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Racial/Ethnic Differences in 25-Hydroxy Vitamin D and Parathyroid Hormone Levels and Cardiovascular Disease Risk Among Postmenopausal Women.
J Am Heart Assoc. 2019 02 19; 8(4):e011021.JA

Abstract

Background Recent evidence suggests that racial/ethnic differences in circulating levels of free or bioavailable 25-hydroxy vitamin D (25[ OH ]D) rather than total 25(OH)D may explain apparent racial disparities in cardiovascular disease (CVD). We prospectively examined black-white differences in the associations of total, free, and bioavailable 25(OH)D, vitamin D-binding protein, and parathyroid hormone levels at baseline with incident CVD (including nonfatal myocardial infarction, nonfatal stroke, and CVD death) in postmenopausal women. Methods and Results We conducted a case-cohort study among 79 705 postmenopausal women, aged 50 to 79 years, who were free of CVD at baseline in the WHI-OS (Women's Health Initiative Observational Study). A subcohort of 1300 black and 1500 white participants were randomly chosen as controls; a total of 550 black and 1500 white women who developed incident CVD during a mean follow-up of 11 years were chosen as cases. We directly measured total 25(OH)D, vitamin D-binding protein, albumin, parathyroid hormone, and calculated free and bioavailable 25(OH)D. Weighted Cox proportional hazards models were used to examine their associations with CVD risk. Although vitamin D-binding protein and total, free, and bioavailable 25(OH)D were not significantly associated with CVD risk in black or white women, a significant positive association between parathyroid hormone and CVD risk persisted in white women (hazard ratio comparing the highest quartile with the lowest, 1.37; 95% CI , 1.06-1.77) but not in black women (hazard ratio comparing the highest quartile with the lowest, 1.12; 95% CI, 0.79-1.58), independent of total, free, and bioavailable 25(OH)D or vitamin D-binding protein. Conclusions Circulating levels of vitamin D biomarkers are not related to CVD risk in either white or black women. Higher parathyroid hormone levels may be an independent risk factor for CVD in white women.

Authors+Show Affiliations

1 Department of Epidemiology Indiana University Richard M. Fairbanks School of Public Health Indianapolis IN.2 Department of Biostatistics Indiana University School of Medicine Indianapolis IN.3 Division of Preventive Medicine Department of Medicine Brigham and Women's Hospital Harvard Medical School Boston MA. 4 Department of Epidemiology Harvard T. H. Chan School of Public Health Boston MA.5 Public Health Division Fred Hutchinson Cancer Research Center Seattle WA.6 School of Public Health Brown University Providence RI. 7 The Warren Alpert School of Medicine Brown University Providence RI.8 Department of Epidemiology University of Pittsburgh, Graduate School of Public Health Pittsburgh PA.9 Department of Public Health Sciences University of California Davis CA.10 The University of Texas Medical Branch Galveston TX.11 Division of Cardiology School of Medicine and Health Sciences George Washington University Washington DC.12 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL.1 Department of Epidemiology Indiana University Richard M. Fairbanks School of Public Health Indianapolis IN.

Pub Type(s)

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

Language

eng

PubMed ID

30764690

Citation

Zhang, Xi, et al. "Racial/Ethnic Differences in 25-Hydroxy Vitamin D and Parathyroid Hormone Levels and Cardiovascular Disease Risk Among Postmenopausal Women." Journal of the American Heart Association, vol. 8, no. 4, 2019, pp. e011021.
Zhang X, Tu W, Manson JE, et al. Racial/Ethnic Differences in 25-Hydroxy Vitamin D and Parathyroid Hormone Levels and Cardiovascular Disease Risk Among Postmenopausal Women. J Am Heart Assoc. 2019;8(4):e011021.
Zhang, X., Tu, W., Manson, J. E., Tinker, L., Liu, S., Cauley, J. A., Qi, L., Mouton, C., Martin, L. W., Hou, L., & Song, Y. (2019). Racial/Ethnic Differences in 25-Hydroxy Vitamin D and Parathyroid Hormone Levels and Cardiovascular Disease Risk Among Postmenopausal Women. Journal of the American Heart Association, 8(4), e011021. https://doi.org/10.1161/JAHA.118.011021
Zhang X, et al. Racial/Ethnic Differences in 25-Hydroxy Vitamin D and Parathyroid Hormone Levels and Cardiovascular Disease Risk Among Postmenopausal Women. J Am Heart Assoc. 2019 02 19;8(4):e011021. PubMed PMID: 30764690.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial/Ethnic Differences in 25-Hydroxy Vitamin D and Parathyroid Hormone Levels and Cardiovascular Disease Risk Among Postmenopausal Women. AU - Zhang,Xi, AU - Tu,Wanzhu, AU - Manson,JoAnn E, AU - Tinker,Lesley, AU - Liu,Simin, AU - Cauley,Jane A, AU - Qi,Lihong, AU - Mouton,Charles, AU - Martin,Lisa W, AU - Hou,Lifang, AU - Song,Yiqing, PY - 2019/2/16/entrez PY - 2019/2/16/pubmed PY - 2020/3/7/medline KW - 25(OH)D KW - biomarker KW - cardiovascular disease KW - parathyroid hormone/calcitonin KW - vitamin D KW - women SP - e011021 EP - e011021 JF - Journal of the American Heart Association JO - J Am Heart Assoc VL - 8 IS - 4 N2 - Background Recent evidence suggests that racial/ethnic differences in circulating levels of free or bioavailable 25-hydroxy vitamin D (25[ OH ]D) rather than total 25(OH)D may explain apparent racial disparities in cardiovascular disease (CVD). We prospectively examined black-white differences in the associations of total, free, and bioavailable 25(OH)D, vitamin D-binding protein, and parathyroid hormone levels at baseline with incident CVD (including nonfatal myocardial infarction, nonfatal stroke, and CVD death) in postmenopausal women. Methods and Results We conducted a case-cohort study among 79 705 postmenopausal women, aged 50 to 79 years, who were free of CVD at baseline in the WHI-OS (Women's Health Initiative Observational Study). A subcohort of 1300 black and 1500 white participants were randomly chosen as controls; a total of 550 black and 1500 white women who developed incident CVD during a mean follow-up of 11 years were chosen as cases. We directly measured total 25(OH)D, vitamin D-binding protein, albumin, parathyroid hormone, and calculated free and bioavailable 25(OH)D. Weighted Cox proportional hazards models were used to examine their associations with CVD risk. Although vitamin D-binding protein and total, free, and bioavailable 25(OH)D were not significantly associated with CVD risk in black or white women, a significant positive association between parathyroid hormone and CVD risk persisted in white women (hazard ratio comparing the highest quartile with the lowest, 1.37; 95% CI , 1.06-1.77) but not in black women (hazard ratio comparing the highest quartile with the lowest, 1.12; 95% CI, 0.79-1.58), independent of total, free, and bioavailable 25(OH)D or vitamin D-binding protein. Conclusions Circulating levels of vitamin D biomarkers are not related to CVD risk in either white or black women. Higher parathyroid hormone levels may be an independent risk factor for CVD in white women. SN - 2047-9980 UR - https://www.unboundmedicine.com/medline/citation/30764690/Racial/Ethnic_Differences_in_25_Hydroxy_Vitamin_D_and_Parathyroid_Hormone_Levels_and_Cardiovascular_Disease_Risk_Among_Postmenopausal_Women_ L2 - https://www.ahajournals.org/doi/10.1161/JAHA.118.011021?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -