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
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.
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。
