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循环维生素D、补充剂使用与心血管疾病风险:男性骨质疏松性骨折患者睡眠研究

Circulating vitamin D, supplement use, and cardiovascular disease risk: the MrOS Sleep Study.

作者信息

Bajaj Archna, Stone Katie L, Peters Katherine, Parimi Neeta, Barrett-Connor Elizabeth, Bauer Doug, Cawthon Peggy M, Ensrud Kristine E, Hoffman Andrew R, Orwoll Eric, Schernhammer Eva S

机构信息

Temple University Hospital (A.B.), Philadelphia, Pennsylvania 19140; California Pacific Medical Center Research Institute (K.L.S., K.P., N.P., E.B.-C., D.B., P.M.C., E.O.), San Francisco, California 94107; University of Minnesota and Minneapolis VA Health System (K.E.E.), Minneapolis, Minnesota 55417; Department of Medicine (A.R.H.), Stanford University School of Medicine, Stanford, California 94305; Channing Division of Network Medicine (E.S.S.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115; Division of Sleep Medicine (E.S.S.), Harvard Medical School, Boston, Massachusetts 02115; and Department of Epidemiology (E.S.S.), Harvard School of Public Health, Boston, Massachusetts 02115.

出版信息

J Clin Endocrinol Metab. 2014 Sep;99(9):3256-62. doi: 10.1210/jc.2013-4178. Epub 2014 Mar 26.

Abstract

CONTEXT

Evidence suggests an inverse association between circulating 25(OH) vitamin D and cardiovascular disease (CVD).

OBJECTIVE

To determine the association between serum 25(OH) vitamin D and risk for CVD events.

SETTING AND DESIGN

From March 2000 to April 2002, participants were recruited for the Osteoporotic Fractures in Men (MrOS) study. Between December 2003 and March 2005, members of the MrOS cohort were invited to participate in the MrOS Sleep Study. Participants were recruited from 6 clinical centers across the United States and followed for a mean of 5.9 years. Three-thousand-one-hundred-thirty-five men ages 65 and older were included from the MrOS cohort, of whom 116 were excluded for missing vitamin D or CVD data. Participants were divided into two groups based on serum 25(OH) vitamin D levels, <20 ng/mL and ≥20 ng/mL. Participants were followed for CVD endpoints including coronary heart disease (CHD) and cerebrovascular events. Age- and multivariable-adjusted hazard ratios were calculated and stratified by use of vitamin D containing supplements.

RESULTS

We observed no significant association between circulating 25(OH) vitamin D and risk of CVD event (HR, 0.91; 95% confidence interval (CI), 0.73-1.13) and CHD event (HR, 0.81; 95% CI, 0.61-1.07). For cerebrovascular events, men with vitamin D deficiency exhibited a higher risk (HR, 1.44; 95% CI, 1.00-2.08) using the minimally adjusted model and after excluding supplement users (HR, 1.70; 95% CI, 1.02-2.83).

CONCLUSIONS

25(OH) vitamin D was not associated with risk of CVD and CHD events. However, vitamin D deficiency may be associated with an increased risk of cerebrovascular events.

摘要

背景

有证据表明循环25(OH)维生素D与心血管疾病(CVD)之间存在负相关。

目的

确定血清25(OH)维生素D与CVD事件风险之间的关联。

设置与设计

2000年3月至2002年4月,招募参与者进行男性骨质疏松性骨折(MrOS)研究。2003年12月至2005年3月,MrOS队列成员受邀参加MrOS睡眠研究。参与者从美国6个临床中心招募,平均随访5.9年。MrOS队列纳入了3135名65岁及以上的男性,其中116名因维生素D或CVD数据缺失而被排除。根据血清25(OH)维生素D水平将参与者分为两组,<20 ng/mL和≥20 ng/mL。对参与者进行随访,观察心血管疾病终点事件,包括冠心病(CHD)和脑血管事件。计算年龄和多变量调整后的风险比,并按是否使用含维生素D的补充剂进行分层。

结果

我们观察到循环25(OH)维生素D与CVD事件风险(风险比,0.91;95%置信区间(CI),0.73 - 1.13)和CHD事件风险(风险比,0.81;95%CI,0.61 - 1.07)之间无显著关联。对于脑血管事件,在使用最小调整模型时以及排除补充剂使用者后,维生素D缺乏的男性表现出更高的风险(风险比,1.44;95%CI,1.00 - 2.08)(风险比,1.70;95%CI,1.02 - 2.83)。

结论

25(OH)维生素D与CVD和CHD事件风险无关。然而,维生素D缺乏可能与脑血管事件风险增加有关。

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