Measuring coronary artery calcification: Is serum vitamin D relevant?

Objectives: To synthesize evidence of the association between low vitamin D levels and subclinical coronary atherosclerosis measured by coronary artery calcium (CAC). Methods: A systematic MEDLINE search was conducted for relevant published literature. Ten studies (7 cross-sectional, 3 longitudinal) met the inclusion criteria. Results: Three of 6 studies showed association with CAC prevalence (CAC >0 or >10). Four of 8 studies found an association with CAC severity. One of two studies reported an association with CAC progression, while the only study that assessed CAC incidence did not find a significant relationship. Several of the studies had small sample sizes, many did not adjust for confounders and the cut-off for low vitamin D was inconsistent. Conclusion: There is insufficient evidence to support a consistent association between low vitamin D levels and CAC. Further high-quality studies are needed to examine serum 25-OH vitamin D in relation to subclinical coronary atherosclerosis.