Division of Aging, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Am J Cardiol. 2013 Sep 15;112(6):827-30. doi: 10.1016/j.amjcard.2013.05.014. Epub 2013 Jun 1.
Previous studies have suggested that vitamin D deficiency might contribute to the pathogenesis of heart failure (HF); however, limited data are available on the association of vitamin D-binding protein (VDBP)--a major transport protein for vitamin D--and the development of HF. Thus, we investigated whether plasma VDBP is inversely associated with HF risk. Using a prospective nested case-control design, we selected 464 cases and 464 matched controls from the Physicians' Health Study for the present analyses. VDBP was determined using an enzyme-linked immunoassay. Self-reported HF was obtained through annual follow-up questionnaires and validated in a subsample by a review of the medical records. We used conditional logistic regression analyses to compute the adjusted odds ratios. The mean age was 58.6 years, and the median VDBP was 307.8 μg/ml (interquartile range 265.2 to 354.6). Plasma VDBP was not associated with HF in our study. Across the consecutive quintiles of VDBP, the odds ratio was 1.0 (95% confidence interval [CI] reference), 1.05 (95% CI 0.66 to 1.65), 1.28 (95% CI 0.80 to 2.06), 1.07 (95% CI 0.65 to 1.75), and 1.28 (95% CI 0.76 to 2.15); p for linear trend = 0.41, after adjustment for matching factors, body mass index, diabetes, atrial fibrillation, hypertension, and high-sensitivity C-reactive protein. In conclusion, our data have shown no significant association between the plasma levels of VDBP and HF risk in apparently healthy male physicians.
先前的研究表明,维生素 D 缺乏可能导致心力衰竭 (HF) 的发病机制;然而,关于维生素 D 结合蛋白 (VDBP)——维生素 D 的主要转运蛋白——与 HF 发展之间的关联,数据有限。因此,我们研究了血浆 VDBP 是否与 HF 风险呈负相关。我们采用前瞻性巢式病例对照设计,从医师健康研究中选择了 464 例病例和 464 例匹配对照进行本分析。使用酶联免疫吸附试验测定 VDBP。HF 通过每年的随访问卷获得,并在子样本中通过审查病历进行验证。我们使用条件逻辑回归分析计算调整后的优势比。平均年龄为 58.6 岁,中位 VDBP 为 307.8μg/ml(四分位距 265.2 至 354.6)。在我们的研究中,血浆 VDBP 与 HF 无关。在 VDBP 的连续五分位中,比值比为 1.0(95%置信区间 [CI] 参考值),1.05(95%CI 0.66 至 1.65),1.28(95%CI 0.80 至 2.06),1.07(95%CI 0.65 至 1.75)和 1.28(95%CI 0.76 至 2.15);调整匹配因素、体重指数、糖尿病、心房颤动、高血压和高敏 C 反应蛋白后,线性趋势的 p 值为 0.41。总之,我们的数据表明,在明显健康的男性医生中,血浆 VDBP 水平与 HF 风险之间没有显著关联。