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Associations of Vitamin D-Binding Globulin and Bioavailable Vitamin D Concentrations With Coronary Heart Disease Events: The Multi-Ethnic Study of Atherosclerosis (MESA).
J Clin Endocrinol Metab. 2017 08 01; 102(8):3075-3084.JC

Abstract

Context

Low 25-hydroxyvitamin D [25(OH)D] is associated with coronary heart disease (CHD) in people who are white and Chinese but not black or Hispanic. Vitamin D binding globulin (VDBG) avidly binds 25(OH)D, reducing its bioavailability, and differs in isoform and concentration by race.

Objective

Evaluate associations of VDBG with CHD and whether accounting for VDBG or estimating bioavailable 25(OH)D explains the heterogeneity of the association of 25(OH)D with CHD.

Design and Setting

We conducted a case-cohort study within the Multi-Ethnic Study of Atherosclerosis. Participants with an incident CHD event over 12 years of follow-up (n = 538) and a randomly assigned subcohort (n = 999) were included. We measured baseline 25(OH)D, VDBG, and isoforms using mass spectrometry and estimated bioavailable 25(OH)D from published equations.

Results

VDBG was associated with an increased risk of CHD [hazard ratio, 1.77 (95% confidence interval, 1.46 to 2.14) per standard deviation increment, P < 0.0001], without evidence of heterogeneity by race or isoform (each P for interaction > 0.1). Low total 25(OH)D was differentially associated with CHD events, by race, with or without adjustment for VDBG (P for interaction = 0.04 or 0.05, respectively). Associations of 25(OH)D with CHD were strengthened with adjustment for VDBG among participants who were white or Chinese, and bioavailable 25(OH)D was associated with CHD events only among white participants.

Conclusions

High VDBG concentration was associated with CHD events in all racial and ethnic groups. Incorporation of VDBG strengthened existing associations of 25(OH)D with CHD but did not explain racial heterogeneity in associations of 25(OH)D with CHD.

Authors+Show Affiliations

Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington 98195.Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington 98195.Department of Laboratory Medicine, University of Washington, Seattle, Washington 98195.Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55455.School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27109.Division of Cardiology, Johns Hopkins University, Baltimore, Maryland 21218. Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 21205.Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York 10032. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10027.Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, Vermont 05405. Department of Biochemistry, University of Vermont, Burlington, Vermont 05405.New York Academy of Medicine, New York, New York 10029.Cardiovascular Health Research Unit, Departments of Epidemiology and Medicine, University of Washington, Seattle, Washington 98101. Department of Health Services, University of Washington, Seattle, Washington 98195. Group Health Research Institute, Seattle, Washington 98101.Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington 98195.Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington 98195.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

28472285

Citation

Robinson-Cohen, Cassianne, et al. "Associations of Vitamin D-Binding Globulin and Bioavailable Vitamin D Concentrations With Coronary Heart Disease Events: the Multi-Ethnic Study of Atherosclerosis (MESA)." The Journal of Clinical Endocrinology and Metabolism, vol. 102, no. 8, 2017, pp. 3075-3084.
Robinson-Cohen C, Zelnick LR, Hoofnagle AN, et al. Associations of Vitamin D-Binding Globulin and Bioavailable Vitamin D Concentrations With Coronary Heart Disease Events: The Multi-Ethnic Study of Atherosclerosis (MESA). J Clin Endocrinol Metab. 2017;102(8):3075-3084.
Robinson-Cohen, C., Zelnick, L. R., Hoofnagle, A. N., Lutsey, P. L., Burke, G., Michos, E. D., Shea, S. J. C., Tracy, R., Siscovick, D. S., Psaty, B., Kestenbaum, B., & de Boer, I. H. (2017). Associations of Vitamin D-Binding Globulin and Bioavailable Vitamin D Concentrations With Coronary Heart Disease Events: The Multi-Ethnic Study of Atherosclerosis (MESA). The Journal of Clinical Endocrinology and Metabolism, 102(8), 3075-3084. https://doi.org/10.1210/jc.2017-00296
Robinson-Cohen C, et al. Associations of Vitamin D-Binding Globulin and Bioavailable Vitamin D Concentrations With Coronary Heart Disease Events: the Multi-Ethnic Study of Atherosclerosis (MESA). J Clin Endocrinol Metab. 2017 08 1;102(8):3075-3084. PubMed PMID: 28472285.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of Vitamin D-Binding Globulin and Bioavailable Vitamin D Concentrations With Coronary Heart Disease Events: The Multi-Ethnic Study of Atherosclerosis (MESA). AU - Robinson-Cohen,Cassianne, AU - Zelnick,Leila R, AU - Hoofnagle,Andrew N, AU - Lutsey,Pamela L, AU - Burke,Gregory, AU - Michos,Erin D, AU - Shea,Steven J C, AU - Tracy,Russell, AU - Siscovick,David S, AU - Psaty,Bruce, AU - Kestenbaum,Bryan, AU - de Boer,Ian H, PY - 2017/01/31/received PY - 2017/04/27/accepted PY - 2017/5/5/pubmed PY - 2017/9/21/medline PY - 2017/5/5/entrez SP - 3075 EP - 3084 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 102 IS - 8 N2 - Context: Low 25-hydroxyvitamin D [25(OH)D] is associated with coronary heart disease (CHD) in people who are white and Chinese but not black or Hispanic. Vitamin D binding globulin (VDBG) avidly binds 25(OH)D, reducing its bioavailability, and differs in isoform and concentration by race. Objective: Evaluate associations of VDBG with CHD and whether accounting for VDBG or estimating bioavailable 25(OH)D explains the heterogeneity of the association of 25(OH)D with CHD. Design and Setting: We conducted a case-cohort study within the Multi-Ethnic Study of Atherosclerosis. Participants with an incident CHD event over 12 years of follow-up (n = 538) and a randomly assigned subcohort (n = 999) were included. We measured baseline 25(OH)D, VDBG, and isoforms using mass spectrometry and estimated bioavailable 25(OH)D from published equations. Results: VDBG was associated with an increased risk of CHD [hazard ratio, 1.77 (95% confidence interval, 1.46 to 2.14) per standard deviation increment, P < 0.0001], without evidence of heterogeneity by race or isoform (each P for interaction > 0.1). Low total 25(OH)D was differentially associated with CHD events, by race, with or without adjustment for VDBG (P for interaction = 0.04 or 0.05, respectively). Associations of 25(OH)D with CHD were strengthened with adjustment for VDBG among participants who were white or Chinese, and bioavailable 25(OH)D was associated with CHD events only among white participants. Conclusions: High VDBG concentration was associated with CHD events in all racial and ethnic groups. Incorporation of VDBG strengthened existing associations of 25(OH)D with CHD but did not explain racial heterogeneity in associations of 25(OH)D with CHD. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/28472285/Associations_of_Vitamin_D_Binding_Globulin_and_Bioavailable_Vitamin_D_Concentrations_With_Coronary_Heart_Disease_Events:_The_Multi_Ethnic_Study_of_Atherosclerosis__MESA__ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2017-00296 DB - PRIME DP - Unbound Medicine ER -