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25-Hydroxyvitamin D deficiency is associated with fatal stroke among whites but not blacks: The NHANES-III linked mortality files.
Nutrition. 2012 Apr; 28(4):367-71.N

Abstract

OBJECTIVE

Deficient 25-hydroxyvitamin D (25[OH]D) levels are associated with cardiovascular disease (CVD) events and mortality. 25(OH)D deficiency and stroke are more prevalent in blacks. We examined whether low 25(OH)D contributes to the excess risk of fatal stroke in blacks compared with whites.

METHODS

The Third National Health and Nutrition Examination Survey, a probability sample of U.S. civilians, measured 25(OH)D levels and CVD risk factors from 1988 through 1994. Vital status through December 2006 was obtained by a linkage with the National Death Index. In white and black adults without CVD reported at baseline (n = 7981), Cox regression models were fit to estimate hazard ratios (HR) for fatal stroke by 25(OH)D status and race.

RESULTS

During a median of 14.1 y, there were 116 and 60 fatal strokes in whites and blacks, respectively. The risk of fatal stroke was greater in blacks compared with whites in models adjusted for socioeconomic status and CVD risk factors (HR 1.60, 95% confidence interval 1.01-2.53). Mean baseline 25(OH)D levels were significantly lower in blacks compared with whites (19.4 versus 30.8 ng/mL, respectively). In multivariable-adjusted models, deficient 25(OH)D levels lower than 15 ng/mL were associated with fatal stroke in whites (HR 2.13, 1.01-4.50) but not blacks (HR 0.93, 0.49-1.80).

CONCLUSIONS

Vitamin D deficiency was associated with an increased risk of stroke death in whites but not in blacks. Although blacks had a higher rate of fatal stroke compared with whites, the low 25(OH)D levels in blacks were unrelated to stroke incidence. Therefore 25(OH)D levels did not explain this excess risk.

Authors+Show Affiliations

Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA. edonnell@jhmi.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22261577

Citation

Michos, Erin D., et al. "25-Hydroxyvitamin D Deficiency Is Associated With Fatal Stroke Among Whites but Not Blacks: the NHANES-III Linked Mortality Files." Nutrition (Burbank, Los Angeles County, Calif.), vol. 28, no. 4, 2012, pp. 367-71.
Michos ED, Reis JP, Post WS, et al. 25-Hydroxyvitamin D deficiency is associated with fatal stroke among whites but not blacks: The NHANES-III linked mortality files. Nutrition. 2012;28(4):367-71.
Michos, E. D., Reis, J. P., Post, W. S., Lutsey, P. L., Gottesman, R. F., Mosley, T. H., Sharrett, A. R., & Melamed, M. L. (2012). 25-Hydroxyvitamin D deficiency is associated with fatal stroke among whites but not blacks: The NHANES-III linked mortality files. Nutrition (Burbank, Los Angeles County, Calif.), 28(4), 367-71. https://doi.org/10.1016/j.nut.2011.10.015
Michos ED, et al. 25-Hydroxyvitamin D Deficiency Is Associated With Fatal Stroke Among Whites but Not Blacks: the NHANES-III Linked Mortality Files. Nutrition. 2012;28(4):367-71. PubMed PMID: 22261577.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 25-Hydroxyvitamin D deficiency is associated with fatal stroke among whites but not blacks: The NHANES-III linked mortality files. AU - Michos,Erin D, AU - Reis,Jared P, AU - Post,Wendy S, AU - Lutsey,Pamela L, AU - Gottesman,Rebecca F, AU - Mosley,Thomas H, AU - Sharrett,A Richey, AU - Melamed,Michal L, Y1 - 2012/01/20/ PY - 2011/05/24/received PY - 2011/10/26/revised PY - 2011/10/26/accepted PY - 2012/1/21/entrez PY - 2012/1/21/pubmed PY - 2012/8/2/medline SP - 367 EP - 71 JF - Nutrition (Burbank, Los Angeles County, Calif.) JO - Nutrition VL - 28 IS - 4 N2 - OBJECTIVE: Deficient 25-hydroxyvitamin D (25[OH]D) levels are associated with cardiovascular disease (CVD) events and mortality. 25(OH)D deficiency and stroke are more prevalent in blacks. We examined whether low 25(OH)D contributes to the excess risk of fatal stroke in blacks compared with whites. METHODS: The Third National Health and Nutrition Examination Survey, a probability sample of U.S. civilians, measured 25(OH)D levels and CVD risk factors from 1988 through 1994. Vital status through December 2006 was obtained by a linkage with the National Death Index. In white and black adults without CVD reported at baseline (n = 7981), Cox regression models were fit to estimate hazard ratios (HR) for fatal stroke by 25(OH)D status and race. RESULTS: During a median of 14.1 y, there were 116 and 60 fatal strokes in whites and blacks, respectively. The risk of fatal stroke was greater in blacks compared with whites in models adjusted for socioeconomic status and CVD risk factors (HR 1.60, 95% confidence interval 1.01-2.53). Mean baseline 25(OH)D levels were significantly lower in blacks compared with whites (19.4 versus 30.8 ng/mL, respectively). In multivariable-adjusted models, deficient 25(OH)D levels lower than 15 ng/mL were associated with fatal stroke in whites (HR 2.13, 1.01-4.50) but not blacks (HR 0.93, 0.49-1.80). CONCLUSIONS: Vitamin D deficiency was associated with an increased risk of stroke death in whites but not in blacks. Although blacks had a higher rate of fatal stroke compared with whites, the low 25(OH)D levels in blacks were unrelated to stroke incidence. Therefore 25(OH)D levels did not explain this excess risk. SN - 1873-1244 UR - https://www.unboundmedicine.com/medline/citation/22261577/25_Hydroxyvitamin_D_deficiency_is_associated_with_fatal_stroke_among_whites_but_not_blacks:_The_NHANES_III_linked_mortality_files_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899-9007(11)00378-9 DB - PRIME DP - Unbound Medicine ER -