Higher Vitamin D Status Is Independently Associated with Increased HDL-Cholesterol in Older Adults Without Statin Use

Abstract Background Vitamin D may influence lipid metabolism, with some studies suggesting a modest increase in high-density lipoprotein cholesterol (HDL-C) following vitamin D supplementation. However, observational studies examining the relationship between vitamin D status and lipid parameters have yielded inconsistent findings, partly due to confounding by statin use and other factors affecting lipid regulation. We aimed to examine the association between serum 25-hydroxyvitamin D [25(OH)D] concentrations and lipid profiles in older adults after excluding individuals using statins. Methods Adults aged >60 yrs from the TUDA study were analysed after removal of current or prior statin users. Multivariable linear regression was used to examine the relationship of serum 25(OH)D to HDL-C, LDL-C, and TG, adjusting for age, sex, BMI, waist-hip ratio, socioeconomic status, smoking, alcohol, diabetes, timed-up-and-go, C-reactive protein, dairy/fish/meat intake, renal function, thiazide use, β-blocker use, and glucocorticoid use. Results A total of 2,197 participants were included in the study (mean age 74.2±8.6 years; 71.2% female; mean 25(OH)D 62.8±31.2 nmol/L). Higher levels of 25(OH)D were independently associated with higher HDL-C (P < 0.001). No significant associations were observed between 25(OH)D levels and LDL-C or TG. Conclusion In statin-free older adults, higher vitamin D status was associated with higher HDL-C, but not with LDL-C or triglycerides. Vitamin D may enhance HDL metabolism by promoting apolipoprotein A-I and lecithin-cholesterol acyltransferase (LCAT), key proteins in HDL maturation and reverse cholesterol transport. No association was seen with vitamin D and atherogenic lipoproteins. Prospective studies are needed to confirm causality and clinical significance.