Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea.
Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea.
Nutr Metab Cardiovasc Dis. 2024 Sep;34(9):2182-2189. doi: 10.1016/j.numecd.2024.05.007. Epub 2024 May 10.
Vitamin D is known to influence the risk of cardiovascular disease, which is a recognized risk factor for sudden cardiac arrest (SCA). However, the relationship between vitamin D and SCA is not well understood. Therefore, this study aims to investigate the association between vitamin D and SCA in out-of-hospital cardiac arrest (OHCA) patients compared to healthy controls.
Using the Phase II Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance (CAPTURES II) registry, a 1:1 propensity score-matched case-control study was conducted between 2017 and 2020. Serum 25-hydroxyvitamin D (vitamin D) levels in patients with OHCA (454 cases) and healthy controls (454 cases) were compared after matching for age, sex, cardiovascular risk factors, and lifestyle behaviors. The mean vitamin D levels were 14.5 ± 7.6 and 21.3 ± 8.3 ng/mL among SCA cases and controls, respectively. Logistic regression analysis was used adjusting for cardiovascular risk factors, lifestyle behaviors, corrected serum calcium levels, and estimated glomerular filtration rate (eGRF). The adjusted odds ratio (aOR) for vitamin D was 0.89 (95% confidence interval [CI] 0.87-0.91). The dose-response relationship demonstrated that vitamin D deficiency was associated with SCA incidence (severe deficiency, aOR 10.87, 95% CI 4.82-24.54; moderate deficiency, aOR 2.24, 95% CI 1.20-4.20).
Vitamin D deficiency was independently and strongly associated with an increased risk of SCA, irrespective of cardiovascular and lifestyle factors, corrected calcium levels, and eGFR.
维生素 D 已知会影响心血管疾病的风险，而心血管疾病是心搏骤停（SCA）的公认危险因素。然而，维生素 D 与 SCA 之间的关系尚未得到很好的理解。因此，本研究旨在调查与健康对照组相比，维生素 D 与院外心脏骤停（OHCA）患者 SCA 之间的关联。
使用 2017 年至 2020 年期间的第二期心脏骤停追求试验与独特注册和流行病学监测（CAPTURES II）登记处，进行了一项 1:1 倾向评分匹配病例对照研究。比较了 OHCA 患者（454 例）和健康对照者（454 例）的血清 25-羟维生素 D（维生素 D）水平，这些患者在年龄、性别、心血管危险因素和生活方式行为方面进行了匹配。SCA 病例和对照组的平均维生素 D 水平分别为 14.5±7.6 和 21.3±8.3ng/mL。采用调整心血管危险因素、生活方式行为、校正血清钙水平和估计肾小球滤过率（eGFR）的逻辑回归分析。维生素 D 的调整后比值比（aOR）为 0.89（95%置信区间 [CI] 0.87-0.91）。剂量反应关系表明，维生素 D 缺乏与 SCA 发生率相关（严重缺乏，aOR 10.87，95%CI 4.82-24.54；中度缺乏，aOR 2.24，95%CI 1.20-4.20）。
无论心血管和生活方式因素、校正钙水平和 eGFR 如何，维生素 D 缺乏均与 SCA 风险增加独立且密切相关。
