Vitamin D a More Important Marker Than Cholesterol
Quote:
A recently published prospective longitudinal study already demonstrates that individuals with vitamin D (25(OH)D) levels below 37.5 nanomole/liter have a multivariable-adjusted hazard ratio of 1.62 for incident cardiovascular events compared with those with 25(OH)D levels of 37.5 nmol/liter or greater. That�s a 62% increase in risk. A study shows almost half of the British have vitamin D levels below 40 nmol/liter. [Aging Health 4: 99-100, April 2008]
Millions are at undue risk which can be reduced significantly by food fortification or vitamin D pills. Two leading vitamin D researchers, John Cannell MD and Bruce W. Hollis PhD, claim that consumption of 2,000-7,000 IU (500-175 micrograms) vitamin D3 per day of supplemental vitamin D3 should be sufficient to maintain year-round 25(OH)D levels, which is 5 to 17 times greater than the recommended daily allowance (but only equivalent to about 10-45 minutes of total-body summer sun exposure). [Alternative Medicine Review 13: 6-20, March 2008]
With the startling recent report published in Business Week Magazine that statin cholesterol-lowering drugs appear to be nearly worthless for healthy adults, and only prevent one non-mortal heart attack for every high-risk 70 statin drug users, it is a wonder that doctors and patients keep taking these liver-toxic pills. There is vanishing science to substantiate the use of statin drugs and researchers now claim whatever health benefits emanate from statin drugs appear to be unrelated to cholesterol and attributed to the ability of statin drugs to modestly raise vitamin D levels! [American Journal Cardiology 99: 903-05, 2007]
Millions of adults are dying needlessly while cardiologists keep the cholesterol charade going, a travesty that will likely continue till the patient on the most popular cholesterol-lowering drug, Lipitor, expires in 2010.
Public health authorities, including the FDA and the American Heart Association, certainly know all this, but continue to support cholesterol-lowering guidelines, all the while ignoring the need to fortify foods with adequate nutrients. Oddly, patients who take statin drugs appear to be oblivious to the muscle aches and memory problems they commonly experience and are likely to be inappropriately placed on drugs for arthritis or Alzheimer�s disease.
Despite the paucity of scientific documentation of this phenomenon, I am continuing to witness extraordinary increases in HDL cholesterol levels with vitamin D supplementation.
I've touched on the interaction of vitamin D supplementation with HDL in The Heart Scan Blog previously:
At first, I thought it was attributable to other factors. In real life, most people don't modify one factor at a time. They reduce processed carbohydrates/eliminate wheat and cornstarch, lose weight, add or increase omega-3 fatty acids from fish oil, begin niacin, increase exercise and physical activity. All these efforts also impact on HDL.
Among the many things I do, I consult on complex lipid (cholesterol) disorders (complex hyperlipidemias) in my office. A substantial number of these people carry a diagnosis of hypoalphalipoproteinemia, a mouthful that simply means these people are unable to manufacture much apoprotein A1, the principal protein of HDL cholesterol particles. As a result, people with hypoalphalipoproteinemia have HDL cholesterol levels in the neighborhood of 20-30 mg/dl--very low. They are also at high risk for heart disease and stroke.
Encourage these people to exercise, attain ideal weight, eliminate wheat and cornstarch: HDL increases 5 mg/dl or so.
Add niacin, HDL increases another 5-10 mg/dl.
Perhaps we're now sitting somewhere around an HDL of 35-40 mg/dl--better, but hardly great.
Add vitamin D to achieve our target serum level . . . HDL jumps to 50, 60, 70, even 90 mg/dl.
The first few times this occurred, I thought it was an error or fluke. But now that I've witnessed this effect many dozens of time, I am convinced that it is real. Just today, I saw a 40-year old man whose starting HDL was 25 mg/dl increase to 87 mg/dl.
Responses like this are supposed to be impossible. Before vitamin D, I had never witnessed increases of this magnitude.
Not all therapies for raising HDL raise the important large (also known as HDL2b) fraction. With lipoprotein analyses, it appears that is principally the large fraction of HDL that rises with vitamin D supplementation.
Why? How?
That I can't tell you. But for those of you struggling with low HDL cholesterols despite your best efforts, vitamin D can make a world of difference.
An interesting corollary: If super-high HDL cholesterols are associated with extreme longevity, as they are with centenarians, does raising HDL to extraordinary levels with vitamin D lead to longer, healthier life, all the way up to age 110 years?
Again, no answers, but an interesting thought. And one I'd bet on. (And I'm not selling vitamin D.)
Add vitamin D to achieve our target serum level . . . HDL jumps to 50, 60, 70, even 90 mg/dl.
It seems that HDL at high levels is not always as protective against CAD as we always presumed.
High levels of HDL, above 70mg/dl, have been associated with increased coronary artery disease in recent studies.
It seems that APO-I, a sub class of HDL, and HDL particle size are more important than the total HDL. In this respect it seems to be similar to LDL where a sub class, APO-B is a more reliable indicator of CAD. Whilst vitamin D appears to raise APO-I, according to Dr Davis, other means might not be as protective.
High-density lipoprotein cholesterol, high-density lipoprotein particle size, and apolipoprotein A-I: significance for cardiovascular risk: the IDEAL and EPIC-Norfolk studies.
Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.
OBJECTIVES: This study was designed to assess the relationship of high-density-lipoprotein cholesterol (HDL-C), HDL particle size, and apolipoprotein A-I (apoA-I) with the occurrence of coronary artery disease (CAD), with a focus on the effect of very high values of these parameters.
BACKGROUND: High plasma levels of HDL-C and apoA-I are inversely related to the risk of CAD. However, recent data suggest that this relationship does not hold true for very high HDL-C levels, particularly when a preponderance of large HDL particles is observed.
METHODS: We conducted a post-hoc analysis of 2 prospective studies: the IDEAL (Incremental Decrease in End Points through Aggressive Lipid Lowering; n = 8,888) trial comparing the efficacy of high-dose to usual-dose statin treatment for the secondary prevention of cardiovascular events, and the EPIC (European Prospective Investigation into Cancer and Nutrition)-Norfolk case-control study, including apparently healthy individuals who did (cases, n = 858) or did not (control patients, n = 1,491) develop CAD during follow-up. In IDEAL, only HDL-C and apoA-I were available; in EPIC-Norfolk, nuclear magnetic resonance spectroscopy-determined HDL particle sizes were also available.
RESULTS: In the IDEAL study, higher HDL-C proved a significant major cardiac event risk factor following adjustment for age, gender, smoking, apoA-I, and apoB. A similar association was observed for HDL particle size in EPIC-Norfolk. Increased risk estimates were particularly present in the high ends of the distributions. In contrast, apoA-I remained negatively associated across the major part of its distribution in both studies.
CONCLUSIONS: When apoA-I and apoB are kept constant, HDL-C and HDL particle size may confer risk at very high values. This does not hold true for very high levels of apoA-I at fixed levels of HDL-C and apoB. These findings may have important consequences for assessment and treatment of CAD risk.
Its good to know that while all these pharmaceutical companies are scratching around trying to invent a drug that raises HDL, nature has once again provided the answer in vitamin D.
Vitamin D a More Important Marker Than Cholesterol
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