Vitamin D May Not Improve Lipid Levels: A Serial Clinical Laboratory Data Study
Background—Vitamin D deficiency is highly prevalent and associated with dyslipidemia and cardiovascular disease. The impact is unknown of correcting vitamin D deficiency on blood lipids, strong cardiovascular disease prognostic factors.
Methods and Results—To determine relationships between 25-hydroxyvitamin D levels and lipids, we analyzed 4.06 million de-identified patient laboratory test results from September 2009 through February 2011. We performed a cross-sectional study of this population to determine associations between 25-hydroxyvitamin D levels and lipids across clinically defined strata. We also conducted a retrospective cohort study of vitamin D deficient patients to investigate how changes in 25-hydroxyvitamin D levels relate to changes in lipid levels. After exclusions, 108,711 patients with serial testing were selected for cross-sectional analysis. Compared to vitamin D deficient patients (<20 ng/ml), those with optimal levels (≥30 ng/ml) had lower mean total cholesterol (-1.9 mg/dl [95% CI (-1.2, -2.7 mg/dl)]; p <.0001), lower LDL cholesterol (-5.2 mg/dl [95% CI (-4.5, -5.8 mg/dl)]; p <.0001), higher HDL cholesterol (4.8 mg/dl [95% CI (4.5, 5.0 mg/dl)]; p <.0001), and lower triglycerides (-7.5 mg/dl [95% CI (-6.2, -8.7 mg/dl)]; p <.0001). For the retrospective cohort analysis, raising vitamin D levels from <20 ng/ml to ≥30 ng/ml (n = 6,260), compared to those remaining <20 ng/ml (n = 2,332), was associated with a mean increase in total cholesterol (0.77 mg/dl [95% CI (0.18, 1.36 mg/dl)]; p = .01) and HDL cholesterol (0.42 mg/dl [95% CI (0.08, 0.76 mg/dl)]; p = 0.02), but non-significant changes in LDL cholesterol (0.32 mg/dl [95% CI (-0.01, 0.66 mg/dl)]; p = .06) and triglycerides (0.04 mg/dl [95% CI (-2.16, 2.23 mg/dl)]; p = .97)
Conclusions—While vitamin D deficiency is associated with an unfavorable lipid profile in cross-sectional analyses, correcting for a deficiency might not translate into clinically meaningful changes in lipid concentrations, although data from intervention trials is required to confirm these findings.
- Received November 29, 2011.
- Accepted May 17, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited