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The effect of physical activity on dose-relationship between serum 25-hydroxyvitamin D and cardiovascular health events in older adults.
Nutr Metab Cardiovasc Dis. 2020 04 12; 30(4):656-665.NM

Abstract

BACKGROUND AND AIMS

Reverse J- or U-shaped associations between serum 25-hydroxyvitamin D (25[OH]D) concentrations and cardiovascular outcomes have been reported, which need clarifications in older adults. Physical activity, correlating with both serum 25[OH]D concentration and cardiovascular health, may have an effect on the dose-relationships.

METHODS AND RESULTS

At baseline, 2790 participants aged 65 years and over, free of vitamin D supplementation use, had assays for serum 25[OH]D concentrations and health related characteristics and measurements, were followed up for cardiovascular events and death by up to 7 and 15 years, respectively. The dose-response associations of serum 25[OH]D concentrations with cardiovascular events and mortality risk were examined using Cox regression models. After adjusting for physical activity and other covariates, serum 25[OH]D concentration was non-linearly associated with cardiovascular mortality risk (U-shaped, P = 0.009). According to the Institute of Medicine categories, the HR(95% CI) of cardiovascular mortality risk separately in deficient (<25 nmol/L), inadequate (25 to < 50 nmol/L) and potentially harmful (≥125 nmol/L) level was 1.67 (0.23, 12.01), 1.66 (1.25, 2.20) and 2.21 (0.30, 16.37), respectively. The risk of 25[OH]D inadequacy for cardiovascular mortality was significantly attenuated by increased physical activity, especially leisure activity (P for trend = 0.008 and 0.021, respectively). No significant finding was observed for incident cardiovascular events.

CONCLUSION

Both lower and higher serum 25[OH]D concentrations were associated with risk of cardiovascular mortality in Chinese community-dwelling older adults. Physical activity may attenuate the cardiovascular mortality risk of vitamin D inadequacy, but its role in individuals with higher 25[OH]D concentrations remains unclear.

Authors+Show Affiliations

Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong SAR, China.Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Medicine and Geriatrics, Alice Ho Miu Ling Nethersole Hospital and Tai Po Hospital, Hong Kong SAR, China.Division of Occupational and Environmental Health, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China; Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong SAR, China. Electronic address: tkwok@cuhk.edu.hk.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32151483

Citation

Su, Yi, et al. "The Effect of Physical Activity On Dose-relationship Between Serum 25-hydroxyvitamin D and Cardiovascular Health Events in Older Adults." Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, vol. 30, no. 4, 2020, pp. 656-665.
Su Y, Leung J, Lee J, et al. The effect of physical activity on dose-relationship between serum 25-hydroxyvitamin D and cardiovascular health events in older adults. Nutr Metab Cardiovasc Dis. 2020;30(4):656-665.
Su, Y., Leung, J., Lee, J., Ho, K. F., & Kwok, T. (2020). The effect of physical activity on dose-relationship between serum 25-hydroxyvitamin D and cardiovascular health events in older adults. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 30(4), 656-665. https://doi.org/10.1016/j.numecd.2019.12.006
Su Y, et al. The Effect of Physical Activity On Dose-relationship Between Serum 25-hydroxyvitamin D and Cardiovascular Health Events in Older Adults. Nutr Metab Cardiovasc Dis. 2020 04 12;30(4):656-665. PubMed PMID: 32151483.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of physical activity on dose-relationship between serum 25-hydroxyvitamin D and cardiovascular health events in older adults. AU - Su,Yi, AU - Leung,Jason, AU - Lee,Jenny, AU - Ho,Kin-Fai, AU - Kwok,Timothy, Y1 - 2019/12/14/ PY - 2019/08/25/received PY - 2019/11/09/revised PY - 2019/12/05/accepted PY - 2020/3/11/pubmed PY - 2020/9/15/medline PY - 2020/3/11/entrez KW - Aging KW - Cardiovascular health KW - Physical activity KW - Serum vitamin D SP - 656 EP - 665 JF - Nutrition, metabolism, and cardiovascular diseases : NMCD JO - Nutr Metab Cardiovasc Dis VL - 30 IS - 4 N2 - BACKGROUND AND AIMS: Reverse J- or U-shaped associations between serum 25-hydroxyvitamin D (25[OH]D) concentrations and cardiovascular outcomes have been reported, which need clarifications in older adults. Physical activity, correlating with both serum 25[OH]D concentration and cardiovascular health, may have an effect on the dose-relationships. METHODS AND RESULTS: At baseline, 2790 participants aged 65 years and over, free of vitamin D supplementation use, had assays for serum 25[OH]D concentrations and health related characteristics and measurements, were followed up for cardiovascular events and death by up to 7 and 15 years, respectively. The dose-response associations of serum 25[OH]D concentrations with cardiovascular events and mortality risk were examined using Cox regression models. After adjusting for physical activity and other covariates, serum 25[OH]D concentration was non-linearly associated with cardiovascular mortality risk (U-shaped, P = 0.009). According to the Institute of Medicine categories, the HR(95% CI) of cardiovascular mortality risk separately in deficient (<25 nmol/L), inadequate (25 to < 50 nmol/L) and potentially harmful (≥125 nmol/L) level was 1.67 (0.23, 12.01), 1.66 (1.25, 2.20) and 2.21 (0.30, 16.37), respectively. The risk of 25[OH]D inadequacy for cardiovascular mortality was significantly attenuated by increased physical activity, especially leisure activity (P for trend = 0.008 and 0.021, respectively). No significant finding was observed for incident cardiovascular events. CONCLUSION: Both lower and higher serum 25[OH]D concentrations were associated with risk of cardiovascular mortality in Chinese community-dwelling older adults. Physical activity may attenuate the cardiovascular mortality risk of vitamin D inadequacy, but its role in individuals with higher 25[OH]D concentrations remains unclear. SN - 1590-3729 UR - https://www.unboundmedicine.com/medline/citation/32151483/The_effect_of_physical_activity_on_dose_relationship_between_serum_25_hydroxyvitamin_D_and_cardiovascular_health_events_in_older_adults_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0939-4753(19)30453-3 DB - PRIME DP - Unbound Medicine ER -