The Interdependency and Co-Regulation of the Vitamin D and Cholesterol Metabolism

Tara Warren, Roisin McAllister, Amy Morgan, Taranjit Singh Rai, Victoria McGilligan, Matthew Ennis, Christopher Page, Catriona Kelly, Aaron Peace, Bernard Corfe, Mark Mc Auley, Steven Watterson

Research output: Contribution to journalReview articlepeer-review

16 Citations (Scopus)
125 Downloads (Pure)


Vitamin D and cholesterol metabolism overlap significantly in the pathways that contribute to their biosynthesis. However, our understanding of their independent and co-regulation is limited. Cardiovascular disease is the leading cause of death globally and atherosclerosis, the pathology associated with elevated cholesterol, is the leading cause of cardiovascular disease. It is therefore important to understand vitamin D metabolism as a contributory factor. From the literature, we compile evidence of how these systems interact, relating the understanding of the molecular mechanisms involved to the results from observational studies. We also present the first systems biology pathway map of the joint cholesterol and vitamin D metabolisms made available using the Systems Biology Graphical Notation (SBGN) Markup Language (SBGNML). It is shown that the relationship between vitamin D supplementation, total cholesterol, and LDL-C status, and between latitude, vitamin D, and cholesterol status are consistent with our knowledge of molecular mechanisms. We also highlight the results that cannot be explained with our current knowledge of molecular mechanisms: (i) vitamin D supplementation mitigates the side-effects of statin therapy; (ii) statin therapy does not impact upon vitamin D status; and critically (iii) vitamin D supplementation does not improve cardiovascular outcomes, despite improving cardiovascular risk factors. For (iii), we present a hypothesis, based on observations in the literature, that describes how vitamin D regulates the balance between cellular and plasma cholesterol. Answering these questions will create significant opportunities for advancement in our understanding of cardiovascular health.
Original languageEnglish
Article numbere2007
Pages (from-to)1-18
Number of pages18
Issue number8
Publication statusPublished (in print/issue) - 6 Aug 2021

Bibliographical note

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.


  • cholesterol
  • vitamin D
  • systems biology
  • regulation
  • pathway biology


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