Department of Medicine, Kidney Research Institute, University of Washington, Seattle 98104, USA.
JAMA. 2013 Jul 10;310(2):179-88. doi: 10.1001/jama.2013.7228.
Low circulating concentrations of 25-hydroxyvitamin D (25[OH]D) have been consistently associated with an increased risk of coronary heart disease (CHD) in white populations. This association has not been rigorously evaluated in other races or ethnicities, in which the distributions of 25(OH)D concentration and possibly other aspects of 25(OH)D metabolism differ.
To examine the association of serum 25(OH)D concentration with risk of CHD in a multiethnic population.
DESIGN, SETTING, AND PARTICIPANTS: We studied 6436 participants in the Multi-Ethnic Study of Atherosclerosis (MESA), recruited from July 2000 through September 2002, who were free of known cardiovascular disease at baseline. We measured baseline serum 25(OH)D concentrations using a mass spectrometry assay calibrated to established standards. We tested associations of 25(OH)D with adjudicated CHD events assessed through May 2012.
Primary outcome measure was time to first adjudicated CHD event, defined as myocardial infarction, angina, cardiac arrest, or CHD death.
During a median follow-up of 8.5 years, 361 participants had an incident CHD event (7.38 events per 1000 person-years). Associations of 25(OH)D with CHD differed by race/ethnicity (P for interaction < .05). After adjustment, lower 25(OH)D concentration was associated with a greater risk of incident CHD among participants who were white (n = 167 events; hazard ratio [HR], 1.26 [95% CI, 1.06-1.49] for each 10-ng/mL decrement in 25(OH)D) or Chinese (HR, 1.67 [95% CI, 1.07-2.61]; n = 27). In contrast, 25(OH)D was not associated with risk of CHD in participants who were black (HR, 0.93 [95% CI, 0.73-1.20]; n = 94) or Hispanic (HR, 1.01 [95% CI, 0.77-1.33]; n = 73).
Lower serum 25(OH)D concentration was associated with an increased risk of incident CHD events among participants who were white or Chinese but not black or Hispanic. Results evaluating 25(OH)D in ethnically homogeneous populations may not be broadly generalizable to other racial or ethnic groups.
在白种人群中，循环中 25-羟维生素 D（25[OH]D）的浓度较低与冠心病（CHD）风险增加密切相关。在其他种族或族裔人群中，尚未对这种关联进行严格评估，这些人群的 25（OH）D 浓度分布和可能的其他 25（OH）D 代谢方面存在差异。
在多民族人群中研究血清 25（OH）D 浓度与 CHD 风险之间的关系。
设计、地点和参与者：我们研究了 2000 年 7 月至 2002 年 9 月招募的多民族动脉粥样硬化研究（MESA）中的 6436 名参与者，这些参与者在基线时无已知心血管疾病。我们使用经建立的标准校准的质谱分析法测量基线血清 25（OH）D 浓度。我们通过 2012 年 5 月评估了与经裁决的 CHD 事件相关的 25（OH）D 关联。
主要结局是首次经裁决的 CHD 事件的时间，定义为心肌梗塞、心绞痛、心脏骤停或 CHD 死亡。
在中位随访 8.5 年期间，361 名参与者发生了 CHD 事件（每 1000 人年 7.38 例）。25（OH）D 与 CHD 的关联因种族/族裔而异（交互作用 P<0.05）。经过调整后，25（OH）D 浓度较低与白人（n=167 例事件；风险比[HR]，1.26 [95% CI，1.06-1.49]，每降低 10ng/mL）或中国人（HR，1.67 [95% CI，1.07-2.61]；n=27）参与者中发生 CHD 的风险增加相关。相比之下，25（OH）D 与黑人（HR，0.93 [95% CI，0.73-1.20]；n=94）或西班牙裔（HR，1.01 [95% CI，0.77-1.33]；n=73）参与者的 CHD 风险无关。
血清 25（OH）D 浓度较低与白人或中国参与者发生 CHD 事件的风险增加相关，但与黑人或西班牙裔参与者无关。在种族/族裔同质人群中评估 25（OH）D 的结果可能无法广泛推广到其他种族或族裔群体。
