Background: Arterial stiffness is a significant determinant of cardiovascular risk and is related to vascular calcification. Vitamin D may regulate arterial calcification and has been associated with cardiovascular survival benefits. However, data about the relationship between arterial stiffness, aortic calcification, and vitamin D levels in patients with peripheral artery disease (PAD) are limited.

Aim: To examine association between aortic calcification, arterial stiffness, and vitamin D levels in patients with symptomatic PAD and in healthy individuals.

Materials and methods: We studied 78 males with PAD (mean age 63±7 years) and 69 healthy men (mean age 54±7 years). Aortic pulse wave velocity (aPWV) and augmentation index (AIx@75) were determined by applanation tonometry using the Sphygmocor device. Aortic calcification score (ACS) was quantified by computed tomography. Serum 25-hydroxyvitamin D ((25(OH)D) level was measured using a radioimmune assay.

Results: ACS (6.4±5.3 vs 0.7±1.7(cm³); p<0.001), aPWV (10.1±2.5 vs 7.6±1.6(m/s); p<0.001), AIx@75 (28.2±8.1 vs 13.7±11.0(%); p<0.001), and 25(OH)D (37.7±14.0 vs 50.3±16.3(nmol/L); p<0.001) were different for the study groups. There was linear relationship between aPWV and ACS for the patients (p=0.02) and for the controls (p=0.049). 25(OH)D was associated with ACS only in the patient group (p=0.05). In multivariate analysis ACS was independently determined by aPWV and 25(OH)D in patients with PAD (R²=0.42; p<0.0001).

Conclusion: These results indicate that calcification of the thoracic and abdominal aorta is independently associated with aortic stiffness and serum 25(OH)D level in patients with PAD. Aortic stiffness and abnormal vitamin D level may contribute to vascular calcification in these patients.