Abstract: SA-PO0428
Vitamin D Deficiency as an Independent Predictor of Coronary Artery Calcification Severity in Cardiovascular-Kidney-Metabolic Syndrome: A Dual-Center Observational Study
Session Information
- CKM: Clinical - Epidemiology and Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Zhu, Dian, Department of Nephrology, The Affiliated Huai’an Hospital of Xuzhou Medical University and Huai’an Second People’s Hospital, Huai'an, Jiangsu Province, China
- Zheng, Donghui, Department of Nephrology, The Affiliated Huai’an Hospital of Xuzhou Medical University and Huai’an Second People’s Hospital, Huai'an, Jiangsu Province, China
Background
Cardio-Kidney-Metabolic (CKM) syndrome is associated with accelerated vascular calcification and high cardiovascular risk. Prior studies lacked adjustment for intact PTH and phosphorus, nor examined consistency across CKD stages within a unified CKM framework. We evaluated 25-hydroxyvitamin D [25(OH)D] as predictor of coronary artery calcification score (CACS) severity in a dual-center CKM cohort.
Methods
We analyzed 982 CKM patients (AHA 2023 Stages 2–4) from two Jiangsu tertiary centers. Center-stratified adjustments were used. CACS by non-contrast cardiac CT was categorized as mild (≤100), moderate (101–400), or severe (>400). Ordinal logistic regression adjusted for traditional risk factors and mineral metabolism (age, sex, BMI, BP, HbA1c, eGFR, intact PTH, phosphorus). 25(OH)D was standardized. Restricted cubic splines (RCS) evaluated non-linear dose-response.
Results
Vitamin D deficiency (<20 ng/mL) in 26.5%; severe CACS (>400) in 19.0%. Fully adjusted model: each 1-SD increase in 25(OH)D (1 SD = 7.92 ng/mL) was associated with lower odds of higher CACS category (OR = 0.626, 95% CI 0.542–0.724, p < 0.001). Subgroup analyses showed consistent inverse association across age/sex, with no significant modification by advanced kidney disease (P for interaction = 0.136). RCS revealed an L-shaped relationship (P for non-linearity < 0.001); inflection point ~25 ng/mL, below which severe calcification risk increased sharply.
Conclusion
Vitamin D deficiency is independently associated with the severity of coronary calcification in CKM syndrome, persisting after comprehensive adjustment for mineral metabolism parameters and demonstrating consistency across age, sex, and CKD stages. The identified inflection point suggests that a 25(OH)D threshold of approximately 25 ng/mL may represent a clinically relevant cut-off for risk stratification, warranting further prospective trials in this high-risk population.