Vitamin D deficiency is associated with atherosclerosis-promoting risk factor clustering but not vascular damage in children

BACKGROUND Vitamin D has been associated with multiple cardiometabolic risk factors in children but there is a paucity of studies examining its correlation to vascular function and structure. Our objective was to determine whether there is a correlation between vitamin D, cardiometabolic risk, vascular distensibility and carotid artery intima-media thickness (CIMT) in high-risk children. MATERIAL/METHODS This was a cross-sectional, cohort study that compared vitamin D to cardiometabolic risk factors, carotid artery distensibility, and CIMT in 74 children with multiple, modifiable atherosclerosis-promoting risk factors. Vitamin D was used as a continuous variable and also categorized as deficient (<20 ng/mL) or sufficient (≥20 ng/mL). Seven modifiable atherosclerosis-promoting risk factors were analyzed - body mass index, systolic blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting insulin, & tobacco smoke exposure history. RESULTS For the entire cohort, vitamin D was 26.1 ± 9.4 ng/mL (6-63 ng/mL); and the levels were deficient in 20%. The number of modifiable atherosclerosis promoting risk factors per child was 3.3 ± 1.6. Distensibility index was 2.62 ± 0.87% per 10 mmHg, CIMT 0.54 ± 0.06 mm. There was an inverse correlation between vitamin D and risk factor score (r=-0.27, p=0.02); this remained significant after adjusting for age, sex, and race. There was no association between vitamin D levels and distensibility index or CIMT. CONCLUSIONS Even though vitamin D levels were inversely correlated with cardiometabolic risk factor score in high-risk children, there are no demonstrable vascular functional or structural effects.