Cardiovascular disease outcomes in relation to 25-hydroxyvitamin D and its seasonal variation: Results from the BiomarCaRE consortium
Year: 2025
Type: article
Abstract: BACKGROUND: It has been hypothesized but seldom tested that the winter excess in cardiovascular disease (CVD) is related to hypovitaminosis D. The present study examined the association between CVD and (i) seasonality of 25-hydroxyvitamin D (25[OH]D) and (ii) individual 25(OH)D concentrations. METHODS AND FINDINGS: Harmonized 25(OH)D data were obtained from the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) project, including 79,570 participants examined between 1984 and 2010. One 25(OH)D measurement was available per participant. Primary endpoints were CVD incidence (coronary heart disease or stroke; n = 6006) and CVD mortality (n = 2985). To study (i), Poisson regression-derived rate ratios were compared according to two-month categories, ordered by baseline 25(OH)D concentrations. To study (ii), Cox regression-derived hazard ratios were compared according to quarters of baseline 25(OH)D concentrations. With respect to (i), despite a median 25(OH)D concentration ratio of 1:1.79, the trough months of 25(OH)D in March and April had a similar CVD incidence as the peak months of 25(OH)D in August and September (rate ratio: 1.07, 95% CI: 0.98-1.17). CVD mortality was slightly higher in the trough months compared to the peak months (rate ratio: 1.27, 95% CI: 1.12-1.44) but not compared to the other months (despite median 25[OH]D concentration ratios up to 1:1.62; p ≥ 0.077). The CVD mortality peak in January preceded the 25(OH)D trough, not adhering to the temporality criterion of Bradford Hill. With respect to (ii), compared to the lowest quarter, the highest quarter of 25(OH)D was associated with lower CVD incidence (hazard ratio: 0.82, 95% CI: 0.76-0.89) and CVD mortality (hazard ratio: 0.64, 95% CI: 0.57-0.72). CONCLUSION: The present study does not support the hypothesis that seasonal increases in CVD are driven by short-term reductions in 25(OH)D. As in most observational studies, higher 25(OH)D concentrations were inversely associated with CVD.
Source: PLoS ONE
Authors: Viktor Oskarsson, Veikko Salomaa, Pekka Jousilahti, Luigi Palmieri, Chiara Donfrancesco, Susana Sans, Licia Iacoviello, Simona Costanzo, Marco M. Ferrario, Giancarlo Cesana, Barbara Thorand, Annette Peters, Hugh Tunstall-Pedoe, Mark Woodward, Tanja Zeller, Stefan Blankenberg, Kari Kuulasmaa, Stefan Söderberg
Institutions: Umeå University, Finnish Institute for Health and Welfare, Istituto Superiore di Sanità, Generalitat de Catalunya, Departament de Salut, Istituto Neurologico Mediterraneo, LUM Jean Monnet University, University of Insubria, University of Milano-Bicocca, Helmholtz Munich, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München, German Centre for Cardiovascular Research, University of Dundee, The George Institute for Global Health, UNSW Sydney, The George Institute for Global Health, Imperial College London, Universität Hamburg
Language: English
Topic: Vitamin D Research Studies
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,382
Award: G4214759083
OpenAlex ID: W4409737857