Association of Vitamin D and Endothelial Function in a Subsample of the Participants in the Longitudinal Study of Adult Health (ELSA-BRASIL)

Rapid Communication

Int J Nutr Sci. 2023; 8(2): 1078.

Association of Vitamin D and Endothelial Function in a Subsample of the Participants in the Longitudinal Study of Adult Health (ELSA-BRASIL)

Sousa MCR¹; Silva IFO¹*; Reis EA²; Ribeiro ALP³; Brant LCC³; Gonçalves LG³; Barreto S³

¹Faculdade de Farmácia, Universidade Federal de Minas Gerais, Brazil

²Departamento de Estatística, Universidade Federal de Minas Gerais, Brazil

³Faculdade de Medicina, Universidade Federal de Minas Gerais, Brazil

*Corresponding author: Silva IFO Faculdade de Farmácia, Universidade Federal de Minas Gerais. Avenida Antônio Carlos, 6627 - Campus Pampulha Belo Horizonte - Minas Gerais - 31270-901, Brazil. Tel: +55 (31) 3409-6881, +55 (31) 99281-4057; Fax: +55 (31) 31 3409-6895 Email: iedafos@farmacia.ufmg.br or iedafos@yahoo.com.br

Received: September 15, 2023 Accepted: October 07, 2023 Published: October 14, 2023

Abstract

The Longitudinal Study of Adult Health (ELSA-BRASIL) is a multicentric and multidisciplinary cohort study aimed at investigating the incidence and risk factors of chronic diseases. Vitamin D deficiency has been associated with several comorbidities. In this context, the need to assess the impact of vitamin D on endothelial dysfunction in a large-scale study is justified. Thus, in this study, serum levels of vitamin D were determined by HPLC in 509 participants of the ELSA-BRASIL, and its association with endothelial function parameters by Peripheral Arterial Tonometry (BPA and PATratio). Reduced levels of vitamin D were shown to be associated with indicative measures of worse endothelial function. In the logistic regression model, the variables male sex, white color, increase in age, BMI, triglycerides, and vitamin D<30ng/mL were also indicative of worse endothelial function. In summary, vitamin D has presented an association with endothelial function, which may indicate a protective action of vitamin D to the vascular endothelium.

Keywords: ELSA-BRASIL; Vitamin D; Endothelial dysfunction; EndoPAT

Introduction

Vitamin D is involved in cell development and growth, autoimmunity, insulin resistance and cardiovascular diseases [1,2]. Vitamin D levels are also possibly associated with endothelial function through the renin-angiotensin system, by promoting Nitric Oxide (NO) availability and immunomodulation [3,4].

There are indications that vitamin D could be somehow related to endothelial function, nonetheless the data found in the literature is contradictory [5,6] and inconclusive [7]. Hence the present study aimed to evaluate vitamin D and endothelial function in a subsample of adults residing in Minas Gerais participating in the Longitudinal Study of Adult Health (ELSA-BRASIL) who underwent measurement of microvascular endothelial function by Peripheral Arterial Tonometry (PAT).

Materials and Methods

Overview

The present study is part of the ELSA-BRASIL, a multicentric cohort, approved by the Research Ethics Committee of Universidade Federal de Minas Gerais (UFMG) under registration number ETIC 186/06. The project was carried out in accordance with the guidelines of the Declaration of Helsinki.

A serum subsample of 509 participants, age 35 to 74 years old, was used to determine vitamin D levels. The endothelial function parameters were provided via a database collected between 2008 and 2010 by the researchers of the ELSA-BRASIL study, following standardized protocols. After quality control, the results of 20 participants were excluded due to technical issues.

Vitamin D blood concentrations were categorized into vitamin D levels above or below 30 ng/mL in accordance with the International Osteoporosis Foundation and the American Geriatrics Society, which designate vitamin D “insufficiency” when blood vitamin D is between 12 and 30 ng/mL [8,9].

Vitamin D Blood Analysis

Vitamin D blood concentration of the participants was quantified using the technique of High-Performance Liquid Chromatography (HPLC) according to [10].

Endothelial Function Assessment

The endothelial function was assessed using an automated device (EndoPAT2000; Itamar Medical, Caesarea, Israel). From these measurements, the PATratio was calculated, which is the ratio between the amplitude of the vascular pulse 90 to 120 seconds after cuff deflation and the mean basal pulse amplitude (mean BPA) [11,12].

Statistical Analysis

Categorical data were described by the absolute and relative frequencies, while continuous variables were summarized by the median and interquartile range (Q1-Q3).

To investigate the explanatory variables associated with the vitamin D response variables or endothelial function, the logistic regression model was used, according to the definition of the response variable as qualitative. The level of significance used was 5%. The computer program used was R CORE-TEAM, 2020.

Results

Vitamin D Categories

In the sample of this study (n=509), 124 (24.4%) had values below 30 ng/mL and 385 (75.6%) of the participants, above 30 ng/mL.

Endothelial Function Measurements

Descriptive statistics with BPA and PATratio values (Table 1).