The Association between Vitamin D and Peripheral Arterial Disease and its Value as a Prognostic and Diagnostic Marker...

Vitamin D deficiency is associated with increased cardiovascular morbidity and mortality through pathways that foster atherosclerosis. This review aims to clarify the relationship between serum vitamin D and peripheral artery disease (PAD), while evaluating the prognostic implications and diagnostic utility of vitamin D deficiency in PAD patients.

Patients with PAD, displayed significantly lower serum vitamin D levels compared to non-PAD individuals, mean difference (MD), - 2.12ng/mL (95%CI:-4.13 to - 0.12). Individuals with vitamin D deficiency (< 20 ng/mL) exhibited a higher prevalence of PAD relative to those with insufficient or sufficient levels, odds ratio (OR), 1.52 (95%CI:1.07-2.18). Unadjusted prognostic factor analysis displayed an increased hazard for PAD occurrence among deficient patients, hazard ratio (HR), 1.04 (95%CI:1.02-1.06), an outcome that failed to retain its statistical significance upon parameter adjustment, adjusted HR, 1.01 (95%CI:0.99-1.03). Diagnostic accuracy analysis displayed the poor performance of the 20ng/mL threshold with pooled sensitivity and specificity of 0.76 (95%CI:0.55-0.90) and 0.34 (95%CI:0.17-0.57). Further analysis identified a negative predictive value (NPV) of 94% for the 19.65ng/mL threshold, indicating a 6% prevalence of PAD above this cutoff. While this review displayed both decreased vitamin D concentrations for PAD patients and an increased prevalence of PAD among patients with vitamin D deficiency, the prognostic effect of vitamin D on the development of PAD remains inconclusive. Despite the poor performance of vitamin D deficiency as a diagnostic marker, the NPV displayed by the analysis further supports the possible association between vitamin D deficiency and PAD.