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J Clin Endocrinol Metab. 2018 Mar 1;103(3):1161-1170. doi: 10.1210/jc.2017-02328.

Plasma 25-Hydroxyvitamin D and Mortality in Patients With Suspected Stable Angina Pectoris.

Author information

1
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
2
Department of Clinical Science, University of Bergen, Bergen, Norway.
3
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
4
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
5
Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
6
Department of Cardiology, Stavanger University Hospital, Stavanger, Norway.
7
Bevital AS, Bergen, Norway.
8
Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway.

Abstract

Context and Objective:

Vitamin D status may affect cardiovascular disease (CVD) development and survival. We studied the relationship between concentrations of the circulating biomarker 25-hydroxyvitamin D (25OHD) and all-cause and cardiovascular mortality risk.

Design, Setting, Participants, and Main Outcome Measures:

25OHD, the sum of 25-hydroxyvitamin D3 and 25-hydroxyvitamin D2, was analyzed in plasma samples from 4114 white patients suspected of having stable angina pectoris and was adjusted for seasonal variation. Hazard ratios (HRs) for all-cause and cardiovascular mortality were estimated by using multivariable Cox models with 25OHD as the main exposure variable, with adjustment for study site, age, sex, smoking, body mass index, estimated glomerular filtration rate, and systolic blood pressure.

Results:

A total of 895 (21.8%) deaths, including 407 (9.9%) from CVD causes, occurred during a mean ± standard deviation follow-up of 11.9 ± 3.0 years. Compared with the first 25OHD quartile, HRs in the second, third, and fourth quartiles were 0.64 [95% confidence interval (CI), 0.54 to 0.77], 0.56 (95% CI, 0.46 to 0.67), and 0.56 (95% CI, 0.46 to 0.67) for all-cause mortality and 0.70 (95% CI, 0.53 to 0.91), 0.60 (95% CI, 0.45 to 0.79), and 0.57 (95% CI, 0.43 to 0.75) for cardiovascular mortality, respectively. Threshold analysis demonstrated increased all-cause and CVD mortality in patients with 25OHD concentrations below ∼42.5 nmol/L. Moreover, analysis suggested increased all-cause mortality at concentrations >100 nmol/L.

Conclusion:

Plasma 25OHD concentrations were inversely associated with cardiovascular mortality and nonlinearly (U-shaped) associated with all-cause mortality.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00354081.

PMID:
29325121
DOI:
10.1210/jc.2017-02328
[Indexed for MEDLINE]

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