Serum 25-hydroxyvitamin D and the incidence of peripheral artery disease in the elderly: The Pro.V.A study

Aim: This study was conducted to examine whether low serum levels of 25-hydroxyvitamin D (250HD) are associated with a higher risk of incident peripheral artery disease (PAD) in a representative group of elderly people. Methods: We followed 1568 community-dwelling elderly participants without PAD at the baseline among a sample of 2097 initially eligible over a mean of 4.4 years as part of the Progetto Veneto Anziani (Pro.V.A.) study. The baseline serum 250HD levels were categorized as <24, 25-49, 50-74, >75 nmol/L, and incident PAD was defined as an ankle-brachial index below 0.9. Results: At the baseline, there were no differences in known risk factors for PAD (BMI), waist circumference, diabetes, cardiovascular diseases, smoking habits, total cholesterol or in the ankle-brachial index (ABI) between the groups with different serum 250HD levels (<24, 25-49, 50-74, > 75 nmol/L). During a 4.4-year follow-up, 371 subjects developed PAD. The group with serum 250HD levels >75 nmol/L was set as the reference group, and an adjusted Cox's regression analysis showed no association between low vitamin D levels and incident PAD during the follow-up: the hazard ratio ranged from 0.76 95%CI: 0.41-1.42 for participants with serum 250HD levels below 25 nmol/L to 1.32 95%CI: 0.72-2.39 for those with serum 250HD levels between 50-74 nmol/L (p for trend = 0.08). These results did not change when participants were stratified by several risk factors for PAD. Conclusions: Baseline hypovitaminosis D did not predict the onset of PAD over a 4.4-year follow-up in elderly people.