Evidence mapPaperPMID 41688998Full record

ArticleBMC pulmonary medicine2026

Vitamin D and vitamin D receptor polymorphisms modify cardiovascular outcomes in asthma: a prospective cohort study based on the UK Biobank.

Ziwei Zhang, Lifen Gong, Junbao Du, Jialiang Wang, Zenghui Li, Yadong Gao, Hang Cheng

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Article in BMC pulmonary medicine, 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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5 · Who and what money

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7 authors.

Ziwei Zhang *Department of Pediatrics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China.
Lifen Gong *Department of Pediatrics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China.
Junbao DuDepartment of Pediatrics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China.
Jialiang WangDepartment of Pediatrics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China.
Zenghui LiDepartment of Respiratory Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Yadong GaoDepartment of Allergy, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China. gaoyadong@zju.edu.cn.ORCID http://orcid.org/0000-0003-1251-7608
Hang ChengDepartment of Pediatrics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China. hangcheng@zju.edu.cn.ORCID http://orcid.org/0000-0001-7913-3372

Funding

Jilin Provincial Key Laboratory of Biotherapy 20200201464JCScientific Research Project of Education Department of Jilin Province JJKH20221077KJZhejiang University Hundred Talents Program (Clinical medicine) Initial Funding B202311
6 · The paper itself

Abstract

backgroundThe association between vitamin D (VD) status and cardiovascular disease (CVD) risk in patients with asthma remains unclear, and the role of vitamin D receptor (VDR) polymorphisms in this context is not well established.

objectivesThis study aimed to investigate the associations of vitamin D status and VDR polymorphisms with incident CVD risk in patients with asthma.

methodsWe included 30,534 asthmatic and 251,249 non-asthmatic participants from the UK Biobank. The relationship between serum 25(OH)D levels and CVD risk in asthma was assessed using multivariable-adjusted restricted cubic spline and Cox proportional hazards models. The analyses for effect modification (by VDR polymorphisms) and mediation (by predefined factors) were conducted using Cox models with interaction terms and a bootstrap-based mediation approach (1,000 resamples), respectively. Additionally, CVD risks were compared across 25(OH)D categories between asthmatic and non-asthmatic participants.

resultsA significant L-shaped association was observed between serum 25(OH)D levels and incident CVD risk in patients with asthma (P for nonlinearity = 0.002), with an inflection point at approximately 50 nmol/L. After multivariable adjustment, asthmatic patients with 25(OH)D levels ≥ 75 nmol/L had a significantly lower CVD risk than those with levels < 25 nmol/L (HR: 0.83; 95% CI: 0.76–0.91; P < 0.001). Among asthmatic patients with severe vitamin D deficiency, the T allele of BsmI (rs1544410) and the G allele of TaqI (rs731236) were associated with a significant attenuation of the protective effect of vitamin D against CVD, whereas the A allele of ApaI (rs7975232) significantly enhanced this protective association. Mediation analysis indicated that body mass index, log-transformed C-reactive protein, and glycated hemoglobin accounted for 35.50%, 20.66%, and 9.88% of the total protective effect of vitamin D, respectively. Furthermore, compared with the non-asthmatic population, asthmatic individuals had a higher CVD risk across all 25(OH)D categories, but the magnitude of this excess risk demonstrated a decreasing trend with increasing vitamin D levels.

conclusionsLower vitamin D status is nonlinearly associated with an elevated CVD risk in asthma patients. VDR polymorphisms modify this protective effect in cases of severe vitamin D deficiency. These findings underscore the importance of maintaining adequate 25(OH)D levels for CVD prevention in asthma.

Indexed as

AsthmaCardiovascular DiseasesReceptors, CalcitriolVitamin DVitamin D DeficiencyAdultAgedFemaleHumansMaleMiddle AgedPolymorphism, GeneticPolymorphism, Single NucleotideProportional Hazards ModelsProspective StudiesRisk Factors25-hydroxyvitamin DReceptors, CalcitriolVDR protein, humanVitamin DAsthmaCardiovascular diseasesProspective cohort studyVitamin DVitamin D receptor gene polymorphism

Identifiers

PMID41688998
PMCPMC13005465

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.