Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, USA.
Department of Health Science Research, Mayo Clinic, Rochester, MN, USA.
J Steroid Biochem Mol Biol. 2021 Oct;213:105953. doi: 10.1016/j.jsbmb.2021.105953. Epub 2021 Jul 15.
Concentrations of serum 25-hydroxyvitamin D [25(OH)D] below 20 ng/mL and above 50 ng/mL have been associated with chronic adverse events including cardiovascular disease.
To conduct a comprehensive population-based study in the United States of the relationship of low and high serum 25(OH)D levels with cardiovascular disease.
We identified all serum 25(OH)D measurements in adults age 18 years and older residing in Olmsted County, MN between January 1, 2005 and December 31, 2011, using the resources of the Rochester Epidemiology Project. Any new diagnosis of cardiovascular disease was the primary outcome, and time zero was 30 days after first 25(OH)D measurement. Patients were followed until their last clinical visit as an Olmsted County resident, December 31, 2014, or death. Categories of 25(OH)D values were examined using predetermined ranges of interest: <12, 12-19, 20-50 (reference range), and >50 ng/mL. Multivariable Cox proportional hazards models were adjusted for age, BMI, sex, race, smoking history, season of 25(OH)D measurement, hypertension, hyperlipidemia, socioeconomic status and Charlson comorbidity index at time of 25(OH)D measurement.
A total of 11,002 unique persons had a 25(OH)D measurement, with a mean (±SD) value of 30.0 ± 12.9 ng/mL. Mean age was 54.3 ± 17.2 years, and the majority were female (77.1 %) and white (87.6 %). There were 4124 new diagnoses of cardiovascular disease in this cohort after a median overall follow-up of 4.8 years (IQR 3.4-6.2). Adjusted cardiovascular disease hazard ratios (HRs) (95 % confidence interval) for 25(OH)D values <12, 12-19, and >50 ng/mL, compared to the reference range 20-50 ng/mL, were 1.28 (1.12-1.46), 1.19 (1.09-1.31), and 1.10 (0.95-1.26), respectively.
Values of 25(OH)D <20 ng/mL were associated with development of a new diagnosis of cardiovascular disease. There was no significant association between 25(OH)D values >50 ng/mL and cardiovascular disease.
血清 25-羟维生素 D [25(OH)D]浓度低于 20ng/ml 和高于 50ng/ml 与慢性不良事件有关，包括心血管疾病。
在美国进行一项综合的基于人群的研究，以调查低和高血清 25(OH)D 水平与心血管疾病的关系。
我们使用罗切斯特流行病学项目的资源，确定了明尼苏达州奥姆斯特德县所有年龄在 18 岁及以上的成年人在 2005 年 1 月 1 日至 2011 年 12 月 31 日之间的血清 25(OH)D 测量值。任何新的心血管疾病诊断都是主要结局，时间为首次 25(OH)D 测量后 30 天。患者在奥姆斯特德县的最后一次临床就诊或 2014 年 12 月 31 日死亡之前一直随访。使用预先设定的感兴趣范围检查 25(OH)D 值类别：<12、12-19、20-50（参考范围）和>50ng/ml。多变量 Cox 比例风险模型根据年龄、BMI、性别、种族、吸烟史、25(OH)D 测量季节、高血压、高血脂、社会经济地位和 25(OH)D 测量时的 Charlson 合并症指数进行调整。
共有 11002 名患者进行了 25(OH)D 测量，平均（±SD）值为 30.0±12.9ng/ml。平均年龄为 54.3±17.2 岁，大多数为女性（77.1%）和白人（87.6%）。在中位总随访 4.8 年后（IQR 3.4-6.2），该队列中共有 4124 例新诊断的心血管疾病。与 20-50ng/ml 的参考范围相比，25(OH)D 值<12、12-19 和>50ng/ml 的心血管疾病调整后的危险比（HR）（95%置信区间）分别为 1.28（1.12-1.46）、1.19（1.09-1.31）和 1.10（0.95-1.26）。
25(OH)D 值<20ng/ml 与新诊断的心血管疾病发展有关。25(OH)D 值>50ng/ml 与心血管疾病之间无显著相关性。
