Skip to main content Accessibility help

Vitamin D3 and the risk of CVD in overweight and obese women: a randomised controlled trial

  • Amin Salehpour (a1), Farzad Shidfar (a1), Farhad Hosseinpanah (a2), Mohammadreza Vafa (a1), Maryam Razaghi (a1), Anahita Hoshiarrad (a3) and Mahmoodreza Gohari (a4)...

Evidence indicates that vitamin D deficiency contributes to CVD. We investigated the effect of vitamin D3 supplementation on cardiovascular risk factors in women. Healthy premenopausal overweight and obese women (n 77; mean age 38 (sd 8·1) years) were randomly allocated to the vitamin D (25 μg/d as cholecalciferol) or the placebo group in a double-blind manner for 12 weeks. Blood pressure, serum lipoproteins, apolipoproteins and anthropometric parameters were recorded. Dietary intake was recorded using 24 h food recall and FFQ. Physical activity was assessed by the International Physical Activity Questionnaire. Mean total cholesterol concentrations increased in the vitamin D group (0·08 (sd 0·56) mmol/l) but declined in the placebo group (0·47 (sd 0·58) mmol/l), and a significant effect was observed (P ≤ 0·001). In the vitamin D group, mean HDL-cholesterol concentration increased, whereas it decreased in the placebo group (0·07 (sd 0·2) v. − 0·03 (sd 0·2) mmol/l; P = 0·037). Mean apoA-I concentration increased in the vitamin D group, although it decreased in the placebo group (0·04 (sd 0·39) v. − 0·25 (sd 0·2) g/l; P ≤ 0·001). Mean LDL-cholesterol:apoB-100 ratio augmented in the vitamin D group, while this ratio declined in the placebo group (0·11 (sd 0·6) v. − 0·19 (sd 0·3); P = 0·014). Body fat mass was significantly decreased in the vitamin D group more than the placebo group ( − 2·7 (sd 2) v. − 0·4 (sd 2) kg; P ≤ 0·001). The findings showed that supplementation with vitamin D3 can significantly improve HDL-cholesterol, apoA-I concentrations and LDL-cholesterol:apoB-100 ratio, which remained significant in the multivariate model including anthropometric, dietary and physical activity measures.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Vitamin D3 and the risk of CVD in overweight and obese women: a randomised controlled trial
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Vitamin D3 and the risk of CVD in overweight and obese women: a randomised controlled trial
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Vitamin D3 and the risk of CVD in overweight and obese women: a randomised controlled trial
      Available formats
Corresponding author
*Corresponding author: Dr F. Shidfar, fax +98 21 88779487, email
Hide All
1Holick, M (1989) Phylogenetic and evolutionary aspects of vitamin D from phytoplankton to humans. In Vertebrate Endocrinology: Fundamentals and Biomedical Implications [, editors]. San Diego: Academic Press.
2Holick, MF (2003) Vitamin D: a millennium perspective. J Cell Biochem 88, 296307.
3Dunnigan, MG, Harland, WA & Fyfe, T (1970) Seasonal incidence and mortality of ischemic heart disease. Lancet ii, 793797.
4Bull, GM & Morton, J (1975) Seasonal and short-term relationships of temperature with deaths from myocardial and cerebral infarction. Age Ageing 4, 1931.
5Scragg, R (1981) Seasonality of cardiovascular disease mortality and the possible protective effect of ultraviolet radiation. Int J Epidemiol 10, 337341.
6Grimes, DS, Hindle, E & Dyer, T (1996) Sunlight, cholesterol and coronary heart disease. QJM 89, 579589.
7Rostand, SG (1997) Ultraviolet light may contribute to geographic and racial blood pressure differences. Hypertension 30, 150156.
8Zittermann, A, Schleithoff, SS & Koerfer, R (2005) Putting cardiovascular disease and vitamin D insufficiency into perspective. Br J Nutr 94, 483492.
9Caballero, B (2007) The global epidemic of obesity: an overview. Epidemiol Rev 29, 15.
10Bray, GA & Bellanger, T (2006) Epidemiology, trends, and morbidities of obesity and the metabolic syndrome. Endocrine 29, 109117.
11Sarti, C & Gallagher, J (2006) The metabolic syndrome: prevalence, CHD risk, and treatment. J Diabetes Complications 20, 121132.
12Parikh, SJ, Edelman, M, Uwaifo, GI, et al. (2004) The relationship between obesity and serum 1,25-dihydroxy vitamin D concentrations in healthy adults. J Clin Endocrinol Metab 89, 11961199.
13Wilson, PW, Kannel, WB, Silbershatz, H, et al. (1999) Clustering of metabolic factors and coronary heart disease. Arch Intern Med 159, 11041109.
14Krause, R, Buhring, M, Hopfenmuller, W, et al. (1998) Ultraviolet B and blood pressure. Lancet 352, 709710.
15Merke, J, Hofmann, W, Goldschmidt, D, et al. (1987) Demonstration of 1,25(OH)2 vitamin D3 receptors and actions in vascular smooth muscle cells in vitro. Calcif Tissue Int 41, 112114.
16Merke, J, Milde, P, Lewicka, S, et al. (1989) Identification and regulation of 1,25-dihydroxyvitamin D3 receptor activity and biosynthesis of 1,25-dihydroxyvitamin D3: studies in cultured bovine aortic endothelial cells and human dermal capillaries. J Clin Invest 83, 19031915.
17Scragg, R, Sowers, M & Bell, C (2007) Serum 25-hydroxyvitamin D, ethnicity, and blood pressure in the Third National Health and Nutrition Examination Survey. Am J Hypertens 20, 713719.
18Jorde, R, Figenschau, Y, Emaus, N, et al. (2010) Serum 25-hydroxyvitamin D levels are strongly related to systolic blood pressure but do not predict future hypertension. Hypertension 55, 792798.
19Holick, MF (2006) High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 81, 353373.
20Li, YC, Kong, J, Wei, M, et al. (2002) 1,25-Dihydroxyvitamin D (3) is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest 110, 229238.
21Rostand, SG & Drueke, TB (1999) Parathyroid hormone, vitamin D, and cardiovascular disease in chronic renal failure. Kidney Int 56, 383392.
22Sambrook, PN, Chen, JS, March, LM, et al. (2004) Serum parathyroid hormone is associated with increased mortality independent of 25-hydroxy vitamin D status, bone mass and renal function in the frail and very old: a cohort study. J Clin Endocrinol Metab 89, 54775481.
23Hashemipour, S, Larijani, B, Adibi, H, et al. (2004) Vitamin D deficiency and causative factors in the population of Tehran. BMC Public Health 4, 3844.
24Heshmat, R, Mohammad, K, Majdzadeh, SR, et al. (2008) A multi-center study among different urban areas. Iranian J Publ Health 1, Suppl., 7278.
25 World Health Organization (2011) Obesity and Overweight. Fact Sheet no. 311. (updated February 2011).
26World Health Organization (1995) Physical Status: The Use and Interpretation of Anthropometry. Technical Report Series no. 854. Geneva: WHO.
27Craig, CL, Marshall, AL, Sjostrom, M, et al. (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35, 13811395.
28Esfahani, FH, Asghari, G, Mirmiran, P, et al. (2010) Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study. J Epidemiol 20, 150158.
29Azar, M & Sarkisian, E (1980) Food Composition Table of Iran. Tehran: National Nutrition and Food Research Institute, Shaheed Beheshti University.
30United States Department of Agriculture, Agriculture of Research Service (2009) Nutrient Data Laboratory (updated 27 April 2009).
31Aloia, JF, Patel, M, Dimaano, R, et al. (2008) Vitamin D intake to attain a desired serum 25 hydroxyvitamin D concentration. Am J Clin Nutr 87, 19521958.
32Tishkoff, DX, Nibbelink, KA, Holmberg, KH, et al. (2008) Functional vitamin D receptor (VDR) in the t-tubules of cardiac myocytes: VDR knockout cardiomyocyte contractility. Endocrinology 149, 558564.
33Giovannucci, E, Liu, Y, Hollis, BW, et al. (2008) 25-Hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med 168, 11741180.
34Dobnig, H, Pilz, S, Scharnagl, H, et al. (2008) Independent association of low serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels with all-cause and cardiovascular mortality. Arch Intern Med 168, 13401349.
35Wang, TJ, Pencina, MJ, Booth, SL, et al. (2008) Vitamin D deficiency and risk of cardiovascular disease. Circulation 117, 503511.
36Snijder, MB, Lips, P, Seidell, JC, et al. (2007) Vitamin D status and parathyroid hormone levels in relation to blood pressure: a population-based study in older men and women. J Intern Med 261, 558565.
37Zittermann, A, Frisch, S, Berthold, HK, et al. (2009) Vitamin D supplementation enhances the beneficial effects of weight loss on cardiovascular disease risk markers. Am J Clin Nutr 89, 13211327.
38Major, GC, Alarie, F, Doré, J, et al. (2007) Supplementation with calcium+vitamin D enhances the beneficial effect of weight loss on plasma lipid and lipoprotein concentrations. Am J Clin Nutr 85, 5459.
39Pfeifer, M, Begerow, B, Minne, HW, et al. (2001) Effects of a short-term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab 86, 16331637.
40Schluter, KD & Piper, H (1998) Cardiovascular actions of parathyroid hormone and parathyroid hormone-related peptide. Cardiovasc Res 37, 3441.
41Amann, K, Tornig, J, Flechtenmacher, C, et al. (1995) Blood-pressure-independent wall thickening of intramyocardial arterioles in experimental uraemia: evidence for a permissive action of PTH. Nephrol Dial Transplant 10, 20432048.
42Somjen, D, Weisman, Y, Kohen, F, et al. (2005) 25-Hydroxyvitamin D3-1α-hydroxylase is expressed in human vascular smooth muscle cells and is upregulated by parathyroid hormone and estrogenic compounds. Circulation 111, 16661671.
43Schluter, KD & Piper, HM (1992) Trophic effects of catecholamines and parathyroid hormone on adult ventricular cardiomyocytes. Am J Physiol 263, H1739H1746.
44Perkovic, V, Hewitson, TD, Kelynack, KJ, et al. (2003) Parathyroid hormone has a prosclerotic effect on vascular smooth muscle cells. Kidney Blood Press Res 26, 2733.
45Andersson, P, Rydberg, E & Willenheimer, R (2004) Primary hyperparathyroidism and heart disease – a review. Eur Heart J 25, 17761787.
46Garcia de la Torre, N, Wass, JA & Turner, HE (2003) Parathyroid adenomas and cardiovascular risk. Endocr Relat Cancer 10, 309322.
47Martin-Ventura, JL, Ortego, M, Esbrit, P, et al. (2003) Possible role of parathyroid hormone-related protein as a proinflammatory cytokine in atherosclerosis. Stroke 34, 17831789.
48Foley, RN, Parfrey, PS & Sarnaak, MJ (1998) Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 32, 5 Suppl. 3, S112S119.
49Khajehdehi, P & Taheri, S (2003) Effect of oral calcitriol pulse therapy on the lipid, calcium, and glucose homeostasis of hemodialysis patients: its safety in a combination with oral calcium carbonate. J Ren Nutr 13, 7883.
50Lacour, B, Basile, C, Drueke, T, et al. (1982) Parathyroid function and lipid metabolism in the rat. Miner Electrolyte Metab 7, 157165.
51Chiu, KC, Chu, A, Go, VLW, et al. (2004) Hypovitaminosis D is associated with insulin resistance and β cell dysfunction. Am J Clin Nutr 79, 820825.
52John, WG, Noonan, K, Mannan, N, et al. (2005) Hypovitaminosis D is associated with reductions in serum apolipoprotein A-I but not with fasting lipids in British Bangladeshis. Am J Clin Nutr 82, 517522.
53Barger-Lux, MJ, Heaney, RP, Lanspa, SJ, et al. (1995) An investigation of sources of variation in calcium absorption efficiency. J Clin Endocrinol Metab 80, 406411.
54Denke, MA, Fox, MM & Schulte, MC (1993) Short-term dietary calcium fortification increases fecal saturated fat content and reduces serum lipids in men. J Nutr 123, 10471053.
55Reid, IR (2004) Effects of calcium supplementation on circulating lipids: potential pharmacoeconomic implications. Drugs Aging 21, 717.
56Vaskonen, T, Mervaala, E, Sumuvuori, V, et al. (2002) Effects of calcium and plant sterols on serum lipids in obese Zucker rats on a low-fat diet. Br J Nutr 87, 239245.
57Van der Meer, R, Welberg, JW, Kuipers, F, et al. (1990) Effects of supplemental dietary calcium on the intestinal association of calcium, phosphate, and bile acids. Gastroenterology 99, 16531659.
58Malik, S (2003) Transcriptional regulation of the apolipoprotein AI gene. Front Biosci 8, d360d368.
59Auwerx, J, Bouillon, R & Kesteloot, H (1992) Relation between 25-hydroxyvitamin D3, apolipoprotein A-1 and high density lipoprotein cholesterol. Aterioscler Thromb 12, 671674.
60Wehmeier, K, Beers, A, Haas, MJ, et al. (2005) Inhibition of apolipoprotein AI gene expression by 1,25-dihydroxyvitamin D3. Biochim Biophys Acta 1737, 1626.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed