Vitamin D and Cardiometabolic Disease: From Observation to Intervention

Vitamin D deficiency has become a major public health problem worldwide due to its increasing prevalence and potential health risks. There is growing evidence from experimental studies to suggest that vitamin D may influence risk of cardiometabolic disease through multiple pathways, including inhibition of the release of proinflammatory cytokines; regulation of the renin-angiotensin system; and favorable effects on lipids, blood pressure, insulin secretion and action, and thrombosis. Human observational data, primarily from cross-sectional studies, have shown that low dietary vitamin D intake or vitamin D levels are inversely related to various cardiometabolic risk factors. Prospective studies have suggested the relationship between low 25(OH)D and increased risk of cardiometabolic disease, including hypertension, type 2 diabetes, and cardiovascular disease. Evidence from small randomized trials and post-hoc analyses of large clinical trials for the effect of vitamin D supplements on cardiometabolic risk factors, however, remains inconsistent. This article aims to summarize epidemiologic data on the relationship between vitamin D and major cardiometabolic disease and highlight the challenges in translating observational evidence to future intervention studies.