Vitamin D and conjugated equine estrogen: the association with coronary artery atherosclerosis in cynomolgus monkeys

作者：McCurdy Rebekah; Jiang Xuezhi; Clarkson Thomas B; Nudy Matthew; Schnatz Peter F^*

来源：Menopause-The Journal of the North American Menopause Society, 2016, 23(5): 481-487.

DOI：10.1097/GME.0000000000000582

• Cardioprotection
• Coronary artery disease
• Hormonal therapy
• Postmenopausal health
• Vitamin D

Objective: To analyze vitamin D-3 plasma concentrations among monkeys randomized to oral conjugated equine estrogen (CEE) versus control and the association with coronary artery atherosclerosis (CAA).
Methods: Surgically postmenopausal monkeys (N = 50) were fed an atherogenic diet containing a woman's equivalent of 1000 IU/day of vitamin D-3. The monkeys were randomized at baseline to receive CEE (equivalent of 0.45 mg/d, n = 25) or placebo (n = 25). 25-hydroxyvitamin D-3 (25OHD(3)) was measured at baseline and 20 months later. At 20 months, CAA evidence of coronary artery remodeling, and American Heart Association (AHA) severity scores were assessed.
Results: The percent change in 25OHD(3) concentrations from baseline to 20 months postrandomization was inversely correlated with plaque area of the right coronary artery (P = 0.048), left circumflex artery (P = 0.039), left anterior descending artery (P = 0.017), and AHA severity score (AHA LADmax) (P = 0.016). Those with increased 25OHD(3) concentrations who were taking CEE also had significantly lower AHA scores compared with those who were not taking CEE and did not have an increase in 25OHD(3) (P = 0.01).
Conclusions: Monkeys with increases in 25OHD(3) concentrations had significantly less severe CAA. Those with increases in 25OHD(3) with CEE were associated with significantly decreased AHA lesion scores, decreased plaque, and greater coronary artery remodeling. If these findings are present in women, achieving higher 25OHD(3) concentrations (or being a vitamin D supplementation "responder'') may be associated with cardioprotection, and further studies to evaluate a synergistic effect with CEE and vitamin D on cardiovascular health are needed.

• 出版日期2016-5