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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: azittermann@hdz-nrw.de

© 2007 Lippincott Williams & Wilkins, Inc.