Association of Vitamin D Deficiency with Endothelial Dysfunction and Subclinical Atherosclerosis in Obese Adults: A Biomarker-Based Evaluation
DOI:
https://doi.org/10.53350/pjmhs02026205.3Keywords:
Vitamin D Deficiency; Endothelial Dysfunction; Obesity; Subclinical Atherosclerosis; Obesity is associated with endothelial dysfunction, inflammation and subclinical vascular atherosclerotic changes. Obese adults are frequently vitamin D deficient and vitamin D deficiency is increasingly recognised to play a role in cardiovascular and metabolic disease. But its role in endothelial dysfunction and subclinical atherosclerosis is poorly understood in biomarker-based clinical practice.Abstract
Objective: To assess the relationship between vitamin D deficiency and endothelial dysfunction and subclinical atherosclerosis in obese adults, using vascular and inflammatory biomarkers.
Methods: A cross-sectional analytical study was conducted between March 2024 and February 2025 in a tertiary care teaching hospital. One hundred obese adults (body mass index [BMI] ≥30 kg/m²) were recruited by consecutive sampling. Serum 25-hydroxyvitamin D [25(OH)D], interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP) were assessed. Flow-mediated dilation (FMD) of the brachial artery was measured to assess endothelial function, and carotid intima-media thickness (CIMT) was measured by high-resolution ultrasonography to assess subclinical atherosclerosis.
Results: 64.0% of the participants had vitamin D deficiency. The vitamin D-deficient group had a significantly lower FMD and higher CIMT than the non-deficient group (5.9 ± 1.8% vs 8.1 ± 2.2%, p <0.001 and 0.79 ± 0.11 mm vs 0.64 ± 0.09 mm, p <0.001, respectively). The deficient group also had significantly higher serum IL-6 and hs-CRP. Serum vitamin D was positively associated with FMD and inversely associated with CIMT, IL-6 and hs-CRP.
Conclusion: Vitamin D deficiency is strongly linked to endothelial dysfunction, elevated inflammatory markers and early subclinical atherosclerosis in obese adults. This study suggests that vitamin D status could be a useful biomarker-associated predictor of cardiovascular risk in obesity. Carotid Intima-Media Thickness; Flow-Mediated Dilation
References
CHEN Y, LIU X, ZHANG H, WANG J, LI Q, ZHOU Y, et al. 2025. Effect of vitamin D supplementation on endothelial function: an umbrella meta-analysis. Nutrition Metabolism and Cardiovascular Diseases, 35, 101–110. doi:10.1016/j.numecd.2024.12.003
OJAROODI AF, HASSANZADEH S, KHALILI M, RAHIMI M, AZIZI F, MORADI M, et al. 2024. Recent updates on vitamin D and cardiovascular risk: role in endothelial function and thrombosis. Nutrients, 17, 90. doi:10.3390/nu17010090
KOSE M, SENKAL N, TUKEK T, CEBECI T, ATALAR SC, ALTINKAYNAK M, et al. 2022. Severe vitamin D deficiency is associated with endothelial inflammation. European Review for Medical and Pharmacological Sciences, 26, 7046–7052. doi:10.26355/eurrev_202210_29888
KIM DH, MEZA CA, CLARKE H, KIM JS, HICKNER RC. 2020. Vitamin D and endothelial function. Nutrients, 12, 575. doi:10.3390/nu12020575
MCSORLEY ST, HORGAN PG, MCMILLAN DC. 2020. The systemic inflammatory response and endothelial dysfunction in cardiovascular disease. Annals of Surgical Oncology, 27, 1674–1682. doi:10.1245/s10434-019-08190-9
DOLAN RD, MCSORLEY ST, HORGAN PG, LAIRD B, MCMILLAN DC. 2020. The role of inflammation in vascular dysfunction and atherosclerosis. Cancers, 12, 1755. doi:10.3390/cancers12071755
CATA JP, LASALA J, PRATT G, FENG L, SHAH JB. 2021. Perioperative inflammatory response and vascular dysfunction. Journal of Clinical Anesthesia, 68, 110099. doi:10.1016/j.jclinane.2020.110099
SATO N, TAMURA T, MINAMI K, YAMAMOTO M, SUZUKI T, KATO Y, et al. 2021. Cytokine response and endothelial dysfunction in metabolic disease. Surgery Today, 51, 1326–1334. doi:10.1007/s00595-020-02192-7
LIESENFELD LF, KRON M, GOLLA V, WEISSER J, KLEIN M, HOFFMANN J, et al. 2021. Inflammatory biomarkers and vascular outcomes in obesity. International Journal of Colorectal Disease, 36, 1987–1996. doi:10.1007/s00384-021-03930-8
BIANCONI M, FERRARO S, RAUSEI S, ANDREONI B, PELLEGRINI L, BASSI G, et al. 2020. Inflammatory markers and vascular risk in obesity. Updates in Surgery, 72, 1065–1074. doi:10.1007/s13304-020-00773-7
WELSCH T, MÜLLER SA, ULRICH A, KISCHLAT A, HINZ U, BÜCHLER MW, et al. 2020. IL-6 and endothelial dysfunction in metabolic disease. Langenbeck’s Archives of Surgery, 405, 313–321. doi:10.1007/s00423-020-01838-8
SIERZEGA M, NIEKOWAL B, KULIG J, POPIELA T, KOŁODZIEJCZYK P, MATYJA A, et al. 2021. Inflammatory cytokines and early vascular dysfunction. World Journal of Gastrointestinal Surgery, 13, 1204–1215. doi:10.4240/wjgs.v13.i10.1204
GIACCAGLIA V, SALVI PF, ANTONELLI MS, NIGRI G, PIROZZI F, CASAGRANDA B, et al. 2021. Cytokines and endothelial injury in obesity-related inflammation. Journal of Investigative Surgery, 34, 967–975. doi:10.1080/08941939.2019.1705984
WARSCHKOW R, TARANTINO I, UKEGJINI K, BEUTNER U, STEFFEN T, SCHÄFER M, et al. 2020. Biomarkers and early vascular dysfunction. International Journal of Colorectal Disease, 35, 2231–2240. doi:10.1007/s00384-020-03727-7
SINGH PP, ZENG ISL, SRINIVASA S, LEMANU DP, CONNOLLY AB, HILL AG. 2020. Inflammatory biomarkers in predicting vascular dysfunction. British Journal of Surgery, 107, e241–e252. doi:10.1002/bjs.11492
ZHANG Y, LIU X, WANG J, LI H, ZHOU Y, SUN L, et al. 2023. Association of vitamin D levels with endothelial dysfunction and inflammation. BMC Cardiovascular Disorders, 23, 145. doi:10.1186/s12872-023-03145-2
FENG S, LI Z, LIU M, YE Q, XUE T, ZHANG H, et al. 2023. Vitamin D and vascular inflammation in obesity. BMC Gastroenterology, 23, 156. doi:10.1186/s12876-023-02800-9
ZHAO G, ZHU J, SHI C, WANG D, WU W, KUANG T, et al. 2023. Cytokine-mediated endothelial dysfunction and vascular injury. Surgical Infections, 24, 811–817. doi:10.1089/sur.2023.108
JIAO Y, ZHANG X, LIU M, WANG Y, CHEN Z, LI H, et al. 2022. Systemic inflammation and early vascular damage. BMC Gastroenterology, 22, 403. doi:10.1186/s12876-022-02482-9
PROCHÁZKA V, LACINA L, SMETANA K, KALA Z, IHNAT P, VÁVRA P, et al. 2023. Inflammatory markers and vascular injury progression. World Journal of Surgical Oncology, 21, 384. doi:10.1186/s12957-023-03270-9
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