Relationship between vitamin D status and left ventricular geometry in a healthy population: results from the Baltimore Longitudinal Study of Aging

Ameri P, Canepa M, Milaneschi Y, Spallarossa P, Leoncini G, Giallauria F, Strait JB, Lakatta EG, Brunelli C, Murialdo G, Ferrucci L (University of Genova, Genova, Italy; Clinical Research Branch, National Institute on Aging, NIH, Baltimore, MD, USA; National Institute on Aging, NIH, Baltimore, MD, USA; and VU University Medical Center/GGZ inGeest, Amsterdam, The Netherlands). Relationship between vitamin D status and left ventricular geometry in a healthy population: results from the Baltimore Longitudinal Study of Aging. J Intern Med 2013; 273: 253-262. Objectives The effects of vitamin D on the heart have been studied in patients with cardiac disease, but not in healthy persons. We investigated the relation between vitamin D status and left ventricular (LV) structure and function in community-dwelling subjects without heart disease. Design The relationship between concentrations of 25-hydroxyvitamin D [25(OH)D], a marker of vitamin D reserve, and LV transthoracic echocardiography measures was analysed in 711 participants in the Baltimore Longitudinal Study of Aging who were without cardiac disease. Results Mean 25(OH)D in the study population was 32.3 +/- 11.4ngmL1; only 15.5% of subjects had moderate or severe vitamin D deficiency [25(OH)D<20ngmL1]. Adjusting for age, body mass index, cardiovascular disease risk factors, physical activity, calcium and parathyroid hormone, 25(OH)D was positively correlated with LV thickness ( 0.095, SE 0.039, P<0.05) and LV mass index ( 7.5, SE 2.6, P<0.01). A significant nonlinear relation between 25(OH)D and LV concentric remodelling was observed. LV remodelling was more likely in participants with 25(OH)D levels <30ngmL1 [odds ratio (OR) 1.24; 95% confidence interval (CI) 0.831.85] or 38ngmL1 (OR 1.73; 95% CI 1.132.65), compared with those with 3037ngmL1 25(OH)D. Consistently, LV relative wall thickness was significantly lower (P for trend=0.05), and LV diastolic internal diameter index (P for trend<0.05) and end-diastolic volume index (P for trend<0.05) were significantly higher in subjects with 3037ngmL1 25(OH)D compared to the rest of the study population. There was a significant interaction between 25(OH)D and hypertension on the risk of LV hypertrophy (P<0.05). Conclusions In a population-based sample of predominantly vitamin D-sufficient subjects without heart disease, LV geometry was most favourable at intermediate 25(OH)D concentrations.