The effects of vitamin D repletion on endothelial function and inflammation in patients with coronary artery disease

Seth I. Sokol, Vankeepuram Srinivas, Jill P. Crandall, Mimi Kim, George Tellides, Amir Lebastchi, Yiting Yu, Alok K. Gupta, Michael H. Alderman

Research output: Contribution to journalArticlepeer-review

74 Scopus citations

Abstract

Adequate vitamin D levels may promote cardiovascular health by improving endothelial function and down-regulating inflammation. The objective of this pilot trial was to investigate the effects of vitamin D repletion on endothelial function and inflammation in patients with coronary artery disease (CAD). Using a double-blind placebo wait-list control design, 90 subjects with CAD and vitamin D deficiency (< 20 ng/ml) were randomized 1:1 to 50,000 IU of oral ergocalciferol or placebo weekly for 12 weeks. Endothelial function (reactive hyperemia peripheral arterial tonometry, RH-PAT), circulating adhesion molecules, and pro-inflammatory cytokines were measured at baseline and 12 weeks. The median increase in serum 25-vitamin D from baseline was 26 ± 17 ng/ml in the active group and 4 ± 8 ng/ml in the placebo group (between-group difference = 22 ng/ml, p < 0.001). The median within-subject change in RH-PAT score was 0.13 ± 0.73 with active treatment and -0.04 ± 0.63 with placebo (between-group difference = 0.17, p = 0.44). Within-group and between-group differences in intercellular adhesion molecule levels were greater with placebo (between-group difference = 6 ng/ml, p = 0.048). Vascular cell adhesion molecule levels decreased in both groups by a similar magnitude (median difference between groups = 8.5 ng/ml, p = 0.79). There was no difference between groups in magnitude of reduction in interleukin (IL)-12 (-8.6 ng/ml, p = 0.72) and interferon-gamma (0.52 ng/ml, p = 0.88). No significant differences in blood pressure, e-selectin, high-sensitivity c-reactive protein, IL-6 or the chemokine CXCL-10 were found with treatment. In conclusion, repleting vitamin D levels in subjects with CAD failed to demonstrate any benefits on surrogate markers of cardiovascular health. These results question the role of vitamin D supplementation in modifying cardiovascular disease.

Original languageEnglish (US)
Pages (from-to)394-404
Number of pages11
JournalVascular Medicine (United Kingdom)
Volume17
Issue number6
DOIs
StatePublished - Dec 2012

Keywords

  • coronary disease
  • endothelium
  • inflammation
  • prospective studies
  • randomized controlled trials
  • vascular
  • vitamin D

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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