Association of Serum 25-hydroxyvitamin D in Carotid Intima-media Thickness: A Study from South India

Abnormal carotid intima-media thickness (IMT) is a marker of carotid atherosclerosis which is a risk factor for cerebrovascular and cardiovascular diseases. Recent studies have found an association of 25-hydroxyvitamin D deficiency with abnormal carotid IMT.

The purpose of the study was to investigate the association of serum 25-hydroxyvitamin D levels with carotid IMT in Indian participants.

We prospectively recruited 300 participants at Yashoda Hospital, Hyderabad, during the study period between January 2012 and December 2014. All participants were assessed for fasting blood sugar, lipid profile, C-reactive protein (CRP), serum alkaline phosphatase, serum calcium, serum phosphorous, serum 25-hydroxyvitamin D levels, and carotid Doppler examination.

Among the 300 participants, men were 190 (63.3%) and mean age was 51.9 ± 7.7 years with a range from 35 to 64 years. On risk factors evaluation, 105 (35%) were hypertensive, 79 (26.3%) diabetics, 63 (21%) smokers, and 56 (18.6%) were alcoholics. On evaluation of biochemical parameters, 81 (27%) had dyslipidemia, 120 (40%) had elevated CRP levels, 119 (39.6%) had 25-hydroxyvitamin D deficiency, mean alkaline phosphatase was 93.9 ± 14.9 IU/L, serum calcium (mg/dL) was 9.2 ± 2.3, and serum phosphorous 4.4 ± 1.2 mg/dL. On carotid imaging, 121 (40.3%) had abnormal IMT. After multivariate analysis, 25-hydroxyvitamin D deficiency (odds ratio [OR]: 2.14; 95% confidence interval [CI]: 1.29-3.55), dyslipidemia (OR: 2.53; 95% CI: 1.46-4.40), elevated CRP (OR: 2.27; 95% CI: 1.37-3.76), smoking (OR: 2.09; 95% CI: 1.16-3.77), and diabetes (OR: 1.84; 95% CI: 1.05-3.21) were independently associated with abnormal IMT.

In our study, we established 25-hydroxyvitamin D deficiency as an independently associated with abnormal IMT in Indian participants.