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Semin Thromb Hemost 2012; 38(01): 114-124
DOI: 10.1055/s-0031-1300957
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Vitamin D, Thrombosis, and Hemostasis: More than Skin Deep

Giovanni Targher
1   Section of Endocrinology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
,
Isabella Pichiri
1   Section of Endocrinology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
,
Giuseppe Lippi
2   Clinical Chemistry Laboratory, Department of Clinical Pathology and Laboratory Medicine, Academic Hospital, University of Parma, Italy
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Publikationsdatum:
07. Februar 2012 (online)

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Abstract

Vitamin D3 deficiency is a highly prevalent condition worldwide. Clinically, vitamin D3 has a key role in calcium homeostasis and bone mineralization and has recently been implicated in the pathogenesis and/or progression of several acute and chronic illnesses, including cardiovascular disease (CVD). Accumulating evidence from observational, prospective studies suggests that low levels of serum 25-hydroxyvitamin D3 are independently associated with an increased risk of CVD events and death. The molecular mechanisms of this association remain incompletely understood. A variety of biologically plausible mechanisms may mediate a cardiovascular role for the active metabolite of vitamin D3. 1-α,25-dihydroxyvitamin D3 regulates the renin–angiotensin system, suppresses proliferation of vascular cell smooth muscle, improves insulin resistance and endothelial cell-dependent vasodilation, inhibits myocardial cell hypertrophy, exerts anticoagulant and antifibrotic activity, and modulates macrophage activity and cytokine generation. Overall, the high prevalence of vitamin D3 deficiency and the plausible biological mechanisms linking this to CVD risk suggest that the treatment of vitamin D3 deficiency to prevent CVD is a promising field to explore. Large placebo-controlled randomized clinical trials are urgently needed to determine whether vitamin D supplementation could have any potential benefit in reducing future CVD events and mortality risk.

Keywords

vitamin D deficiency - cardiovascular disease - hemostasis - thrombosis
 

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