https://www.lipidjournal.com/article/S1933-2874(15)00384-0/fulltext
The pathophysiology for deficient 25(OH)D causing an atherogenic lipid profile is unclear. Inadequate dietary intake of vitamin D may reduce calcium absorption in the gastrointestinal system. Prior studies have shown that deficient dietary intake of calcium is associated with higher body weight and a more atherogenic lipid metabolism,53x53Reid, I.R. Effects of calcium supplementation on circulating lipids: potential pharmacoeconomic implications. Drugs Aging. 2004; 21: 7–17
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PubMed | Google ScholarSee all References potentially due to increased lipid metabolism in the body or reduced intake of cholesterol in the gut. However, the observed association between 25(OH)D and dyslipidemia may be confounded by shared metabolic risk factors rather than a causal mechanism. Serum 25(OH)D has been shown to be decreased in obese patients, in whom sequestration of 25(OH)D in body fat reduces detectable 25(OH)D in the serum.55x55Wortsman, J., Matsuoka, L.Y., Chen, T.C., Lu, Z., and Holick, M.F. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000; 72: 690–693
PubMed | Google ScholarSee all References This phenomenon results in an inverse association between BMI and 25(OH)D. Given that BMI is also associated with dyslipidemia, the presence of obesity may explain the observed association of 25(OH)D with dyslipidemia. Unfortunately, we did not have BMI available in our data set to adjust for this potentially confounding variable. There also appears to be an association between lipid-lowering medication usage and increases in 25(OH)D,56x56Ertugrul, D.T., Yavuz, B., Cil, H. et al. STATIN-D study: comparison of the influences of rosuvastatin and fluvastatin treatment on the levels of 25 hydroxyvitamin D. Cardiovasc Ther. 2011; 29: 146–152
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Abstract | Full Text | Full Text PDF | PubMed | Scopus (125) | Google ScholarSee all References suggesting that the observed association between low 25(OH)D levels and dyslipidemia may be due to patients with lipid derangements not being on statin therapy.
Although vitamin D supplementation is inexpensive, widely available, and effective in raising serum 25(OH)D, clinical trials have yet to find any link between vitamin D supplementation and changes in lipid profile or reduced CVD mortality.15x15Kienreich, K., Tomaschitz, A., Verheyen, N. et al. Vitamin D and cardiovascular disease. Nutrients. 2013; 5: 3005–3021
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Crossref | PubMed | Scopus (121) | Google ScholarSee all References Mendelian randomization studies have used single nucleotide polymorphisms leading to variations in 25(OH)D to examine vitamin D's role in the development of an atherogenic lipid profile and CVD.49x49Ooi, E.M., Afzal, S., and Nordestgaard, B.G. Elevated remnant cholesterol in 25-hydroxyvitamin D deficiency in the general population: Mendelian randomization study. Circ Cardiovasc Genet. 2014; 7: 650–658
Crossref | PubMed | Scopus (17) | Google ScholarSee all References, 62x62Vimaleswaran, K.S., Berry, D.J., Lu, C. et al. Causal relationship between obesity and vitamin D status: bi-directional mendelian randomization analysis of multiple cohorts. PLoS Med. 2013; 10: e1001383
Crossref | PubMed | Scopus (370) | Google ScholarSee all References, 63x63Afzal, S., Brondum-Jacobsen, P., Bojesen, S.E., and Nordestgaard, B.G. Genetically low vitamin D concentrations and increased mortality: Mendelian randomisation analysis in three large cohorts. BMJ. 2014; 349: g6330
Crossref | PubMed | Scopus (102) | Google ScholarSee all References These studies have shown evidence that single nucleotide polymorphisms causing a genetically increased RLP-C49x49Ooi, E.M., Afzal, S., and Nordestgaard, B.G. Elevated remnant cholesterol in 25-hydroxyvitamin D deficiency in the general population: Mendelian randomization study. Circ Cardiovasc Genet. 2014; 7: 650–658
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Crossref | PubMed | Scopus (370) | Google ScholarSee all References are associated with reduced 25(OH)D. This supports the notion that 25(OH)D may be a marker for overall health rather than an independent risk factor for CVD. As there is not currently any definitive evidence that vitamin D has a causal role in atherosclerotic CVD,21x21Manson, J.E. and Bassuk, S.S. Vitamin D research and clinical practice: at a crossroads. JAMA. 2015; 313: 1311–1312
Crossref | PubMed | Scopus (73) | Google ScholarSee all References the associations seen in observational studies may be due to confounding factors that impact both serum 25(OH)D and serum lipids