Vitamin D and Its Role in the Lipid Metabolism and the Development of Atherosclerosis

[Sly Saint]

Abstract
Vitamin D, a crucial hormone in the homeostasis and metabolism of calcium bone, has lately been found to produce effects on other physiological and pathological processes genomically and non-genomically, including the cardiovascular system.

While lower baseline vitamin D levels have been correlated with atherogenic blood lipid profiles, 25(OH)D supplementation influences the levels of serum lipids in that it lowers the levels of total cholesterol, triglycerides, and LDL-cholesterol and increases the levels of HDL-cholesterol, all of which are known risk factors for cardiovascular disease. Vitamin D is also involved in the development of atherosclerosis at the site of the blood vessels.

Deficiency of this vitamin has been found to increase adhesion molecules or endothelial activation and, at the same time, supplementation is linked to the lowering presence of adhesion surrogates. Vitamin D can also influence the vascular tone by increasing endothelial nitric oxide production, as seen in supplementation studies. Deficiency can lead, at the same time, to oxidative stress and an increase in inflammation as well as the expression of particular immune cells that play a pivotal role in the development of atherosclerosis in the intima of the blood vessels, i.e., monocytes and macrophages. Vitamin D is also involved in atherogenesis through inhibition of vascular smooth muscle cell proliferation. Furthermore, vitamin D deficiency is consistently associated with cardiovascular events, such as myocardial infarction, STEMI, NSTEMI, unstable angina, ischemic stroke, cardiovascular death, and increased mortality after acute stroke. Conversely, vitamin D supplementation does not seem to produce beneficial effects in cohorts with intermediate baseline vitamin D levels.

5. Vitamin D’s Action on Lipid Profile
Deficient vitamin D levels corelated with unfavorable serum lipid levels and sufficient values with good lipid profiles in observational and interventional studies [33]. More recent studies confirm these findings [34,35,36]. In a 2016 study examining a Polish cohort of patients, there was an inverse relationship between vitamin D levels and total cholesterol (TC), low-density-lipoprotein cholesterol (LDL-C), and triglycerides (TGs) [34].

A study analyzing the levels of 25(OH)D and various lipid fractions of more than 20,000 showed a statistically significant correlation between vitamin D deficiency and an atherogenic lipid profile of the patients [35]. Moreover, recently, meta-analyses have been published evaluating vitamin D levels and vitamin D supplementation and their correlation with the lipid profile [37,38,39]. In one 2015 meta-analysis of eight randomized controlled trials (RCTs) evaluating the impact of vitamin D supplementation on the lipid profile found a lowering effect for TG and a correlation with increasing high-density-lipoprotein cholesterol (HDL-C) but also with LDL-C [37]. The interpretation of these results should be cautionary because of the reduced number of studies considered and the high heterogeneity of outcomes and interventions, i.e., the dose of vitamin D supplementation.

In a much larger meta-analysis evaluating the pooled effect of vitamin D supplementation on TG, TC, LDL-C, and HDL-C in up to 39 RCTs, there was an inverse and statistically significant relationship between vitamin D supplementation and TG, TC, and LDL-C. In contrast, vitamin D supplementation increased levels of HDL-C [38]. Similarly, in a meta-analysis of seven RCTs of co-supplementation of vitamin D and calcium in overweight and obese patients, the authors found that less than 8 weeks of supplementation led to a statistically significant TG, TC, and LDL-C reduction and an increase in HDL-C levels [39].

Low levels of vitamin D have been identified in polycystic ovary syndrome (PCOS), especially in obese patients and those with a waist-to-hip ratio above 0.85 [40]. Additionally, vitamin D deficiency may be a risk factor in the development of this endocrine-metabolic pathology [41]. A meta-analysis of 11 RCTs that included 483 patients with PCOS evaluated the effect of vitamin D supplementation versus placebo [42]. The group treated with vitamin D supplements showed a reduction in insulin resistance and TC versus the placebo group. However, vitamin D supplements did not improve HDL-C and TG levels in patients with PCOS.

Vitamin D and Its Role in the Lipid Metabolism and the Development of Atherosclerosis - PMC

 

[Sly Saint]

see also
Association of changes in lipid levels with changes in vitamin D levels in a real-world setting

Abstract

In clinical trials, vitamin D supplementation has been reported to reduce serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) but not high-density lipoprotein cholesterol (HDL-C). In this cohort study we evaluated the association between changes in vitamin D (25-hydroxyvitamin D) and changes in lipid levels in a real-world setting. Changes in lipid levels over a 1-year period were evaluated among individuals whose vitamin D levels increased (group 1) or decreased (group 2) by ≥ 10 ng/mL in year 2018 versus 2017 (cohort 1; n = 5580), in 2019 versus 2018 (cohort 2, n = 6057), or in 2020 versus 2019 (cohort 3, n = 7249). In each cohort, levels of TC, LDL-C, and TG decreased in group 1 and increased in group 2. Between-group differences in average changes in the 3 cohorts ranged from 10.71 to 12.02 mg/dL for TC, from 7.42 to 8.95 mg/dL for LDL-C, and from 21.59 to 28.09 mg/dL for TG. These differences were significant after adjusting for age, sex, race, education, body mass index, blood pressure, smoking status, geographical location, and baseline levels of vitamin D and lipids (P < 0.001). Changes in vitamin D levels were not significantly associated with changes in HDL-C levels.

Association of changes in lipid levels with changes in vitamin D levels in a real-world setting | Scientific Reports

and
Association between serum vitamin D levels and lipid profiles: a cross-sectional analysis - PMC

 

[MeSci]

I think there is an error here: It says:

"25(OH)D supplementation influences the levels of serum lipids in that it lowers the levels of total cholesterol, triglycerides, and LDL-cholesterol and increases the levels of HDL-cholesterol, all of which are known risk factors for cardiovascular disease."

Surely HDL-C has a negative impact on cardiovascular problems? In other words, it is good because it protects.