Received November 10, 2008
Accepted on March 17, 2009

CLINICAL RESEARCH

25-Hydroxyvitamin D Levels Inversely Associate with Risk for Developing Coronary Artery Calcification

Ian H. de Boer ^*1, Bryan Kestenbaum ^*, Abigail B. Shoben , Erin D. Michos , Mark J. Sarnak ^||, and David S. Siscovick ^*

*Department of Medicine, Division of Nephrology, and Department of Biostatistics, University of Washington, Seattle, Washington; Department of Medicine, Johns Hopkins University, Baltimore, Maryland; and ||Department of Medicine, Division of Nephrology, Tufts Medical Center, Boston, Massachusetts

¹ To whom correspondence should be addressed. E-mail: deboer{at}u.washington.edu.

	Abstract

Vitamin D deficiency associates with increased risk for cardiovascular events and mortality, but the mechanism driving this association is unknown. Here, we tested whether circulating 25-hydroxyvitamin D concentration associates with coronary artery calcification (CAC), a measure of coronary atherosclerosis, in the Multi-Ethnic Study of Atherosclerosis. We included 1370 participants: 394 with and 976 without chronic kidney disease (estimated GFR <60 ml/min per 1.73 m²). At baseline, CAC was prevalent among 723 (53%) participants. Among participants free of CAC at baseline, 135 (21%) developed incident CAC during 3 yr of follow-up. Lower 25-hydroxyvitamin D concentration did not associate with prevalent CAC but did associate with increased risk for developing incident CAC, adjusting for age, gender, race/ethnicity, site, season, physical activity, smoking, body mass index, and kidney function. Further adjustment for BP, diabetes, C-reactive protein, and lipids did not alter this finding. The association of 25-hydroxyvitamin D with incident CAC seemed to be stronger among participants with lower estimated GFR. Circulating 1,25-dihydroxyvitamin D concentrations among participants with chronic kidney disease did not significantly associate with prevalent or incident CAC in adjusted models. In conclusion, lower 25-hydroxyvitamin D concentrations associate with increased risk for incident CAC. Accelerated development of atherosclerosis may underlie, in part, the increased cardiovascular risk associated with vitamin D deficiency.