Association of serum vitamin D with diagnosis and growth of abdominal aortic aneurysm

Shivshankar Thanigaimani, PhD; Rachel E. Neale, PhD; Mary Waterhouse, PhD; Joseph V. Moxon, PhD; Bu B. Yeap, PhD; Paul E. Norman, PhD; Leon Flicker, PhD; Graeme J. Hankey, PhD; Jason Jenkins, PhD; Frank Quigley, PhD; Michael W. Clarke, PhD; Jonathan Golledge, MA, FRCS, FRACS

JVS - Vascular Science (Jan 2024)

Association of serum vitamin D with diagnosis and growth of abdominal aortic aneurysm

Shivshankar Thanigaimani, PhD,
Rachel E. Neale, PhD,
Mary Waterhouse, PhD,
Joseph V. Moxon, PhD,
Bu B. Yeap, PhD,
Paul E. Norman, PhD,
Leon Flicker, PhD,
Graeme J. Hankey, PhD,
Jason Jenkins, PhD,
Frank Quigley, PhD,
Michael W. Clarke, PhD,
Jonathan Golledge, MA, FRCS, FRACS

Affiliations

Shivshankar Thanigaimani, PhD: Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
Rachel E. Neale, PhD: Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; School of Public Health, University of Queensland, Brisbane, QLD, Australia
Mary Waterhouse, PhD: Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
Joseph V. Moxon, PhD: Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
Bu B. Yeap, PhD: Medical School, University of Western Australia, Perth, WA, Australia; Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, WA, Australia
Paul E. Norman, PhD: Medical School, University of Western Australia, Perth, WA, Australia
Leon Flicker, PhD: Medical School, University of Western Australia, Perth, WA, Australia
Graeme J. Hankey, PhD: Medical School, University of Western Australia, Perth, WA, Australia; Perron Institute for Neurological and Translational Science, Perth, WA, Australia
Jason Jenkins, PhD: Department of Vascular Surgery, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
Frank Quigley, PhD: Mater Hospital, Townsville, QLD, Australia
Michael W. Clarke, PhD: Metabolomics Australia, Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Perth, WA, Australia; School of Biomedical Sciences, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia
Jonathan Golledge, MA, FRCS, FRACS: Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia; Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, QLD, Australia; Correspondence: Jonathan Golledge, MA, FRCS, FRACS, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, 1 James Cook Dr, Douglas, QLD 4814, Australia

Journal volume & issue: Vol. 5
p. 100208

Abstract

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Objective: We examined the associations between 25-hydroxy vitamin D (25(OH)D3) concentration and the diagnosis and growth of abdominal aortic aneurysm (AAA). Methods: AAA cases and healthy controls were recruited from vascular centers or the community. A subset of participants with AAA were monitored by repeat ultrasound examination to assess AAA growth. Serum 25(OH)D3 concentration was measured using a validated mass spectrometry method and categorized into guideline-recommended cut-points after deseasonalization. The associations between deseasonalized 25(OH)D3 concentration and AAA diagnosis and growth were examined using logistic regression and linear mixed effects modeling. Results: A total of 4673 participants consisting of 873 (455 controls and 418 cases) from Queensland and 3800 (3588 controls and 212 cases) from Western Australia were recruited. For every 1 standard deviation increase in 25(OH)D3 concentration, odds of AAA diagnosis was significantly reduced in both Queensland (adjusted odds ratio: 0.81; 95% confidence interval [CI]: 0.69-0.95; P = .009) and Western Australia (adjusted odds ratio: 0.80; 95% CI: 0.68-0.94; P = .005) cohorts. A subset of 310 eligible participants with small AAA from both regions were followed for a median of 4.2 (interquartile range: 2.0-5.8) years. Compared with vitamin D sufficient participants (50 to ˂75 nmol/L), annual mean AAA growth was significantly greater in those with higher vitamin D (≥75 nmol/L) (adjusted mean difference: 0.1 mm/y, 95% CI: 0.1-0.2; P < .001). Conclusions: High 25(OH)D3 concentration was paradoxically associated with a lower likelihood of AAA diagnosis and faster AAA growth. Further research is needed to resolve these conflicting findings. : Clinical Relevance: The findings of this study suggest that relative vitamin D deficiency increases the risk of abdominal aortic aneurysm diagnosis, but paradoxically high circulating markers of vitamin D are associated with faster aneurysm growth. These findings support the need for vitamin D sufficiency not excess, but need validation in other cohorts before incorporation into clinical management protocols.

Published in JVS - Vascular Science

ISSN: 2666-3503 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/jvs-vascular-science

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