Vitamin D deficiency and risk of cardiovascular disease

Article

关键词: PLASMA-RENIN ACTIVITY;    SMOOTH-MUSCLE-CELLS;    3RD NATIONAL-HEALTH;    PARATHYROID-HORMONE;    BLOOD-PRESSURE;    D SUPPLEMENTATION;    PHYSICAL-ACTIVITY;    SERUM 25-HYDROXYVITAMIN-D;    1,25-DIHYDROXYVITAMIN D-3;    ENDOTHELIAL-CELLS;   

DOI  :  10.1161/CIRCULATIONAHA.107.706127

来源: SCIE

【 摘 要 】

Background - Vitamin D receptors have a broad tissue distribution that includes vascular smooth muscle, endothelium, and cardiomyocytes. A growing body of evidence suggests that vitamin D deficiency may adversely affect the cardiovascular system, but data from longitudinal studies are lacking. Methods and Results - We studied 1739 Framingham Offspring Study participants (mean age 59 years; 55% women; all white) without prior cardiovascular disease. Vitamin D status was assessed by measuring 25-dihydroxyvitamin D (25-OH D) levels. Prespecified thresholds were used to characterize varying degrees of 25-OH D deficiency (< 15 ng/mL, < 10 ng/mL). Multivariable Cox regression models were adjusted for conventional risk factors. Overall, 28% of individuals had levels < 15 ng/mL, and 9% had levels < 10 ng/mL. During a mean follow-up of 5.4 years, 120 individuals developed a first cardiovascular event. Individuals with 25-OH D < 15 ng/mL had a multivariable-adjusted hazard ratio of 1.62 (95% confidence interval 1.11 to 2.36, P = 0.01) for incident cardiovascular events compared with those with 25-OH D >= 15 ng/mL. This effect was evident in participants with hypertension (hazard ratio 2.13, 95% confidence interval 1.30 to 3.48) but not in those without hypertension (hazard ratio 1.04, 95% confidence interval 0.55 to 1.96). There was a graded increase in cardiovascular risk across categories of 25-OH D, with multivariable-adjusted hazard ratios of 1.53 (95% confidence interval 1.00 to 2.36) for levels 10 to < 15 ng/mL and 1.80 (95% confidence interval 1.05 to 3.08) for levels < 10 ng/mL (P for linear trend = 0.01). Further adjustment for C-reactive protein, physical activity, or vitamin use did not affect the findings. Conclusions - Vitamin D deficiency is associated with incident cardiovascular disease. Further clinical and experimental studies may be warranted to determine whether correction of vitamin D deficiency could contribute to the prevention of cardiovascular disease.

【 授权许可】

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