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钙剂和维生素 D 补充与新发缺血性心脏事件或死亡风险无关:来自英国生物银行队列研究的结果。

Calcium and Vitamin D Supplementation Are Not Associated With Risk of Incident Ischemic Cardiac Events or Death: Findings From the UK Biobank Cohort.

机构信息

MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.

NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.

出版信息

J Bone Miner Res. 2018 May;33(5):803-811. doi: 10.1002/jbmr.3375. Epub 2018 Feb 8.

Abstract

We investigated associations between calcium/vitamin D supplementation and incident cardiovascular events/deaths in a UK population-based cohort. UK Biobank is a large prospective cohort comprising 502,637 men and women aged 40 to 69 years at recruitment. Supplementation with calcium/vitamin D was self-reported, and information on incident hospital admission (ICD-10) for ischemic heart disease (IHD), myocardial infarction (MI), and subsequent death was obtained from linkage to national registers. Cox proportional hazards models were used to investigate longitudinal relationships between calcium/vitamin D supplementation and hospital admission for men/women, controlling for covariates. A total of 475,255 participants (median age 58 years, 55.8% women) had complete data on calcium/vitamin D supplementation. Of that number, 33,437 participants reported taking calcium supplements; 19,089 vitamin D; and 10,007 both. In crude and adjusted analyses, there were no associations between use of calcium supplements and risk of incident hospital admission with either IHD, or subsequent death. Thus, for example, in unadjusted models, the hazard ratio (HR) for admission with myocardial infarction was 0.97 (95% confidence interval [CI] 0.79-1.20, p = 0.79) among women taking calcium supplementation. Corresponding HR for men is 1.16 (95% CI 0.92-1.46, p = 0.22). After full adjustment, HR (95% CI) were 0.82 (0.62-1.07), p = 0.14 among women and 1.12 (0.85-1.48), p = 0.41 among men. Adjusted HR (95% CI) for admission with IHD were 1.05 (0.92-1.19), p = 0.50 among women and 0.97 (0.82-1.15), p = 0.77 among men. Results were similar for vitamin D and combination supplementation. There were no associations with death, and in women, further adjustment for hormone-replacement therapy use did not alter the associations. In this very large prospective cohort, there was no evidence that use of calcium/vitamin D supplementation was associated with increased risk of hospital admission or death after ischemic cardiovascular events. © 2018 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals, Inc.

摘要

我们在英国人群队列中研究了钙/维生素 D 补充剂与心血管事件/死亡的发生率之间的关联。英国生物库是一个大型前瞻性队列,由 502637 名年龄在 40 至 69 岁的男性和女性组成。钙/维生素 D 的补充是自我报告的,通过与国家登记册的链接获得缺血性心脏病(IHD)、心肌梗死(MI)和随后死亡的入院(ICD-10)的信息。Cox 比例风险模型用于研究男性/女性钙/维生素 D 补充剂与住院之间的纵向关系,控制了协变量。共有 475255 名参与者(中位年龄 58 岁,55.8%为女性)完成了钙/维生素 D 补充剂的完整数据。在这一数字中,有 33437 名参与者报告服用了钙补充剂;19089 名参与者服用了维生素 D;10007 名参与者同时服用了钙和维生素 D。在未调整和调整分析中,钙补充剂的使用与 IHD 或随后死亡的入院风险之间均无关联。例如,在未调整模型中,服用钙补充剂的女性患心肌梗死的入院风险比(HR)为 0.97(95%置信区间 [CI] 0.79-1.20,p=0.79)。男性的相应 HR 为 1.16(95% CI 0.92-1.46,p=0.22)。在完全调整后,女性的 HR(95% CI)为 0.82(0.62-1.07),p=0.14,男性为 1.12(0.85-1.48),p=0.41。女性因 IHD 入院的调整 HR(95% CI)为 1.05(0.92-1.19),p=0.50,男性为 0.97(0.82-1.15),p=0.77。维生素 D 和联合补充的结果相似。与死亡没有关联,并且在女性中,进一步调整激素替代疗法的使用并未改变关联。在这个非常大的前瞻性队列中,没有证据表明钙/维生素 D 补充剂的使用与缺血性心血管事件后的住院或死亡风险增加有关。© 2018 作者。由 Wiley Periodicals, Inc. 出版的《骨与矿物研究杂志》

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c18/5969111/869a2687706d/JBMR-33-803-g001.jpg

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