Evidence map›Paper›PMID 42160784›Full record

ArticleClinics (Sao Paulo, Brazil)2026

HDL-C as a potential mediator between serum 25(OH)D and the angiographic severity of coronary artery disease: a single-center cross-sectional study.

Marjan Mahdavi-Roshan, Zeinab Ghorbani, Morvarid Noormohammadi, Nargeskhatoon Shoaibinobarian, Sara Khoshdooz, Arsalan Salari

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Article in Clinics (Sao Paulo, Brazil), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Marjan Mahdavi-RoshanDepartment of Clinical Nutrition, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Zeinab GhorbaniDepartment of Clinical Nutrition, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Electronic address: zeinab.ghorbani@gums.ac.ir.
Morvarid NoormohammadiGastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Nargeskhatoon ShoaibinobarianDepartment of Clinical Nutrition, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Sara KhoshdoozDepartment of Clinical Nutrition, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Arsalan SalariSchool of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionVitamin D deficiency has been associated with increased Coronary Artery Disease (CAD) risk, potentially through its associations with lipid metabolism, particularly HDL-C. This study investigates the mediating role of HDL-C in the relationship between serum vitamin D and the severity of CAD.

methodsIn this cross-sectional study, 1015 participants undergoing elective angiography were enrolled from the Nutrition Heshmat Registry (NUTHER). Serum 25(OH)D levels were categorized as very low (< 12 ng/mL), low (12-20 ng/mL), marginal (20-30 ng/mL), and normal (≥ 30 ng/mL). CAD severity was quantified using the Gensini score, with severe CAD defined as a score ≥ 60. Logistic regression, restricted cubic spline analysis, and mediation models were employed to assess associations and potential mediation effects of HDL-C.

resultsParticipants with normal vitamin D levels (serum 25(OH)D ≥ 30 ng/mL) had 39% lower odds (adjusted OR = 0.61, 95% CI 0.40-0.93, P for trend = 0.017) of severe CAD compared to those with very low levels. A dose-response analysis confirmed a linear inverse association between 25(OH)D and CAD severity (P for overall = 0.0160). Mediation analysis revealed that HDL-C accounted for 18.1% (95% CI 11.8%, 44.0%) of the total effect of vitamin D on CAD severity, while LDL-C, total cholesterol, and triglycerides showed negligible mediation.

conclusionHigher serum vitamin D levels are associated with lower CAD severity, partially mediated by HDL-C. These findings suggest that adequate levels of both vitamin D and HDL-C may be associated with a lower severity of CAD. Further research, including randomized trials, is needed to confirm these associations and explore clinical implications.

Indexed as

DyslipidemiaGensini scoreHDL-CMediation analysisVitamin D

Identifiers

PMID42160784
PMCPMC13213810

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