Key result
Circulating 3-epi-25(OH)D3 levels show no association with arterial stiffness or major CV events and mortality.
Why the study?
Circulating 3-epi-25(OH)D 3 declines with advancing CKD, but its role in vascular health and related cardiovascular outcomes remains largely unknown.
Are circulating 3-epi-25(OH)D3 levels associated with arterial stiffness and longitudinal cardiovascular outcomes in patients with advanced CKD?
Observational (n=270)
Are circulating 3-epi-25(OH)D3 levels associated with arterial stiffness and longitudinal cardiovascular outcomes in patients with advanced CKD?
In patients with advanced CKD, circulating 3-epi-25(OH)D3 levels are not independently associated with arterial stiffness, major cardiovascular events, or all-cause mortality.
Answers are grounded in this paper and cite their sources.
3-epi-25(OH)D3 shows no association with arterial stiffness in advanced CKD; leaves open non-vascular mediation of CV functional capacity links.
Rationale & Objective 3-epi-25(OH)D 3 , an epimeric form of 25(OH)D 3 generated by C-3 epimerization, declines with advancing CKD, yet its role in vascular health and related outcomes remains largely unknown. We aimed to determine whether circulating 3-epi-25(OH)D 3 levels are associated with arterial stiffness and longitudinal cardiovascular (CV) outcomes in advanced CKD (stages 5 and 5D). Study Design Prospective observational study. Setting & Participants 270 patients with advanced CKD using the Cambridge Coventry Vascular Cohort. Exposure (s) or Predictor (s) Baseline 3-epi-25(OH)D 3 measured by liquid chromatography–tandem mass spectrometry. Outcome (s) Arterial stiffness was assessed by carotid–femoral pulse wave velocity (PWV) and augmentation index (Aix75). Longitudinal outcomes included a composite of major CV events and all-cause mortality. Analytical Approach 3-epi-25(OH)D 3 was categorized into quartiles. Associations were assessed using multivariable regression adjusted for age, race, and dialysis status. Kaplan–Meier and Cox models assessed longitudinal outcomes. Results Among 270 participants, quartiles were Q1 < 0.30 ng/mL (n = 64), Q2 0.30–0.456 ng/mL (n = 71), Q3 0.457–0.729 ng/mL (n = 68), and Q4 ≥ 0.73 ng/mL (n = 67). Strata were similar in age (44.9 years), sex, and BMI (all P>0.05). Race differed by quartile (P<0.001); 87.4% were White. 24.8% were pre-dialytic, 61.1% on hemodialysis, and 14.1% on peritoneal dialysis. Arterial stiffness was similar across quartiles (AIx75 ∼20–21%, P=0.99; PWV: 7.8–8.0 m/s, P=0.94). 3-epi-25(OH)D 3 showed no association with AIx75 or PWV before or after adjustment using multiple regression modeling. Over 9.3 years, 115 composite events occurred (97 CV events, 18 deaths). Kaplan–Meier analysis did not discriminate risk across 3-epi-25(OH)D 3 quartiles for the composite outcome (log-rank P=0.23), and adjusted Cox models showed no association. Limitations Observational design with possible residual confounding. Conclusion In advanced CKD, 3-epi-25(OH)D 3 showed no independent association with arterial stiffness or CV events and mortality. Further studies are needed to determine the role of epimeric vitamin D in CKD patients.
No takes yet. Share an insight, caveat, or question.
Campos et al. (2026) conducted an observational in Advanced CKD (stages 5 and 5D) (n=270). 3-epi-25(OH)D3 vs. Other quartiles was evaluated on Arterial stiffness and a composite of major CV events and all-cause mortality (p=0.23). Circulating 3-epi-25(OH)D3 levels showed no association with arterial stiffness or a composite of cardiovascular events and mortality (115 events over 9.3 years; log-rank P=0.23).
Synapse has enriched 10 related papers. Consider them for comparative context: