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Free 25-Hydroxyvitamin D Is Associated With the Risk of Mortality in Subjects With Coronary Artery Disease (CAD)

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Dr. Yu recently published a paper entitled “Serum Bioavailable and Free 25-Hydroxyvitamin D Levels, but Not ItsTotal Level, Are Associated With the Risk of Mortality in Patients With Coronary Artery Disease" (Circulation Research. 2018;123:996–1007).

A cohort of 1387 subjects with angiographically confirmed CAD was followed up during 6.7 years, and total 25OH Vitamin D, Bioavailable 25OH Vitamin D, and Free 25OH Vitamin D were measured at baseline and at endpoint.

The authors found out that Bioavailable and Free 25OH Vitamin D, but not Total 25OH Vitamin D, nor DBP, show a significant inverse association with the risk of both all-cause mortality, and cardiovascular mortality.

They conclude that this study demonstrates that bioavailable and free 25OH Vitamin D are potential predictors of adverse outcomes among CAD subjects.

Dr. Premer and Dr. Schulman wrote an editorial about this study, entitled "Have We Been Measuring the Wrong Form of Vitamin D? Vitamin D as a Prognostic Biomarker for Coronary Artery Disease Mortality" (

Albeit they cautioned the role ethnicity may have played in this study, as all participating subjects were Chinese—a population with relatively lower levels of CAD mortality compared with the Western population, they wondered how the measurement of bioavailable and free 25-hydroxyvitamin D in prior clinical trials would have affected the results. Furthermore, does changing the specific forms of vitamin D levels that are measured translate into meaningful clinical therapeutic advancements?

According to their opinion, Yu et al makes an important contribution to the field by demonstrating that total 25-hydroxyvitamin D—a parameter that has been commonly used to assess vitamin D body stores—is perhaps not what we should be measuring, but rather bioavailable and free 25-hydroxyvitamin D.

The article is available at

More information: Free 25OH Vitamin D ELISA

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