血清维生素D与二尖瓣环及主动脉瓣钙化风险的关系(来自动脉粥样硬化多民族研究)
Relation of Serum Vitamin D to Risk of Mitral Annular and Aortic Valve Calcium (from the Multi-Ethnic Study of Atherosclerosis).
作者信息
Tibuakuu Martin, Zhao Di, de Boer Ian H, Guallar Eliseo, Bortnick Anna E, Lutsey Pamela L, Budoff Matthew J, Kizer Jorge R, Kestenbaum Bryan R, Michos Erin D
机构信息
Division of Cardiology, Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
出版信息
Am J Cardiol. 2017 Aug 1;120(3):473-478. doi: 10.1016/j.amjcard.2017.05.004. Epub 2017 May 11.
Serum 25-hydroxyvitamin D [25(OH)D] concentration has been identified as a possible modifiable risk factor for cardiovascular disease (CVD). We hypothesized that serum 25(OH)D concentration would be associated with calcifications of the left-sided heart valves, which are markers of CVD risk. Aortic valve calcium (AVC) and mitral annular calcium (MAC) were quantified from cardiac computed tomography scans performed on 5,530 Multi-Ethnic Study of Atherosclerosis participants at the baseline examination (2000 to 2002) and at a follow-up visit at either Examination 2 (2002 to 2004) or Examination 3 (2004 to 2005). 25(OH)D was measured from serum samples collected at the baseline examination. Using relative risk regression, we evaluated the multivariable-adjusted risk of prevalent and incident AVC and MAC in this ethnically diverse population free of clinical CVD at baseline. The mean age of participants was 62 ± 10 years; 53% were women, 40% white, 26% black, 21% Hispanic, and 12% Chinese. Prevalent AVC and MAC were observed in 12% and 9% of study sample, respectively. There were no significant associations between 25(OH)D and prevalent AVC or MAC. Over a mean follow-up of 2.5 years, 4% developed incident AVC and 5% developed incident MAC. After adjusting for demographic variables, each 10 ng/ml higher serum 25(OH)D was associated with a 15% (relative risk 0.85, 95% confidence interval 0.74 to 0.98) lower risk of incident MAC but not AVC. However, this association was no longer significant after adjusting for lifestyle and CVD risk factors. Results suggest a possible link between serum 25(OH)D and the risk for incident MAC, but future studies with longer follow-up are needed to further test this association.
血清25-羟维生素D[25(OH)D]浓度已被确定为心血管疾病(CVD)一个可能的可改变风险因素。我们推测血清25(OH)D浓度会与左侧心脏瓣膜钙化相关,而左侧心脏瓣膜钙化是CVD风险的标志物。在多民族动脉粥样硬化研究的5530名参与者基线检查(2000年至2002年)以及第二次检查(2002年至2004年)或第三次检查(2004年至2005年)的随访中,通过心脏计算机断层扫描对主动脉瓣钙化(AVC)和二尖瓣环钙化(MAC)进行定量。在基线检查时采集的血清样本中测量25(OH)D。使用相对风险回归,我们评估了在这个基线时无临床CVD的多民族人群中,现患和新发AVC及MAC的多变量调整风险。参与者的平均年龄为62±10岁;53%为女性,40%为白人,26%为黑人,21%为西班牙裔,12%为华裔。在研究样本中,分别有12%和9%观察到现患AVC和MAC。25(OH)D与现患AVC或MAC之间无显著关联。在平均2.5年的随访中,4%出现新发AVC,5%出现新发MAC。在调整人口统计学变量后,血清25(OH)D每升高10 ng/ml,新发MAC的风险降低15%(相对风险0.85,95%置信区间0.74至0.98),但与新发AVC无关。然而,在调整生活方式和CVD风险因素后,这种关联不再显著。结果表明血清25(OH)D与新发MAC风险之间可能存在联系,但需要进一步的长期随访研究来进一步验证这种关联。