Thanigaimani Shivshankar, Neale Rachel E, Waterhouse Mary, Moxon Joseph V, Yeap Bu B, Norman Paul E, Flicker Leon, Hankey Graeme J, Jenkins Jason, Quigley Frank, Clarke Michael W, Golledge Jonathan
Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.
Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia.
JVS Vasc Sci. 2024 Jun 19;5:100208. doi: 10.1016/j.jvssci.2024.100208. eCollection 2024.
We examined the associations between 25-hydroxy vitamin D (25(OH)D) concentration and the diagnosis and growth of abdominal aortic aneurysm (AAA).
AAA cases and healthy controls were recruited from vascular centers or the community. A subset of participants with AAA were monitored by repeat ultrasound examination to assess AAA growth. Serum 25(OH)D concentration was measured using a validated mass spectrometry method and categorized into guideline-recommended cut-points after deseasonalization. The associations between deseasonalized 25(OH)D concentration and AAA diagnosis and growth were examined using logistic regression and linear mixed effects modeling.
A total of 4673 participants consisting of 873 (455 controls and 418 cases) from Queensland and 3800 (3588 controls and 212 cases) from Western Australia were recruited. For every 1 standard deviation increase in 25(OH)D concentration, odds of AAA diagnosis was significantly reduced in both Queensland (adjusted odds ratio: 0.81; 95% confidence interval [CI]: 0.69-0.95; = .009) and Western Australia (adjusted odds ratio: 0.80; 95% CI: 0.68-0.94; = .005) cohorts. A subset of 310 eligible participants with small AAA from both regions were followed for a median of 4.2 (interquartile range: 2.0-5.8) years. Compared with vitamin D sufficient participants (50 to ˂75 nmol/L), annual mean AAA growth was significantly greater in those with higher vitamin D (≥75 nmol/L) (adjusted mean difference: 0.1 mm/y, 95% CI: 0.1-0.2; < .001).
High 25(OH)D concentration was paradoxically associated with a lower likelihood of AAA diagnosis and faster AAA growth. Further research is needed to resolve these conflicting findings.
我们研究了25-羟基维生素D（25(OH)D）浓度与腹主动脉瘤（AAA）的诊断及生长之间的关联。
从血管中心或社区招募AAA病例和健康对照。对一部分AAA参与者进行重复超声检查以监测AAA的生长情况。采用经过验证的质谱法测量血清25(OH)D浓度，并在去除季节性因素后按照指南推荐的切点进行分类。使用逻辑回归和线性混合效应模型研究去除季节性因素后的25(OH)D浓度与AAA诊断及生长之间的关联。
共招募了4673名参与者，其中873名（455名对照和418例病例）来自昆士兰，3800名（3588名对照和212例病例）来自西澳大利亚。25(OH)D浓度每增加1个标准差，昆士兰队列（调整后的优势比：0.81；95%置信区间[CI]：0.69 - 0.95；P = 0.009）和西澳大利亚队列（调整后的优势比：0.80；95% CI：0.68 - 0.94；P = 0.005）中AAA诊断的几率均显著降低。对来自两个地区的310名符合条件的小AAA参与者进行了中位时间为4.2年（四分位间距：2.0 - 5.8年）的随访。与维生素D充足的参与者（50至˂75 nmol/L）相比，维生素D水平较高（≥75 nmol/L）的参与者的AAA年平均生长速度显著更快（调整后的平均差异：0.1 mm/年，95% CI：0.1 - 0.2；P < 0.001）。
矛盾的是，高25(OH)D浓度与较低的AAA诊断可能性及更快的AAA生长相关。需要进一步研究来解决这些相互矛盾的发现。
