Low Levels of Serum 25-Hydroxyvitamin D Are Associated with Increased Risk of Myocardial Infarction, Especially in Women: Results from the MONICA/KORA Augsburg Case-Cohort Study
Low Levels of Serum 25-Hydroxyvitamin D Are Associated with Increased Risk of Myocardial Infarction, Especially in Women: Results from the MONICA/KORA Augsburg Case-Cohort Study
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DOI：
10.1210/jc.2012-2368
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发表时间：
2013-01-01
影响因子：
5.8
通讯作者：
Herder, Christian
中科院分区：
文献类型：
--
作者：
Karakas, Mahir;Thorand, Barbara;Herder, Christian
背景和目的：越来越多的证据表明，维生素D缺乏可能对心血管系统产生不利影响。因此，我们考虑前瞻性地评估血清25-羟基维生素D(维生素D状态的最常用指标)与冠心病发病率之间的关系。设计、环境和患者：我们在奥格斯堡研究地区的基于人群的心血管疾病趋势和决定因素监测/合作健康研究中，测量了1783名健康中年受试者(964名男性，819名女性)的血清25[OH]D水平。结果：在调整了年龄、调查和采血季节后，女性和男性的危险比和95%可信区间分别为0.32(0.16~0.65)和0.56(0.38~0.82)(P=0.005)。对传统心血管危险因素的进一步调整略微减弱了女性的这种关联[HR0.39(0.18-0.84)；趋势P=0.013]，而男性则变得不显著[HR0.76(0.49-1.17)；趋势P=0.215]。在进一步调整C-反应蛋白、IL-6、可溶性细胞间黏附分子-1和干扰素-γ诱导蛋白-10后，这种关联在女性中仍然显著[HR0.42(0.19-0.93)；趋势P=0.028]，在男性进一步降低[HR0.84(0.52-1.35)；P趋势=0.461]。结论：我们的研究结果表明，较高的维生素D水平与降低冠心病风险有关。这种影响在女性身上比在男性身上更明显。还需要进一步的临床和实验研究，以调查性别差异以及补充维生素D是否有助于预防冠心病。(临床内分泌代谢酶98：272-280,2013)
Context and Objective: A growing body of evidence suggests that vitamin D deficiency may adversely affect the cardiovascular system. Therefore, we thought to prospectively assess the association between serum 25-hydroxyvitamin D, the most commonly used index of vitamin D status, and incident coronary heart disease.Design, Setting, and Patients: We measured serum levels of 25[ OH] D in 1783 healthy middle-aged subjects (964 men, 819 women) in the population-based Monitoring of Trends and Determinants in Cardiovascular Disease/Cooperative Health Research in the Region of Augsburg studies. A total of 298 coronary heart disease cases were identified over a mean follow-up period of 11 yr.Results: After adjustment for age, survey, and season of blood sampling, the hazard ratio (HR) and 95% confidence interval comparing tertile extremes of serum levels of 25[OH] D was 0.32 (0.16-0.65) (P for trend = 0.001) in women and 0.56 (0.38-0.82) (P for trend = 0.005) in men. Further adjustment for traditional cardiovascular risk factors slightly attenuated the association in women [HR 0.39 (0.18-0.84); P for trend = 0.013], whereas it became nonsignificant in men [HR 0.76 (0.49-1.17); P for trend = 0.215]. After additional adjustment for C-reactive protein, IL-6, soluble intercellular adhesion molecule-1, and interferon-gamma-inducible protein-10, the association still remained significant in women [HR 0.42 (0.19-0.93); P for trend = 0.028], and it was further reduced in men [HR 0.84 (0.52-1.35); P for trend = 0.461].Conclusion: Our findings suggest that higher vitamin D levels are associated with decreased risk of coronary heart disease. This effect is more pronounced in women than in men. Further clinical and experimental studies are needed to investigate the sex differences and whether vitamin D supplementation could contribute to the prevention of coronary heart disease. (J Clin Endocrinol Metab 98: 272-280, 2013)