Background/Purpose: Vitamin D is involved in immune reactions, and vitamin D deficiency is associated with autoimmune diseases and with cardiovascular diseases. In Feiring Heart Biopsy Study (FHBS), we previously demonstrated a high occurrence of mononuclear cell infiltrates (MCIs) in subintimal layers of the aorta, related to inflammatory rheumatic disease (IRD). In theory, vitamin D deficiency might contribute to vascular inflammation involved in the pathogenesis of cardiovascular disease (CVD) along with the premature and accelerated CVD in IRD.

We looked for differences in plasma levels of 25(OH)D₃ and 1,25(OH)₂D₃ in patients with coronary arterial disease (CAD) and CAD+IRD, and examined if the levels of 25(OH)D₃ and 1,25(OH)₂D₃ were related to inflammation in subintimal aortic layers in terms of MCIs.

Methods: Plasma levels of 25(OH)D₃ were examined by radioimmunoassay and 1,25(OH)₂D₃ by immunoassay in 53 patients with CAD and 68 patients with CAD and IRD from FHBS. The D vitamin levels were then correlated to the number of MCI previously identified in the subintimal aortic layers of these patients (I. Hollan et.al., Arthritis Rheum, 56 (2007), 2072-9).

Results: From our univariate analysis, we observed no differences in 25(OH)D₃ and 1,25(OH)₂D₃ levels between patients with CAD+IRD and patients with CAD only (see Table). Nor did we observe any relationships between vitamin D levels and occurrence of MCIs in the subintimal aortic layers. However, after adjustment for variables with p<0,20 (CRP, glucocorticosteroids, daily vitamin and mineral supplementation, group, MCI) and age and sex, there was a significant inverse relationship between 1,25(OH)₂D₃and the occurrence of MCIs in the subintimal aortic layers (B=-17, p=0.019, CI= -31.3, -2.8).

	CAD-IRD (n=68)	CAD-nonIRD (n=53)	P value
Age – years	67±10	68±10	0.601
Women – no. (%)	26 (38)	19 (36)	0.851
25(OH)D3 – nmol/l	59±20	59±14	0.930
1,25(OH)2D3 – pmol/l	108±46	96±23	0.055
MCI in aortic adventitia – no. (%)	30 (48)	10 (20)	0.002

Conclusion: Our study does not support the hypothesis that vitamin D deficiency contributes to the premature and accelerated CVD in IRD. However, based on multivariate analyses, low 1,25(OH)₂D₃ might  be related to the presence inflammation in the subintimal layers of the aorta.  This fact needs more exploration in future studies. If there is a causal relationship, vitamin d supplementation might represent a simple and cheap treatment for vascular inflammation.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/vitamin-d-levels-and-inflammation-in-the-aortic-wall-of-patients-with-inflammatory-rheumatic-disease-and-coronary-artery-disease/