Association between serum 25(OH)D and Life's Essential 8 score: A cross-sectional study

Cardiovascular diseases remain the leading cause of global mortality, and serum 25-hydroxyvitamin D (25(OH)D) deficiency has been identified as a potential contributing risk factor. The American Heart Association introduced Life's Essential 8, a comprehensive framework comprising eight core metrics for assessing cardiovascular health. However, current evidence on the association between serum 25(OH)D status and Life's Essential 8 score remains limited, particularly regarding potential nonlinear relationships. Therefore, this study aims to examine the association between serum 25(OH)D levels and cardiovascular health measured by Life's Essential 8 score.

We conducted a cross-sectional analysis of 17,198 adults using data from the National Health and Nutrition Examination Survey 2007-2018. Life's Essential 8 score were calculated following standardized protocols. Statistical analyses included multivariable logistic regression, restricted cubic spline models, and mediation analysis.

Our analysis revealed a significant nonlinear association between serum 25(OH)D levels and Life's Essential 8 score, with an optimal threshold observed at approximately 127 nmol/L (β = 0.05, P < 0.001). This association persisted after adjusting for traditional cardiovascular risk factors (P < 0.05). Mediation analysis indicated that uric acid mediates approximately 7% of the indirect effect of the relationship between serum 25(OH)D and cardiovascular health. The results indicate that serum 25(OH)D status is associated with cardiovascular health both in direct and indirect effects.

This study demonstrates a significant association between serum 25(OH)D levels and cardiovascular health, as quantified by Life's Essential 8 score. These findings emphasize the significance of optimal vitamin D supplementation being inversely related to CVD risk.