Secondary hyperparathyroidism, excess parathyroid hormone, resulting from chronic vitamin D deficiency has been associated with CVD potentially through several different pathological pathways, including: (1) increased insulin resistance and pancreatic β cell dysfunction, leading to metabolic syndrome and diabetes, (2) activation of renin-angiotensin-aldosterone system (RAAS), increasing blood pressure, leading to apoptosis and fibrosis, and (3) stimulation of systemic and vascular inflammation leading to atherogenesis (4, 19). This evidence concerns the gene PTH and metabolic syndrome.