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Serum Vitamin D Levels Are Independently Associated With Severity of Coronary Artery Disease
  1. Fatih Akin, MD*,
  2. Burak Ayça, MD,
  3. Nuri Köse, MD,
  4. Mustafa Duran, MD*,
  5. Mustafa Sarı, MD§,
  6. Onur Kadir Uysal, MD*,
  7. Cigdem Karakukcu, MD,
  8. Huseyin Arinc, MD*,
  9. Adrian Covic, MD, PhD, FRCP,
  10. David Goldsmith, MD, FRCP**,
  11. Barış Okçün, MD††,
  12. Mehmet Kanbay, MD‡‡
  1. From the *Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey; †Department of Cardiology, Bağcılar Education and Research Hospital, Istanbul, Turkey; ‡Department of Cardiology, Yücelen Hospital, Muğla, Turkey; §Department of Cardiology, Haseki Education and Research Hospital, Istanbul, Turkey; ∥Department of Biochemistry, Kayseri Education and Research Hospital, Kayseri, Turkey; ¶Nephrology Clinic, Dialysis and Renal Transplant Center, “C.I. PARHON” University Hospital, “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania; **Renal Unit at Guy’s and St Thomas’ NHS Foundation Hospital, London, UK; ††Department of Cardiology, Institute of Cardiology, Istanbul University, Istanbul, Turkey; and ‡‡Division of Nephrology, Department of Medicine, Kayseri Education and Research Hospital, Kayseri, Turkey.
  1. Received December 4, 2011, and in revised form February 28, 2012.
  2. Accepted for publication February 29, 2012.
  3. Reprints: Fatih Akın, MD, Kayseri Education and Training Hospital, Kocasinan, Kayseri, Turkey. E-mail: fatih._akin{at}
  4. The authors declare the absence of any commercial or other associations that might pose a conflict of interest in connection with the submitted article.


Background and Objectives Low-serum vitamin D levels have been associated with increased cardiovascular risk in the general population. We hypothesized that serum vitamin D levels would be inversely associated with inflammation and with severity of coronary atherosclerosis. We therefore investigated the link between serum vitamin D levels and (1) the extent of coronary artery disease (CAD) assessed by the Gensini score and (2) inflammatory parameters, including C-reactive protein and fibrinogen.

Materials and Methods We measured 25-hydroxyvitamin D (25[OH]D) and inflammatory markers in 239 patients who underwent coronary angiography. We analyzed the relation between serum levels of 25(OH)D and inflammatory markers and angiographic severity of CAD. The Gensini lesion severity score was used for assessing the severity of coronary atherosclerosis.

Results Vitamin D insufficiency was very common among our study population: 83% of the study population had levels less than 30 ng/mL. The Gensini score was negatively associated with serum vitamin D levels (r = −0.416, P < 0.001), and positively correlated with age (r = 0.209, P = 0.001), blood pressure (r = 0.379, P < 0.001), diabetes (r = 0.335, P < 0.001), hyperlipidemia (r = 0.150, P = 0,021), and C-reactive protein levels (r = 0.214, P = 0,001). After adjustments for traditional and nontraditional cardiovascular risk factors, vitamin D (B = −0,345, P < 0,001) remained a significant predictor for the severity of CAD.

Conclusions Low-serum 25(OH)D levels are associated with the severity of coronary artery stenosis. Further studies are warranted to determine whether vitamin D supplementation could prevent progression of CAD.

Key Words
  • coronary artery disease
  • 25-hydroxyvitamin D
  • inflammatory markers
  • vitamin D
  • C-reactive protein

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