Serum 25(OH)D Concentration Inversely Correlated with Monocyte-to-High Density Lipoprotein Ratio

by | Dec 12, 2023 | 2023, Cardiovascular Health, Men's Health, Vitamin D - Heart

Written by Taylor Woosley, Staff Writer. Findings from an analysis of 404 male patients experiencing chest pain shows that men diagnosed with acute coronary syndrome had higher MHR values and lower serum 25(OH)D compared to subjects with other ACS subtypes. 

cardiovascular health - sliderCardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide and accounts for approximately one third of deaths globally1. Acute coronary syndrome (ACS) is a common subcategory of CVD and is defined as a set of signs and symptoms related to acutely decreased blood flow in the coronary arteries2. Chronic low-grade inflammation is present in acute coronary syndrome and presents in multiple clinical manifestations ranging from asymptomatic to stable angina, heart failure, and sudden cardiac death3.

Researchers have suggested the use of the monocyte-to-high density lipoprotein (HDL) ratio (MHR) as a marker of inflammation and oxidative stress4. Vitamin D concentrations are present both on the cells of the cardiovascular system (endothelial cells, vascular smooth muscle, cardiomyocytes) and cells of the immune system and has shown promising research for its potential benefits for cardiovascular health5. In the vascular wall, vitamin D provides several beneficial genomic effects including a reduction in thrombogenicity, a decrease in vasoconstrictors, an inhibition of oxidative stress and atherogenesis, and an improvement of endothelial repair6.

Dziedzic et al. conducted a cross-sectional observational study to investigate the differences in MHR values in a cohort of male subjects diagnosed with ACS or chronic coronary syndrome (CCS). Additionally, differences in MHR values and total serum 25(OH)D concentration between subjects with diagnosis of ACS subtypes (unstable angina (UA), non-ST elevation myocardial infarction (NSTEMI), ST-elevation myocardial infarction (STEMI)) and total serum 25(OH)D concentration were analyzed. Data used was from 404 patients who received coronary angiography. Subjects with elevated inflammatory markers, viral or bacterial infection, autoimmune disease, thyroid dysfunction, and those supplementing with vitamin D were excluded from the analysis. All participants were treated with equivalent doses of statins (40 mg of atorvastatin or 20 mg of rosuvastatin).

Fasted blood samples were obtained to analyze total blood count, lipid profile, and serum 25 (OH)D concentrations. Coronary angiography was performed, and The Coronary Artery Surgery Study Score (CASSS) was utilized to assess possible stenoses. ACS was diagnosed if myocardial necrosis markers were increased and if subjects had one of the following: symptoms of myocardial ischemia, signs of ischemia or pathological Q waves on the ECG, a new loss of viable myocardium, a new segmental disturbance in the heart wall movement, or coronary artery thrombus on angiography.

Potential covariates included in the analysis were age, BMI, hyperlipidemia, hypertension, smoking status, type 2 diabetes mellitus status, and examination date. Pearson’s chi-squared test or Fisher’s exact test was used to analyze the prevalence of differences between groups. Significant findings of the study are as follows:

  • STEMI subjects were significantly younger than patients with CCS (p < 0.001) and UA (p = 0.027), presented significantly higher total cholesterol values than UA patients (p = 0.002), and had higher LDL values than CCS subjects (p < 0.001) and UA subjects (p = 0.001).
  • No significant differences in serum 25(OH)D concentrations between participants with different diagnoses were observed after adjusting for age and hyperlipidemia status (p = 0.075).
  • A significant correlation was noted between 25(OH)D, HDL status, and MHR.

Results of the study show that a higher MHR and lower serum 25(OH)D concentration was found in ACS patients. Furthermore, a significant correlation between 25(OH)D and MHR was observed in the analysis. Further research should continue to explore the potential cardiovascular and immune benefits of vitamin D supplementation. Study limitations include the lack of measuring inflammatory cytokines and the small study sample of Polish men which does not allow for generalizability of findings.

Source: Dziedzic, Ewelina A., Jakub S. Gąsior, Agnieszka Tuzimek, Marek Dąbrowski, and Wacław Kochman. “Correlation between Serum 25-Hydroxyvitamin D Concentration, Monocyte-to-HDL Ratio and Acute Coronary Syndrome in Men with Chronic Coronary Syndrome—An Observational Study.” Nutrients 15, no. 20 (2023): 4487.

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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Posted December 12, 2023.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

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