Differences in vitamin D status as a possible contributor to the racial disparity in peripheral arterial disease
Differences in vitamin D status as a possible contributor to the racial disparity in peripheral arterial disease
复制标题
DOI：
10.3945/ajcn.2008.26447
复制
发表时间：
2008-12-01
影响因子：
7.1
通讯作者：
Miller, Edgar R., III
中科院分区：
文献类型：
--
作者：
Reis, Jared P.;Michos, Erin D.;Miller, Edgar R., III
背景：心血管危险因素的种族差异并不能完全解释黑人成年人下肢外周动脉疾病（PAD）的高患病率。目的：我们试图确定这种额外的风险是否可以用维生素D水平来解释，维生素D水平在黑人中比白人低。设计：这项以人群为基础的横断面研究纳入了2001-2004年全国健康和营养检查调查中年龄在bb0 = 40岁的2987名白人和866名黑人。PAD定义为任意一条腿的踝肱压力指数< 0.90。结果：黑人成人25-羟基维生素D [25(OH) D]平均（+/- SEM）浓度显著低于白人成人（分别为39.2 +/- 1.0和63.7 +/- 1.1 nmol/L, P < 0.001）。在白人成年人中，PAD的校正优势比随着25(OH) D四分位数的增加呈剂量依赖性下降[1.00（参考），0.86,0.67和0.53；P代表趋势< 0.001]。在黑人成年人中，这种关联是非线性的；三次样条模型显示，在25(OH) D浓度最低和最高的情况下，PAD的患病几率更高，PAD的患病几率更低。在对社会经济地位的种族差异以及传统和新型风险因素进行调整后，黑人与白人成人相比，PAD的几率从2.11 （95% CI: 1.55, 2.87）降至1.67（1.11,2.51）。在额外调整25(OH) D后，赔率进一步降低到1.33（0.84,2.10）。结论：维生素D水平的种族差异可能解释了黑人比白人患PAD风险高出近三分之一的原因。需要进一步的研究来证实这些发现。J·克林·努尔2008；88: 1469 - 77。
Background: Racial differences in cardiovascular risk factors do not fully explain the higher prevalence of lower-extremity peripheral arterial disease (PAD) in black adults.Objective: We sought to determine whether any of this excess risk may be explained by vitamin D status, which has been widely documented to be lower in blacks than in whites.Design: This population-based cross-sectional study included 2987 white and 866 black persons aged >= 40 y from the 2001-2004 National Health and Nutrition Examination Survey. PAD was defined as an ankle-brachial pressure index of < 0.90 in either leg.Results: Mean (+/- SEM) 25-hydroxyvitamin D [25(OH) D] concentrations were significantly lower in black than in white adults (39.2 +/- 1.0 and 63.7 +/- 1.1 nmol/L, respectively; P < 0.001). Adjusted odds ratios for PAD decreased in a dose-dependent fashion with increasing quartiles of 25(OH) D in white adults [1.00 (referent), 0.86, 0.67, and 0.53; P for trend < 0.001]. In black adults, the association was nonlinear; models with cubic splines suggested evidence of greater odds for PAD and a trend for lower odds for PAD at the lowest and highest concentrations of 25(OH) D, respectively. After adjustment for racial differences in socioeconomic status and for traditional and novel risk factors, odds for PAD in black compared with white adults were reduced from 2.11 (95% CI: 1.55, 2.87) to 1.67 (1.11, 2.51). After additional adjustment for 25(OH) D, the odds were further reduced to 1.33 (0.84, 2.10).Conclusions: Racial differences in vitamin D status may explain nearly one-third of the excess risk of PAD in black compared with white adults. Additional research is needed to confirm these findings. Am J Clin Nutr 2008; 88: 1469-77.