Vitezova Anna, Cartolano Natasha S, Heeringa Jan, Zillikens M Carola, Hofman Albert, Franco Oscar H, Kiefte-de Jong Jessica C
Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
PLoS One. 2015 May 1;10(5):e0125161. doi: 10.1371/journal.pone.0125161. eCollection 2015.
Atrial fibrillation (AF) is the most common chronic arrhythmia and it increases the risk of cardiovascular morbidity and mortality. Still there is not a complete understanding of its etiology and underlying pathways. Vitamin D might regulate renin-angiotensin-aldosterone system and might be involved in inflammation, both implicated in the pathophysiology of AF. The objective of this work was to investigate the association between vitamin D status with the risk of AF in the elderly. This study was conducted within the Rotterdam Study, a community-based cohort of middle-aged and elderly participants in Rotterdam, The Netherlands. We had 3,395 participants who were free of AF diagnosis at the start of our study and who had vitamin D data available. We analyzed the association between serum 25-hydroxivitamin D (25(OH)D) and incidence of AF using Cox regression models. Vitamin D deficiency was defined as serum 25(OH)D concentrations <50 nmol/l, insufficiency between 50 nmol/l and 75 nmol/l, while serum 25(OH)D concentrations equal to and above 75 nmol/l were considered as adequate. After mean follow-up of 12.0 years 263 (7.7%) participants were diagnosed with incident AF. Vitamin D status was not associated with AF in any of the 3 multivariate models tested (model adjusted for socio-demographic factors and life-style factors: HR per 10 unit increment in serum 25(OH)D 0.96, 95% CI: 0.91-1.02; HR for insufficiency: 0.82, 95%CI: 0.60-1.11,and HR for adequate status: 0.76, 95%CI: 0.52-1.12 compared to deficiency). This prospective cohort study does not support the hypothesis that vitamin D status is associated with AF.
心房颤动(AF)是最常见的慢性心律失常,它会增加心血管疾病发病和死亡的风险。然而,目前对其病因和潜在机制仍未完全了解。维生素D可能调节肾素-血管紧张素-醛固酮系统,并且可能参与炎症反应,而这两者都与房颤的病理生理学有关。这项研究的目的是调查老年人维生素D水平与房颤风险之间的关联。本研究在荷兰鹿特丹进行,是一项基于社区的中年和老年参与者队列研究。我们有3395名参与者,在研究开始时未被诊断为房颤,并且有可用的维生素D数据。我们使用Cox回归模型分析血清25-羟基维生素D(25(OH)D)与房颤发生率之间的关联。维生素D缺乏定义为血清25(OH)D浓度<50 nmol/l,不足为50 nmol/l至75 nmol/l,而血清25(OH)D浓度等于或高于75 nmol/l被认为是充足的。经过平均12.0年的随访,2,63名(7.7%)参与者被诊断为新发房颤。在测试的3个多变量模型中,维生素D水平与房颤均无关联(针对社会人口学因素和生活方式因素调整的模型:血清25(OH)D每增加10个单位的风险比为0.96,95%置信区间:0.91-1.02;不足状态的风险比为0.82,95%置信区间:0.60-1.11,充足状态与缺乏状态相比的风险比为0.76,95%置信区间:0.52-1.12)。这项前瞻性队列研究不支持维生素D水平与房颤有关的假设。