Vitamin D status and cardiovascular risk in individuals with metabolic syndrome
DOI:
https://doi.org/10.12957/demetra.2023.68339Abstract
Introduction: Metabolic syndrome is a set of metabolic disorders that are considered cardiovascular risk factors. It is estimated that individuals with metabolic syndrome are three times more likely to develop cardiovascular disease. Inadequate vitamin D status has shown multiple pathophysiological mechanisms that suggest an involvement in the development of cardiovascular disease. Objective: To evaluate the association between vitamin D status and the risk of cardiovascular disease in individuals with metabolic syndrome. Methods: This is a cross-sectional study carried out with 161 adult individuals diagnosed with metabolic syndrome. Anthropometric measurements, blood pressure, and biochemical analyzes were performed, including serum 25(OH)D status. The established criterion for classifying 25(OH)D status was deficient < 20 ng/mL; insufficient ≤ 29 ng/mL and sufficient ≥ 30 ng/mL. Furthermore, the absolute risk of developing cardiovascular disease was assessed using the Framingham Risk Score. Results: The mean 25(OH)D concentration was 29.7 (21-34) ng/mL, indicating insufficient 25(OH)D status in the population. There was no association between vitamin D status and cardiovascular risk in subjects with metabolic syndrome (p > 0.05). Conclusion: There was no association between inadequate 25(OH)D status and increased cardiovascular risk in individuals with metabolic syndrome. However, these results reinforce the importance of clinical monitoring to prevent the impacts of hypovitaminosis D in individuals with metabolic syndrome and the development of new studies to assess the relationship between 25(OH)D status and cardiovascular risk.
Downloads
References
Jani R, Mhaskar K, Tsiampalis T, Kassaw NA, González MAM, Panagiotakos DB. Circulating 25-hydroxy-vitamin D and the Risk of Cardiovascular Diseases. Systematic Review and Meta-analysis of Prospective Cohort Studies. Nutr Metab Cardiovasc Dis. 2021;31(12):3282-304. https://doi.org/10.1016/j.numecd.2021.09.003
Oliveira GMM, Brant LCC, Polanczyk CA, Biolo A, Nascimento BR, Malta DC, et al. Estatística Cardiovascular – Brasil 2020. Arq Bras Cardiol. 2020; 115(3): 308-439. https://doi.org/10.36660/abc.20200812
Kawahara LT, Costa IBSS, Barros CCS, Almeida GC, Bittar CS, Rizk SI, et al. Câncer e Doenças Cardiovasculares na Pandemia de COVID-19. Arq Bras Cardiol. 2020;115(3):547-5. https://doi.org/10.36660/abc.20200405
Sociedade Brasileira de cardiologia. I Diretriz Brasileira de Diagnóstico e Tratamento da Síndrome Metabólica - IDBDSM. Arq Bras Cardiol. 2005;84 Suppl 1:1-28. https://doi.org/10.1590/S0066-782X2005000700001
Alberti G, Zimmet P, Shaw J, Grundy SM. The IDF consensus worldwide definition of the metabolic syndrome. Brussels: International Diabetes Federation; 2006 [cited 2022 Jan 26;1-25. Available from: http://www.idf.org/webdata/docs/IDF_Meta_def_final.pdf
Jahangiry L, Farhangi MA, Rezaei F. Framingham risk score for estimation of 10-years of cardiovascular diseases risk in patients with metabolic syndrome. J Health Popul Nutr. 2017;36(36). https://doi.org/10.1186/s41043-017-0114-0
Oliveira LV, Santos BN, Machado IE, Malta DC, Velasquez-Melendez G, Felisbino-Mendes MS. Prevalência da Síndrome Metabólica e seus componentes na população adulta brasileira. Ciên Saúde Colet. 2020;25(11): 4269-80. http://dx.doi.org/10.1590/1413-812320202511.31202020
Ramírez JP, Leo IB, Huamán HA, González DG, Cuadros MM, Ortiz RC. Vitamina D y su relación con factores de riesgo metabólicos para enfermedad cardiovascular en mujeres adultas. An Fac med. 2018;79(2):119-24. http://dx.doi.org/10.15381/anales.v79i2.14937
Moukayed M, Grant WB. Linking the metabolic syndrome and obesity with
vitamin D status: risks and opportunities for improving cardiometabolic health
and well-being. Diabetes, Metab Syndr Obes Targets Ther. 2019;12:1437-47. http://dx.doi.org/10.2147/DMSO.S176933
Cosentino N, Campodonico J, Milazzo V, Metrio M, Brambilla M, Camera M, et al. Vitamin D and Cardiovascular Disease: Current Evidence and Future Perspectives. Nutrients. 2021;13(10):3603. https://doi.org/10.3390/nu13103603
Wang L, Song Y, Manson JE, Pilz S, März W, Michaëlsson K, et al. Circulating 25-hydroxy-vitamin D and risk of cardiovascular disease: a meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes. 2012;5(6):819-29. https://doi.org/10.1161/CIRCOUTCOMES.112.967604
Bener A, Al-Hamaq AA, Zughaier SM, Öztürk M, Ömer A. Assessment of the Role of Serum 25-Hydroxy Vitamin D Level on Coronary Heart Disease Risk With Stratification Among Patients With Type 2 Diabetes Mellitus. Angiology. 2021;72(1):86-92. https://doi.org/10.1177/0003319720951411
Lloyd-Jones DM. Cardiovascular risk prediction: basic concepts, current status, and future directions. Circulation. 2010;121(15):1768-77. https://doi.org/10.1161/CIRCULATIONAHA.109.849166
Orfanoudaki A, Chesley E, Cadisch C, Stein B, Nouh A, Alberts MJ, et al. Machine learning provides evidence that stroke risk is not linear: The non-linear Framingham stroke risk score. PLoS One. 2020;15(5):e0232414. https://doi.org/10.1371/journal.pone.0232414
Sociedade Brasileira de Cardiologia. VII Diretriz Brasileira de Hipertensão Arterial. Arq Bras Cardiol. 2016;107 Suppl 3:1-103. https://doi.org/10.5935/abc.20160154
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002;106:3143-3421. https://doi.org/10.1161/circ.106.25.3143
Organización Panamericana de la Salud, Guías para el Control y Monitoreo de la Epidemia Tabaquica. In: Instituto Nacional de Câncer (INCA). Abordagem e tratamento do fumante: consenso 2001. Rio de Janeiro: Instituto Nacional de Câncer (INCA); 2001. 2006 [cited 2022 Jan 26;1-25. Available from: https://pesquisa.bvsalud.org/controlecancer/resource/pt/biblio-924606
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911-30. http://dx.doi.org/10.1210/JC.2011-0385
World Health Organization. Obesity: preventing and managing the global epidemic.Report of a WHO Consultation. Geneva: World Health Organ Tech Rep Ser. 2000; 894:265.
Brasil. Ministério da Saúde. Prevenção clínica de doenças cardiovasculares, cerebrovasculares e renais. Brasília: Ministério da Saúde. 2006.
Heidari B, Nargesi AA, Hafezi-Nejad N, Sheikhbahaei S, Pajouhi A, Nakhjavani M, et al. Assessment of serum 25-hydroxy vitamin D improves coronary heart disease risk stratification in patients with type 2 diabetes. Am. Heart J. 2015;170(3):573-79. https://doi.org/10.1016/j.ahj.2015.06.017
Zarooni AA, Marzouqi FI, Darmaki SH, Prinsloo EA, Nagelkerke N. Prevalence of vitamin D deficiency and associated comorbidities among Abu Dhabi Emirates population. BMC Res Notes. 2019;12(1):503. https://doi.org/10.1186/S13104-019-4536-1
Dudenkov DV, Mara KC, Maxson JA, Thacher TD. Serum 25-hydroxyvitamin D values and risk of incident cardiovascular disease: A population-based retrospective cohort study. J Steroid Biochem Mol Biol. 2021;213:105953. https://doi.org/10.1016/j.jsbmb.2021.105953
Barroso WKS, Rodrigues CIS, Bortolotto LA, Mota-Gomes MA, Brandão AA, Feitosa ADM, et al. Diretrizes Brasileiras de Hipertensão Arterial – 2020. Arq Bras Cardiol. 2021;116(3):516-658. https://doi.org/10.36660/abc.20201238
Park CY, Han SN. The Role of Vitamin D in Adipose Tissue Biology: Adipocyte Differentiation, Energy Metabolism, and Inflammation. J Lipid Atherocler. 2021;10(2):130-44. https://doi.org/10.12997/jla.2021.10.2.130
Nimitphong H, Park E, Lee MJ. Vitamin D regulation of adipogenesis and adipose tissue functions. Nutr Res Pract. 2020;14(6):553-67. https://doi.org/10.4162/nrp.2020.14.6.553
Alkhatatbeh MJ, Abdul-Razzak KK, Khasawneh LQ, Saadeh NA. High Prevalence of Vitamin D Deficiency and Correlation of Serum Vitamin D with Cardiovascular Risk in Patients with Metabolic Syndrome. Metab Syndr Relat Disord. 2017;15(5):213-219. http://doi.org/10.1089/met.2017.0003
Dantas-Komatsu RCS, Freire FLA, Lira NRD, Diniz RVZ, Lima SCVC, Pedrosa LFC, et al. Vitamin D status and predictors of 25-hydroxyvitamin D levels in patients with heart failure living in a sunny region. Nutr Hosp. 2021; 19;38(2):349-57. https://doi.org/10.20960/nh.03291
Cunha ATO, Pereira HT, Aquino SLS, Sales CH, Sena-Evangelista KCM, Lima JG, et al. Inadequacies in the habitual nutrient intakes of patients with metabolic syndrome: a cross-sectional study. Diabetol Metab Syndr. 2016;8(32). doi:https://link.gale.com/apps/doc/A449482248/AONE?u=capes&sid=bookmark-AONE&xid=11d51057
Aquino SLS, Cunha ATO, Pereira HT, Freitas EPS, Fayh APT, Lima JG, et al. Predictors of 25-hydroxyvitamin D status among individuals with metabolic syndrome: a cross-sectional study. Diabetol Metab Syndr. 2018;10(1). https://link.gale.com/apps/doc/A546888535/AONE?u=capes&sid=bookmark-AONE&xid=e80aca6f
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Liandra Candido Silva, Séphora Louyse Silva Aquino, Aline Tuane Oliveira Cunha, Josivan Gomes Lima, Lucia Fatima Campos Pedrosa

This work is licensed under a Creative Commons Attribution 4.0 International License.
STATEMENT OF AUTHORSHIP RESPONSIBILITY
Title of the manuscript:
________________________________________________________
1. Statement of responsability
I certify that I have participated in the work above specified and take public responsibility for its content.
I certify that the manuscript represents an original work and that none of the material in the manuscript has been previously published, is included in another manuscript, or is currently under consideration for publication elsewhere, whether in printed form or in electronic media, except that described in the attachment.
In case of acceptance of this text by Demetra: Alimentação, Nutrição & Saude, I declare to be in accordance with the policy of public access and copyright adopted by Demetra, which provides as follows: (a) the authors retain the copyright and grant to the Journal the right of first publication, the work being simultaneously licensed under the Creative Commons Attribution License, which allows the sharing of the work with acknowledgment of authorship and initial publication in this journal; (b) authors are authorized to enter additional contracts separately for non-exclusive distribution of the version of the work published in this journal (eg, publishing in institutional repository or book chapter), with acknowledgment of authorship and initial publication in this journal; and (c) authors are permitted and encouraged to post and distribute their work online (eg, in institutional repositories or on their personal page) at any point before or during the editorial process, as this may lead to productive changes, as well as increase the impact and citation of the published work.
2. Conflict of Interest Statement
I certify that there is no conflict of interest in connection with the submitted article.
Date, signature and full address of all authors.