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Article

The Co-Existence of Hypovitaminosis D and Diabetes Mellitus Triples the Incidence of Severe Coronary Artery Disease in Women

by
Aneta Aleksova
1,2,*,
Milijana Janjusevic
1,2,
Beatrice Pani
2,
Cristina Hiche
1,
Andrea Chicco
3,
Agnese Derin
1,
Lorenzo Zandonà
3,
Elisabetta Stenner
4,
Daria Beltrame
1,
Marco Gabrielli
2,
Stefano Lovadina
5,
Flávia Campos Corgosinho
6,
Stefano D’Errico
2,
Maria Marketou
7,
Donna R. Zwas
8,
Gianfranco Sinagra
1,2 and
Alessandra Lucia Fluca
1,2
1
Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, 34100 Trieste, Italy
2
Department of Medical Surgical and Health Sciences, University of Trieste, 34125 Trieste, Italy
3
SC Laboratorio Unico, Ospedale Maggiore, Azienda Sanitaria Universitaria Giuliano Isontina, 34125 Trieste, Italy
4
Department of Diagnostics, Azienda USL Toscana Nordovest, 56121 Livorno, Italy
5
Department of General and Thoracic Surgery, Cattinara University Hospital, 34149 Trieste, Italy
6
Faculty of Nutrition, Federal University of Goias, Goiânia 74605-050, Brazil
7
Cardiology Department Crete, School of Medicine, Heraklion University General Hospital, University of Crete, 70013 Iraklio, Greece
8
Linda Joy Pollin Cardiovascular Wellness Center for Women, Heart Institute, Hadassah University Medical Center, Jerusalem 91120, Israel
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(22), 6792; https://doi.org/10.3390/jcm13226792
Submission received: 10 October 2024 / Revised: 7 November 2024 / Accepted: 10 November 2024 / Published: 12 November 2024
(This article belongs to the Section Cardiovascular Medicine)
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Abstract

Background and Aims: Hypovitaminosis D is involved in the development and progression of atherosclerosis, and it is more prevalent in women. The differential impact of hypovitaminosis D on the severity of coronary artery disease (CAD) between genders remains poorly understood. This study aims to address this literature gap. Methods: A total of 1484 consecutive patients with acute myocardial infarction (AMI) were enrolled in the study. Hypovitaminosis D was defined as vitamin D ≤ 20 ng/mL. CAD was defined as the presence of at least one coronary vessel stenosis > 50%, while severe CAD was defined as left main disease and/or three-vessel disease > 50%. Results: The mean age of the cohort was 66.3 (11.5) years, with a predominance of the male gender (71.8%). Vitamin D values were significantly lower in women than in men (15.7 [8.4–25.4] ng/mL vs. 17.9 [11–24.3] ng/mL, p = 0.01). A higher prevalence of severe CAD was observed in female patients with hypovitaminosis D compared to those without (33% vs. 19%, p < 0.01). This finding was not observed in men. Among women, hypovitaminosis D significantly increased the risk of severe CAD (OR: 1.85, p = 0.01), together with diabetes mellitus (DM) and older age, adjusted for GFR < 60 mL/min/1.73 m2, cholesterol and body mass index. Furthermore, women with both hypovitaminosis D and DM had more than three times the risk of severe CAD compared with women who lacked both (OR: 3.56, p = 0.02). Conclusions: In women, hypovitaminosis D increases the risk of severe CAD, and the co-existence of hypovitaminosis D and DM triples the incidence of severe CAD.
Keywords: vitamin D; hypovitaminosis D; gender difference; acute myocardial infarction; coronary artery disease vitamin D; hypovitaminosis D; gender difference; acute myocardial infarction; coronary artery disease

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MDPI and ACS Style

Aleksova, A.; Janjusevic, M.; Pani, B.; Hiche, C.; Chicco, A.; Derin, A.; Zandonà, L.; Stenner, E.; Beltrame, D.; Gabrielli, M.; et al. The Co-Existence of Hypovitaminosis D and Diabetes Mellitus Triples the Incidence of Severe Coronary Artery Disease in Women. J. Clin. Med. 2024, 13, 6792. https://doi.org/10.3390/jcm13226792

AMA Style

Aleksova A, Janjusevic M, Pani B, Hiche C, Chicco A, Derin A, Zandonà L, Stenner E, Beltrame D, Gabrielli M, et al. The Co-Existence of Hypovitaminosis D and Diabetes Mellitus Triples the Incidence of Severe Coronary Artery Disease in Women. Journal of Clinical Medicine. 2024; 13(22):6792. https://doi.org/10.3390/jcm13226792

Chicago/Turabian Style

Aleksova, Aneta, Milijana Janjusevic, Beatrice Pani, Cristina Hiche, Andrea Chicco, Agnese Derin, Lorenzo Zandonà, Elisabetta Stenner, Daria Beltrame, Marco Gabrielli, and et al. 2024. "The Co-Existence of Hypovitaminosis D and Diabetes Mellitus Triples the Incidence of Severe Coronary Artery Disease in Women" Journal of Clinical Medicine 13, no. 22: 6792. https://doi.org/10.3390/jcm13226792

APA Style

Aleksova, A., Janjusevic, M., Pani, B., Hiche, C., Chicco, A., Derin, A., Zandonà, L., Stenner, E., Beltrame, D., Gabrielli, M., Lovadina, S., Corgosinho, F. C., D’Errico, S., Marketou, M., Zwas, D. R., Sinagra, G., & Fluca, A. L. (2024). The Co-Existence of Hypovitaminosis D and Diabetes Mellitus Triples the Incidence of Severe Coronary Artery Disease in Women. Journal of Clinical Medicine, 13(22), 6792. https://doi.org/10.3390/jcm13226792

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