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Relationship between 25-hydroxyvitamin D and all-cause and cardiovascular disease mortality.
Am J Med. 2013 Jun; 126(6):509-14.AJ

Abstract

BACKGROUND

Observational studies have suggested a strong relationship between 25(OH)D and all-cause and cardiovascular disease mortality. A few studies also have described a nonlinear trend for this relationship in population subgroups, but less is known about this relationship in healthy adults. We examined the presence of a nonlinear relationship between 25(OH)D and all-cause and cardiovascular disease mortality among healthy adults.

METHODS

We examined 10,170 participants (≥18 years of age) using National Health and Nutrition Examination Survey data (2001-2004) combined with National Death Index for vital status information through December 2006. Cox proportional hazard models with spline (single knot at population median of 25[OH]D) were fit to estimate hazard ratios (HRs) for all-cause and cardiovascular disease mortality for each 10-unit increase in serum 25(OH)D. Models were adjusted for demographic and conventional cardiovascular disease risk factors.

RESULTS

Mean age of study participants was 46.6 (20.5) years, while median (interquartile range) 25(OH)D was 21 (15-27) ng/mL. After a median follow-up of 3.8 years (range 2.8-4.9), 509 all-cause and 184 cardiovascular diseases-related deaths were observed. In univariate analysis, 25(OH)D decreased hazards of all-cause (HR 0.59; 95% confidence interval [CI], 0.45-0.77) and cardiovascular disease (HR 0.56; 95% CI, 0.38-0.82) mortality below but not above its population median. In adjusted models, 25(OH)D retained the inverse association for all-cause (HR 0.54; 95% CI, 0.35-0.84) and cardiovascular disease (HR 0.50; 95% CI, 0.26-0.98) mortality below but not above its population median.

CONCLUSIONS

We found an inverse association between 25(OH)D and all-cause and cardiovascular disease mortality in healthy adults with serum 25(OH)D levels of ≤21 ng/mL. Clinical trials for the primary prevention of cardiovascular disease with 25(OH)D supplementation may target healthy adults with serum 25(OH)D levels of ≤21 ng/mL to validate these findings.

Authors+Show Affiliations

Department of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA. mamer1@jhmi.eduNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

23601272

Citation

Amer, Muhammad, and Rehan Qayyum. "Relationship Between 25-hydroxyvitamin D and All-cause and Cardiovascular Disease Mortality." The American Journal of Medicine, vol. 126, no. 6, 2013, pp. 509-14.
Amer M, Qayyum R. Relationship between 25-hydroxyvitamin D and all-cause and cardiovascular disease mortality. Am J Med. 2013;126(6):509-14.
Amer, M., & Qayyum, R. (2013). Relationship between 25-hydroxyvitamin D and all-cause and cardiovascular disease mortality. The American Journal of Medicine, 126(6), 509-14. https://doi.org/10.1016/j.amjmed.2012.11.021
Amer M, Qayyum R. Relationship Between 25-hydroxyvitamin D and All-cause and Cardiovascular Disease Mortality. Am J Med. 2013;126(6):509-14. PubMed PMID: 23601272.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between 25-hydroxyvitamin D and all-cause and cardiovascular disease mortality. AU - Amer,Muhammad, AU - Qayyum,Rehan, Y1 - 2013/04/17/ PY - 2012/09/20/received PY - 2012/11/15/revised PY - 2012/11/15/accepted PY - 2013/4/23/entrez PY - 2013/4/23/pubmed PY - 2013/8/2/medline SP - 509 EP - 14 JF - The American journal of medicine JO - Am J Med VL - 126 IS - 6 N2 - BACKGROUND: Observational studies have suggested a strong relationship between 25(OH)D and all-cause and cardiovascular disease mortality. A few studies also have described a nonlinear trend for this relationship in population subgroups, but less is known about this relationship in healthy adults. We examined the presence of a nonlinear relationship between 25(OH)D and all-cause and cardiovascular disease mortality among healthy adults. METHODS: We examined 10,170 participants (≥18 years of age) using National Health and Nutrition Examination Survey data (2001-2004) combined with National Death Index for vital status information through December 2006. Cox proportional hazard models with spline (single knot at population median of 25[OH]D) were fit to estimate hazard ratios (HRs) for all-cause and cardiovascular disease mortality for each 10-unit increase in serum 25(OH)D. Models were adjusted for demographic and conventional cardiovascular disease risk factors. RESULTS: Mean age of study participants was 46.6 (20.5) years, while median (interquartile range) 25(OH)D was 21 (15-27) ng/mL. After a median follow-up of 3.8 years (range 2.8-4.9), 509 all-cause and 184 cardiovascular diseases-related deaths were observed. In univariate analysis, 25(OH)D decreased hazards of all-cause (HR 0.59; 95% confidence interval [CI], 0.45-0.77) and cardiovascular disease (HR 0.56; 95% CI, 0.38-0.82) mortality below but not above its population median. In adjusted models, 25(OH)D retained the inverse association for all-cause (HR 0.54; 95% CI, 0.35-0.84) and cardiovascular disease (HR 0.50; 95% CI, 0.26-0.98) mortality below but not above its population median. CONCLUSIONS: We found an inverse association between 25(OH)D and all-cause and cardiovascular disease mortality in healthy adults with serum 25(OH)D levels of ≤21 ng/mL. Clinical trials for the primary prevention of cardiovascular disease with 25(OH)D supplementation may target healthy adults with serum 25(OH)D levels of ≤21 ng/mL to validate these findings. SN - 1555-7162 UR - https://www.unboundmedicine.com/medline/citation/23601272/Relationship_between_25_hydroxyvitamin_D_and_all_cause_and_cardiovascular_disease_mortality_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(13)00084-3 DB - PRIME DP - Unbound Medicine ER -