School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
J Steroid Biochem Mol Biol. 2019 Feb;186:34-41. doi: 10.1016/j.jsbmb.2018.09.007. Epub 2018 Sep 13.
The predictive value of total 25-hydroxyvitamin D (25(OH)D, a biomarker of vitamin D status) in relation to lifetime risk of cardiometabolic mortality is not known. The purpose of this study was to determine the association between standardized and annualized total 25(OH)D levels and lifetime risk for cardiometabolic mortality in middle- to older-aged adults. In this study, we followed up 7958 participants in the Third National Health and Nutrition Examination Survey from 1988 to 1994 (NHANES III) until the occurrence of cardiometabolic death or attainment of 95 years of age (median follow-up 17.9 years, 1371 cardiometabolic-deaths). Lifetime risks were estimated according to recommended total 25(OH)D cutoffs by national guidelines, and a combination of total 25(OH)D status and traditional risk factor burden. We also explored variation in lifetime risk estimates by levels of body mass index (BMI). The results of this study showed that annualized total 25(OH)D <30 nmol/L was associated with high lifetime risk of cardiometabolic mortality (40%). Lifetime risks of cardiometabolic mortality were similar for annualized levels between 30-< 50 nmol/L, 50-< 75 nmol/L and ≥75 nmol/L (31-33%). Lifetime risk was highest among participants with annualized total 25(OH)D <30 nmol/L and ≥2 major traditional risk factors (45%), whereas lifetime risk was lowest among participants with annualized 25(OH)D ≥30 nmol/L and low-intermediate risk factors (28%). Lifetime risk estimates were similar across BMI categories. In conclusion, a single measurement of vitamin D deficiency (annualized levels <30 nmol/L) in middle- to older-aged adults is a strong predictor of high lifetime risk for cardiometabolic mortality, particularly among those with high burden of traditional risk factors.
总 25-羟维生素 D（25(OH)D，维生素 D 状况的生物标志物）的预测价值与心血管代谢死亡率的终生风险之间的关系尚不清楚。本研究旨在确定标准化和年化总 25(OH)D 水平与中老年人群中心血管代谢死亡率终生风险之间的关系。在这项研究中，我们对 1988 年至 1994 年（NHANES III）第三次国家健康和营养检查调查中的 7958 名参与者进行了随访，直到发生心血管代谢死亡或达到 95 岁（中位随访时间 17.9 年，发生 1371 例心血管代谢死亡）。根据国家指南推荐的总 25(OH)D 截止值以及总 25(OH)D 状况和传统危险因素负担的组合，估计了终生风险。我们还探讨了体重指数（BMI）水平对终生风险估计值的影响。研究结果表明，年化总 25(OH)D <30 nmol/L 与心血管代谢死亡率的高终生风险相关（40%）。年化水平在 30-<50 nmol/L、50-<75 nmol/L 和≥75 nmol/L 之间的心血管代谢死亡率终生风险相似（31-33%）。年化总 25(OH)D <30 nmol/L 且有≥2 个主要传统危险因素的参与者终生风险最高（45%），而年化 25(OH)D≥30 nmol/L 且低-中度危险因素的参与者终生风险最低（28%）。在所有 BMI 类别中，终生风险估计值相似。总之，中老年人群中单次维生素 D 缺乏（年化水平<30 nmol/L）是心血管代谢死亡率高终生风险的有力预测因素，尤其是在传统危险因素负担较高的人群中。
