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Updated: May 23, 2026

Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test
Published on: April 27, 2016
25-Hydroxy vitamin D levels and endothelial vasodilator function in normotensive women
Sibel Ertek1, Ebru Akgül, Arrigo F Cicero
1Endocrinology and Metabolic Diseases Department, Ufuk University Medical Faculty, Dr. R. Ege Hospital, Ankara, Turkey.
Introduction:
Vitamin D was shown to be related to endothelial function and blood pressure. Reactive hyperaemia index (RHI) measurement by pulse arterial tonometry is a new method to evaluate vasodilator function of endothelium. We aimed to evaluate the relationship between vitamin D levels and RHI in women.
Material And Methods:
We enrolled 56 normotensive, nonsmoker, normolipidemic and normoglycemic women, (23 with 25-OH-vitamin D levels>20 µg/l, and 33 with values lower than 20 µg/l). The cardiologist who was blind for vitamin D results executed measurements by pulse arterial tonometry. The measurement was performed on the lying patient with pre- and post-occlusion measurements of RHI by digital sensors placed on each index finger, by 5 min intervals. Pulse amplitudes were recorded, pre-occlusion and post-occlusion ratio was compared by the software of device. Stepwise linear regression and multiple regression analyses were performed to evaluate predictors of endothelial function.
Results:
The low vitamin D group had a lower RHI value than the normal vitamin D group (p = 0.042). In regression analysis, positive predictors of RHI were serum 25-OHD (β = 0.401; 95% CI 0.010-0.042, p = 0.002), serum albumin (β = 0.315; 95% CI 0.286-2.350, p = 0.013), and, inversely, serum calcium (β = -0.247; 95% CI (-1.347)-(-0.010), p = 0.047).
Conclusions:
Serum 25-hydroxy vitamin D was significantly related to endothelial functions measured as RHI, even in healthy non-smoker women.
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