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Vitamin D and vascular calcification

Zittermann, Armin; Schleithoff, Stefanie S; Koerfer, Reiner

doi: 10.1097/MOL.0b013e328011c6fc
Nutrition and metabolism

Purpose of review: Vascular calcification is frequently found in patients with osteoporosis, atherosclerosis and chronic kidney disease, leading to high morbidity and mortality rates. The effects of vitamin D excess and deficiency on vascular calcification are reviewed in this article.

Recent findings: There is evidence from experimental studies that mediacalcinosis induced by vitamin D excess is an active and reversible process. Vitamin D excess, however, is rarely seen in the general human population. Experimental data also demonstrate that physiologic vitamin D actions include the inhibition of processes that are important for intimal and medial artery calcification such as pro-inflammatory cytokine release, adhesion molecule release, and proliferation and migration of vascular smooth muscle cells. In uremic rats, low levels of the vitamin D hormone calcitriol are associated with massive vascular and soft tissue calcifications. Whereas retrospective studies already indicate a beneficial effect of active vitamin D on mortality rates in chronic kidney disease, little is yet known about the effect of vitamin D deficiency on cardiovascular morbidity and mortality in the general population.

Summary: Available data indicate that vitamin D exerts a biphasic ‘dose response’ curve on vascular calcification with deleterious consequences not only of vitamin D excess but also of vitamin D deficiency.

Department of Cardiothoracic Surgery, Northrhine Westfalia Heart Center, Ruhr University Bochum, Bad Oeynhausen, Germany

Correspondence to Armin Zittermann, PhD, Associate Professor, Department of Cardio-Thoracic Surgery, Heart Center Northrhine-Westfalia, Ruhr University of Bochum, Georgstraße 11, 32545 Bad Oeynhausen, Germany Tel: +49 5731 97 1912; fax: +49 5731 97 2020; e-mail:

© 2007 Lippincott Williams & Wilkins, Inc.