Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, Albert-Einstein-Allee 23, D-89081 Ulm, Germany.
J Clin Endocrinol Metab. 2013 Jan;98(1):272-80. doi: 10.1210/jc.2012-2368. Epub 2012 Nov 12.
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.
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-γ-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].
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.
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，我们前瞻性地评估了血清 25-羟维生素 D（最常用的维生素 D 状态指标）与冠心病事件之间的关系。
设计、地点和患者：我们在基于人群的监测趋势和心血管疾病决定因素/奥格斯堡合作卫生研究中，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。在平均 11 年的随访期间，共发现 298 例冠心病病例。
在校正年龄、调查和采血季节后，血清 25（OH）D 水平三分类极端值比较的危险比（HR）和 95%置信区间在女性中为 0.32（0.16-0.65）（趋势 P=0.001），在男性中为 0.56（0.38-0.82）（趋势 P=0.005）。进一步调整传统心血管危险因素后，女性的相关性略有减弱[HR 0.39（0.18-0.84）；趋势 P=0.013]，而男性则无统计学意义[HR 0.76（0.49-1.17）；趋势 P=0.215]。在进一步调整 C 反应蛋白、白细胞介素-6、可溶性细胞间黏附分子-1 和干扰素-γ诱导蛋白-10 后，女性的相关性仍然显著[HR 0.42（0.19-0.93）；趋势 P=0.028]，而男性则进一步降低[HR 0.84（0.52-1.35）；趋势 P=0.461]。
我们的研究结果表明，较高的维生素 D 水平与冠心病风险降低相关。这种作用在女性中比男性更明显。需要进一步的临床和实验研究来探讨性别差异以及维生素 D 补充是否有助于预防冠心病。
