Is the Association between Vitamin D and Cardiovascular Disease Risk Confounded by Obesity? Evidence from the Andhra Pradesh Children and Parents Study (APCAPS)

Christopher Paul Baker, Bharati Kulkarni, K V Radhakrishna, M S Charyulu, John Gregson, Mika Matsuzaki, Amy E Taylor, Dorairaj Prabhakaran, Raja Sriswan Mamidi, Jonathan Wells, Ian Wilkinson, Carmel McEniery, [No Value] Yasmin, George Davey Smith, Yoav Ben-Shlomo, Hannah Kuper, Sanjay Kinra

Research output: Contribution to journalArticle (Academic Journal)

12 Citations (Scopus)

Abstract

BACKGROUND: Evidence of an association between serum vitamin D and cardiovascular disease risk is inconsistent and comes predominantly from studies in high-income settings. We assessed the association between serum levels of 25-hydroxyvitamin D3 (25(OH)D) and cardiovascular disease risk factors in a population of young Indian adults.

METHODS: Cross-sectional analyses of data from APCAPS (Andhra Pradesh Children and Parents Study); a prospective birth cohort study in rural south India. Participants were 1038 (40.3% females) adults aged 18-24 years. Main outcome measures were blood pressures, fasting serum lipids (cholesterols and triglycerides), fasting glucose, insulin, measures of arterial stiffness (aortic augmentation index and aortic pulse wave velocity (aPWV)), carotid intima-media thickness, body mass index (BMI) and body fat (dual X-ray absorptiometry).

RESULTS: Vitamin D deficiency (≤20ng/ml) was observed in 41.1% of this lean (mean BMI: 19.5) and active (mean minutes of moderate or vigorous physical activity per day: 186) population. Vitamin D deficiency was associated with higher median body fat in both males (15.9% body fat in vitamin D deficient males vs. 14.6% in non-deficient males, p<0.05) and females (29.1% body fat in vitamin D deficient females vs. 27.8% in non-deficient females, p<0.05) but no associations were observed between vitamin D deficiency and mean BMI or median fat mass index (FMI). Except a weak inverse association with fasting insulin in males, there was no clear association between serum vitamin D levels and cardiovascular disease risk factors in fully adjusted models.

CONCLUSIONS: We did not find clear evidence for an association between serum vitamin D levels and cardiovascular disease risk factors. Our results, consistent with the limited evidence from randomised trials of vitamin D supplementation and Mendelian randomisation experiments, suggest that the postulated link between serum vitamin D and cardiovascular disease may be non-causal. Instead, it may be attributable to confounding by lifestyle factors such as obesity and physical inactivity which may provide more fruitful targets for cardiovascular disease prevention.

Original languageEnglish
Pages (from-to)e0129468
Number of pages11
JournalPLoS ONE
Volume10
Issue number6
DOIs
Publication statusPublished - 2015

Structured keywords

  • Brain and Behaviour
  • Tobacco and Alcohol

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    MRC UoB UNITE Unit - Programme 1

    Davey Smith, G.

    1/06/1331/03/18

    Project: Research

    Cite this

    Baker, C. P., Kulkarni, B., Radhakrishna, K. V., Charyulu, M. S., Gregson, J., Matsuzaki, M., Taylor, A. E., Prabhakaran, D., Mamidi, R. S., Wells, J., Wilkinson, I., McEniery, C., Yasmin, N. V., Davey Smith, G., Ben-Shlomo, Y., Kuper, H., & Kinra, S. (2015). Is the Association between Vitamin D and Cardiovascular Disease Risk Confounded by Obesity? Evidence from the Andhra Pradesh Children and Parents Study (APCAPS). PLoS ONE, 10(6), e0129468. https://doi.org/10.1371/journal.pone.0129468