Vitamin D Inadequacy Is Associated with Significant Coronary Artery Stenosis in a Community-Based Elderly Cohort: The Korean Longitudinal Study on Health and Aging

Context: Recent studies suggest an association between vitamin D activity and cardiometabolic risk. Objective: We investigated vitamin D status and its association with subclinical atherosclerosis in a population-based cohort study, the Korean Longitudinal Study on Health and Aging (KLoSHA). Participants: Participants were 439 men and 561 women aged 65 yr or older who were recruited by random stratified sampling for KLoSHA. Methods: Anthropometric and biochemical parameters, the concentration of 25-hydroxyvitamin D (25-OHD), and intact PTH were measured. Main Outcome Measures: We evaluated the coronary artery calcium score and stenosis using multidetector-row cardiac computed tomography, the intima-media thickness using carotid sonography, pulse wave velocity, and the ankle-brachial index. Results: Among the participants, 49.8, 44.2, and 6.0% had 25-OHD deficiency (< 15 ng/ml), insufficiency (15-29.9 ng/ml), and adequacy (>= 30 ng/ml), respectively. The frequency of coronary artery stenosis (> 50%) differed between 25-OHD categories: 18.5, 12.9, and 1.9% in the 25-OHD-deficient, -insufficient, and -adequate groups, respectively (P < 0.05). After adjusting for cardiometabolic risks and intact PTH concentration, multivariate regression analysis showed that participants with a low 25-OHD concentration had a higher risk of significant coronary artery stenosis; the odds ratios were 2.08 for 25-OHD concentration of 15-29.9 ng/ml vs. at least 30 ng/ml and 3.12 for 25-OHD concentration below 15 ng/ml vs. at least 30 ng/ml (both P < 0.05). Conclusions: The association between 25-OHD inadequacy and subclinical atherosclerosis underscores the clinical implications of vitamin D status. An intervention strategy to increase vitamin D level through vitamin D-fortified diet and adequate sun exposure may mitigate the consequences of vitamin D deficiency. (J Clin Endocrinol Metab 97: 169-178, 2012)