Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA.
Am J Cardiol. 2012 Sep 15;110(6):834-9. doi: 10.1016/j.amjcard.2012.05.013. Epub 2012 Jun 2.
We aimed to examine associations between serum 25-hydroxyvitamin D (25[OH]D) concentration and mortality from heart failure (HF) and cardiovascular disease (CVD) and premature death from all causes using data from the Third National Health and Nutrition Examination Survey, which included 13,131 participants (6,130 men, 7,001 women) ≥35 years old at baseline (1988 to 1994) and followed through December 2000. Premature death was defined all-cause death at <75 years of age. Results indicated that during an average 8-year follow-up, there were 3,266 deaths (24.9%) including 101 deaths from HF, 1,451 from CVD, and 1,066 premature all-cause deaths. Among HF deaths, 37% of decedents had serum 25(OH)D levels <20 ng/ml, whereas only 26% of those with non-HF deaths had such levels (p <0.001). Multivariate-adjusted Cox model indicated that subjects with serum 25(OH)D levels <20 ng/ml had 2.06 times higher risk (95% confidence interval 1.01 to 4.25) of HF death than those with serum 25(OH)D levels ≥30 ng/ml (p <0.001). In addition, hazard ratios (95% confidence intervals) for premature death from all causes were 1.40 (1.17 to 1.68) in subjects with serum 25(OH)D levels <20 ng/ml and 1.11 (0.93 to 1.33) in those with serum 25(OH)D levels of 20 to 29 ng/ml compared to those with serum 25(OH)D levels ≥30 ng/ml (p <0.001, test for trend). In conclusion, adults with inadequate serum 25(OH)D levels have significantly higher risk of death from HF and all CVDs and all-cause premature death.
我们旨在利用第三次全国健康和营养调查的数据，研究血清 25-羟维生素 D（25[OH]D）浓度与心力衰竭（HF）和心血管疾病（CVD）死亡率以及所有原因导致的过早死亡之间的关联，该调查包括 13131 名年龄在 35 岁及以上的参与者（6130 名男性，7001 名女性），基线期为 1988 年至 1994 年，随访至 2000 年 12 月。过早死亡定义为<75 岁的全因死亡。结果显示，在平均 8 年的随访期间，共有 3266 人死亡（24.9%），包括 101 人死于 HF、1451 人死于 CVD 和 1066 人死于所有原因的过早死亡。在 HF 死亡中，37%的死者血清 25（OH）D 水平<20ng/ml，而无 HF 死亡的死者中只有 26%的人血清 25（OH）D 水平如此低（p<0.001）。多变量调整的 Cox 模型表明，血清 25（OH）D 水平<20ng/ml 的受试者 HF 死亡的风险是血清 25（OH）D 水平≥30ng/ml 受试者的 2.06 倍（95%置信区间 1.01 至 4.25）（p<0.001）。此外，血清 25（OH）D 水平<20ng/ml 的受试者全因过早死亡的危险比（95%置信区间）为 1.40（1.17 至 1.68），而血清 25（OH）D 水平为 20 至 29ng/ml 的受试者为 1.11（0.93 至 1.33），与血清 25（OH）D 水平≥30ng/ml 的受试者相比（p<0.001，趋势检验）。总之，血清 25（OH）D 水平不足的成年人 HF 和所有 CVD 以及所有原因导致的过早死亡风险显著增加。
