Association of C-reactive Protein and Vitamin D Deficiency with Cardiovascular Disease: A Nationwide Cross-sectional Study from National Health and Nutrition Examination Survey 2007 to 2008

Objectives: The association of C-reactive protein (CRP) and serum 25-hydroxyvitamin D [25(OH)D] and cardiovascular disease (CVD) remains unknown.

Methods: We performed a cross-sectional analysis on 3848 participants by using the data from the National Health and Nutrition Examination Surveys (2007 to 2008). CVD was defined as a compromise of stroke, myocardial infarction, heart failure, and coronary heart disease. High CRP was defined as ≥0.2 mg/dL, and vitamin D status were categorized as severe deficiency, <25 nmol/mL; deficiency, 25 to 49.9 nmol/mL; insufficiency, 50 to 74.9 nmol/mL; and normal, ≥75 nmol/mL. Statistical analysis was performed using logistic regression models.

Results: We found that both high CRP and low 25(OH)D levels were associated with CVD. Participants with high CRP levels and severe vitamin D deficiency had a higher likelihood of having CVD than those with neither risk factor (odds ratio = 2.69, 95% confidence interval = 1.45-4.98, P = .0017). In stratified analysis, a significant positive association between vitamin D level and CVD was observed only in the high CRP group. However, in the absence of high CRP, even with severe vitamin D deficiency, no association was found with an increasing risk of CVD (P = .6416).

Conclusion: Within a cross-sectional, nationally representative sample, these findings suggest that vitamin D status evaluation, or vitamin D supplement may be especially important for individuals with high CRP levels.