As people get older, their risk of heart disease tends to rise. Doctors usually look at things like blood pressure, cholesterol, and lifestyle to estimate that risk. But scientists are also searching for biological markers—substances in the blood that might help identify who is most likely to develop heart problems. A new study found that both vitamin D levels and a protein called periostin are linked with cardiovascular risk in older adults, suggesting they may offer fresh insights into heart health as we age.
Why Vitamin D and Periostin Matter for the Heart
Vitamin D is well known for keeping bones strong, but it has other roles too. It helps control inflammation, supports immune function, and may affect how the heart and blood vessels work. As people age, vitamin D levels often fall because skin makes less of it from sunlight and the body absorbs less from food.
Periostin is a protein involved in tissue repair and remodeling. It was first studied in bone health, but research shows it may also play a role in heart function, especially after injury. Scientists think periostin may be connected to how well the body repairs heart tissue—making it a potential marker for heart risk in older adults.
Together, these markers could help doctors better understand who is at higher risk for cardiovascular disease beyond traditional measures like age or cholesterol levels.
How the Researchers Studied These Markers
This analysis used data from 299 elderly participants in the InCHIANTI study, a long-term research project in the Chianti region of Italy. Participants were around 72.8 years old on average.
Researchers measured blood levels of:
- 25-hydroxyvitamin D (25(OH)D) — a marker of overall vitamin D status
- 1,25-dihydroxyvitamin D (1,25(OH)₂D) — the active form of vitamin D
- Periostin — the protein linked to tissue repair and heart remodeling
They also calculated cardiovascular risk using:
- A custom CV risk score based on factors like age, body weight, smoking, blood pressure, and cholesterol
- A standard 10-year risk estimate called SCORE2/SCORE2-OP (from European heart health guidelines)
Participants were grouped by whether they had low periostin levels (less than 150 pmol/L) or high periostin levels (150 pmol/L or more) to compare heart risk across groups.
What the Study Found About Heart Risk
Several important patterns emerged:
1. Lower periostin = higher cardiovascular risk
Participants with low periostin levels had higher average heart risk scores and higher estimated 10-year risk of cardiovascular events compared with those who had higher periostin levels.
2. Vitamin D and periostin are closely linked
Blood levels of both markers were strongly related. Higher periostin levels were associated with higher levels of both vitamin D forms, especially 25(OH)D.
3. Low vitamin D predicted low periostin
People with vitamin D deficiency (25(OH)D < 20 ng/mL) were far more likely to have low periostin. Older age (≥75 years) and dyslipidemia (high cholesterol/fats) were also linked to low periostin.
4. Active vitamin D is a strong predictor of heart risk
When researchers looked at all markers together, the active form of vitamin D (1,25(OH)â‚‚D) stood out. Even when accounting for periostin and other factors, low active vitamin D was strongly associated with higher CV risk (about 3 times higher odds).
This suggests that while both markers matter, the active form of vitamin D may be especially important in identifying cardiovascular risk in older adults.
Why These Results Are Interesting
This study provides new insight into the biological links between vitamin D, periostin, and heart risk in older adults. While traditional risk factors like blood pressure and cholesterol are still crucial, this research suggests that measurable blood markers could help identify individuals at higher risk earlier — potentially before major heart problems develop.
It also supports growing evidence that:
- Vitamin D deficiency may be more than just a bone issue — it may reflect wider metabolic or cardiovascular stress
- Periostin, a protein once studied mainly for bone health, may be part of the heart’s response system and signal who is at greater risk for heart disease
However, this study cannot prove that low vitamin D or low periostin cause heart disease. It only shows associations. More research will be needed, including long-term studies that follow people over time.
What This Means for Everyday Health
For older adults and their doctors, this study highlights that:
- Blood levels of vitamin D — especially the active form — is worth checking to see if your levels are in the normal range
- Periostin could become a new biomarker in cardiovascular risk assessment
- Addressing vitamin D deficiency remains important for overall health
Even though these findings need further confirmation, they add to a growing understanding that vitamin levels and tissue markers in the blood can tell us more about heart health than previously appreciated.
For individuals, this reinforces the importance of:
- Regular checkups that assess vitamin D status, especially in later life
- Discussing heart risk with healthcare providers — beyond traditional measures
- Healthy lifestyle habits like balanced diet, physical activity, and safe sun exposure to help maintain vitamin D levels
Source:
Brandi ML, Marini F, Parri S, et al. Evolving our understanding of vitamin D, periostin levels and cardiovascular risk in the elderly: a cross sectional study. Osteoporos Int. 2026;37:243–253. doi:10.1007/s00198-025-07735-3. Accessed by: https://pubmed.ncbi.nlm.nih.gov/41364337/
