Low serum 25-hydroxyvitamin D levels are associated with increased cardiovascular morbidity and mortality

ABSTRACT

Background

There is controversy about the association between vitamin D and cardiovascular disease (CVD). This article aims to explore the association of serum 25-hydroxyvitaminD (25 OHD) with the risk of CVD.

Methods

PubMed, EMBASE, Web of Science database, OVID, and Cochrane Library databases (last updated in August 2022) were systematically searched. The relationship between 25OHD and the risk of CVD was assessed by using the 95% confidence intervals (CI) and hazard ratio (HR). The effect model was selected by the size of heterogeneity.

Results

The meta-analysis included 40 cohort studies that contained 652352 samples. The pooled results showed that a decreased level of 25OHD was associated with an increased relative risk of total CVD events (HR = 1.35, 95% CI: 1.26–1.43). Furthermore, the results also showed that a decreased circulating 25OHD level was associated with an increased mortality of CVD (HR = 1.43, 95% CI: 1.30–1.57) and incidence of CVD (HR = 1.26, 95% CI: 1.16–1.36), especially an increased risk of heart failure (HF) (HR = 1.38, 95% CI: 1.2–1.6), myocardial infarction (MI) (HR = 1.28, 95% CI: 1.13–1.44) and coronary heart disease (CHD) (HR = 1.28, 95% CI: 1.1–1.49).

Conclusions

The current meta-analysis shows that reduced serum 25OHD concentrations is not only associated with increased total cardiovascular events and cardiovascular mortality, but also with increased risk of HF, MI, and CHD.

Limitations

The underlying mechanism still needs to be explored further, and well-designed RCTs are needed to confirm the role of vitamin D in the occurrence and development of CVD.

KEYWORDS:

• Vitamin D
• 25OHD
• cardiovascular disease
• meta-analysis
• mortality
• cohort study

Declaration interests

No potential conflict of interest was reported by the author(s).

Reviewer disclosures

A reviewer on this manuscript has disclosed that they have receive funding from Bio-Tech Pharmacal, Inc. (Fayetteville, AR). Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Author contributions

WL and DX had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: WL, DX and JZ.

Acquisition of data: YZ and QY

Analysis and interpretation of data: All authors.

Drafting of the manuscript: WL.

Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: WL, ZQ and JZ.

Study supervision: DX and JZ

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/00325481.2022.2161250

Additional information

Funding

This paper was not funded.