Original Research Articles