Vitamin D May Not Improve Lipid Levels: A Serial Clinical Laboratory Data Study

• Published in: Circulation (New York, N.Y.) Vol. 126; no. 3; pp. 270 - 277
• Main Authors: PONDA, Manish P, XIAOHUA HUANG, ODEH, Mouneer A, BRESLOW, Jan L, KAUFMAN, Harvey W
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 17.07.2012
• Subjects: Aged; Biological and medical sciences; Blood and lymphatic vessels; Calcium - blood; Cardiology. Vascular system; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Comorbidity; Cross-Sectional Studies; Databases, Factual - statistics & numerical data; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; General and cellular metabolism. Vitamins; Humans; Hyperlipidemias - blood; Hyperlipidemias - epidemiology; Lipids - blood; Longitudinal Studies; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Retrospective Studies; Risk Factors; Triglycerides - blood; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D Deficiency - blood; Vitamin D Deficiency - epidemiology; Lipids; Cardiovascular disease; Vitamin D; Cholesterol
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/CIRCULATIONAHA.111.077875

Vitamin D deficiency is highly prevalent and is associated with dyslipidemia and cardiovascular disease. The impact of correcting vitamin D deficiency on blood lipids, strong cardiovascular disease prognostic factors, is unknown. To determine relationships between 25-hydroxyvitamin D levels and lipids, we analyzed 4.06 million deidentified patient laboratory test results from September 2009 through February 2011. We performed a cross-sectional study of this population to determine associations between 25-hydroxyvitamin D levels and lipids across clinically defined strata. We also conducted a retrospective cohort study of vitamin D deficient patients to investigate how changes in 25-hydroxyvitamin D levels relate to changes in lipid levels. After exclusions, 107 811 patients with serial testing were selected for cross-sectional analysis. Compared with vitamin D deficient patients (<20 ng/mL), those with optimal levels (≥30 ng/mL) had lower mean total cholesterol (-1.9 mg/dL; 95% confidence interval [95% CI], -1.2 to -2.7; P<0.0001), lower low-density lipoprotein cholesterol (-5.2 mg/dL; 95% CI, -4.5 to -5.8; P<0.0001), higher high-density lipoprotein cholesterol (4.8 mg/dL; 95% CI, 4.5-5.0; P<0.0001), and lower triglycerides (-7.5 mg/dL; 95% CI, -6.2 to -8.7; P<0.0001). For the retrospective cohort analysis, raising vitamin D levels from <20 to ≥30 ng/mL (n=6260), compared with remaining at <20 ng/mL (n=2332), was associated with a mean increase in total cholesterol (0.77 mg/dL; 95% CI, 0.18-1.36; P=0.01) and high-density lipoprotein cholesterol (0.42 mg/dL; 95% CI, 0.08-0.76; P=0.02) but nonsignificant changes in low-density lipoprotein cholesterol (0.32 mg/dL; 95% CI, -0.01 to 0.66; P=0.06) and triglycerides (0.04 mg/dL; 95% CI, -2.16 to 2.23 mg/dL; P=0.97). Although vitamin D deficiency is associated with an unfavorable lipid profile in cross-sectional analyses, correcting for a deficiency might not translate into clinically meaningful changes in lipid concentrations; however, data from intervention trials are required to confirm these findings.