In a large cohort of professional male athletes, higher vitamin D status was tracked with lower atherogenic lipid markers, raising new questions about metabolic health beyond training alone.
Study: Vitamin D status and atherogenic lipid profile including lipoprotein(a) in elite athletes. Image credit: Vink Fan / Shutterstock
In a recent study published in the journal nutrientsGerman researchers investigated the association between serum 25-hydroxyvitamin D levels and atherogenic lipid parameters, including lipoprotein(a), in male professional athletes.
background
Did you know that even highly trained athletes can develop unfavorable lipid profiles that can impact long-term cardiovascular health? Vitamin D is critical for bone health, regulating inflammatory responses, and metabolism, but some studies have linked lower vitamin D levels to lower lipid profiles. However, these results differ because obesity, physical inactivity, chronic disease, and drug use can affect both vitamin D status and lipid metabolism.
About research
Researchers conducted a single-center, cross-sectional registry study of male professional athletes who underwent regular preseason sports cardiology evaluations at Giessen University Hospital from 2014 to 2026. Inclusion criteria for the study were male athletes between the ages of 18 and 39 with documented serum 25-hydroxyvitamin D levels. Athletes with known cardiovascular, metabolic, or systemic disease or regularly taking medications were excluded.
The study evaluated 773 professional athletes in handball, basketball, ice hockey, and soccer. All participants underwent standardized assessments including physical examination, blood pressure measurements, electrocardiography, and echocardiography. Information regarding training history and weekly training volume was collected through a standardized questionnaire.
Serum 25-hydroxyvitamin D, parathyroid hormone, lipid indicators, lipoprotein (a), glycated hemoglobin, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, C-reactive protein, and calcium were analyzed from blood samples taken at least 3 hours after meals during routine screening. As fasting was not routinely required, lipid measurements were treated as non-fasting and standardized laboratory methods were applied.
Vitamin D levels were analyzed as a continuous variable and classified into three categories: (<30、30-50、>50 ng/mL). This association was examined by detailed statistical analyzes including subgroup analyses, correlation analyses, and multiple regression models adjusting for age, BMI, sport type, season, training characteristics, year of assessment, and athletic performance.
Research results
The study involved 773 male professional athletes with an average age of 25.5 years. Participants represented a variety of team sports, including handball, basketball, ice hockey, and soccer. The mean blood concentration of 25-hydroxyvitamin D was 34.25 ng/mL. We found that vitamin D concentrations were higher from June to October than from November to May, probably due to seasonal differences in UV exposure.
Participants were categorized according to vitamin D levels for further evaluation. A total of 477 athletes had sufficient vitamin D levels, while 296 athletes had insufficient vitamin D levels. When grouped by vitamin D status, vitamin D-sufficient athletes had better blood lipid profiles than vitamin D-deficient athletes.
Athletes with sufficient vitamin D had lower low-density lipoprotein concentrations than those with insufficient vitamin D (95.08 vs. 101.06 mg/dL). Triglyceride concentrations were also lower compared to athletes with insufficient triglyceride concentrations (96.11 vs. 105.96 mg/dL). Lipoprotein(a) concentrations also differed significantly between groups, but the values were skewed and partially influenced by the detection limit of the assay.
There were no significant differences in high-density lipoprotein concentrations. Total cholesterol only showed a trend toward lower values in athletes with sufficient vitamin D.
Participants with enough vitamin D had higher peak exercise performance, lower parathyroid hormone levels, and slightly higher calcium levels compared to participants who were vitamin D deficient. Age, BMI, and training history were similar between both groups.
Further analysis revealed that participants were categorized into three categories of vitamin D (<30 ng/mL、30 ～ 50 ng/mL、>50 ng/mL). Increased vitamin D concentrations were associated with progressive decreases in total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels. There were significant differences between groups of participants based on lipoprotein(a) distribution by vitamin D level category. However, lipoprotein(a) concentrations were not systematically improved across vitamin D categories.
Correlation analysis of participants revealed that higher vitamin D levels were associated with lower total cholesterol, low-density lipoprotein cholesterol, triglycerides, lipoprotein(a), glycated hemoglobin, and parathyroid hormone levels, while also positively correlated with improved calcium levels and peak exercise performance. There were no significant correlations between vitamin D and age, BMI, C-reactive protein levels, or training volume.
After multivariate analysis, it was concluded that increased vitamin D levels were independently associated with decreased total cholesterol levels, low-density lipoprotein cholesterol levels, triglyceride levels, and lipoprotein (a) levels.
Results showed that for every 1 ng/mL increase in vitamin D, low-density lipoprotein cholesterol decreased by 0.19 mg/dL and lipoprotein(a) decreased by 1.1%. No independent association was found between vitamin D and high-density lipoprotein cholesterol levels.
conclusion
This study found that higher serum 25-hydroxyvitamin D concentrations in male professional athletes were independently associated with a more favorable atherogenic lipid profile. We found that athletes with higher vitamin D levels generally had lower concentrations of low-density lipoprotein cholesterol, triglycerides, and lipoprotein(a), even after accounting for age, BMI, training-related factors, sport discipline, year of assessment, and seasonal variation.
Higher vitamin D levels were also associated with higher peak exercise performance and lower parathyroid hormone levels, but this study cannot determine whether vitamin D directly affects performance or lipid levels.
These results raise the possibility that vitamin D status is an important metabolic correlate of cardiovascular risk-related lipid parameters in elite athletes, as the cross-sectional design of this study precludes conclusions of causality.
The results should be interpreted as exploratory as vitamin D supplementation, dietary intake, body composition, UV exposure, and other lifestyle-related factors were not systematically evaluated.
The authors also noted that multiple statistical comparisons were made without formal adjustment and that only male professional athletes were included, limiting generalizability to female athletes, recreational athletes, and non-athlete populations.
Further research is needed to clarify these relationships in populations with fewer lifestyle-related confounders.
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Reference magazines:
- Groesser, V., Most, A., Sedighi, J., Böttger, P., Sossalla, S., and Bauer, P. (2026). Vitamin D status and atherogenic lipid profile (including lipoprotein(a)) in elite athletes. Nutrients, 18(12). Doi: 10.3390/nu18122013, https://www.mdpi.com/2072-6643/18/12/2013
