The Vitamin D Metabolite Ratio and Incident Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis
Year: 2023
Type: conference-abstract
Abstract: Background: Vitamin D deficiency has been linked to cardiovascular disease (CVD) with mixed results. The vitamin D metabolite ratio (VMR), the ratio of 24,25(OH)2D to 25(OH)D, has shown stronger associations with bone health and mortality than 25(OH)D alone. Our study assessed the association between the VMR and CVD outcomes. Methods: We evaluated 6,313 Multi-Ethnic Study of Atherosclerosis (MESA) participants without CVD using Cox regression to test the associations of both VMR and 25(OH)D with incident CVD (including myocardial infarction, resuscitated cardiac arrest, stroke, coronary heart disease death, and stroke death), heart failure (HF), and cardiovascular mortality. We adjusted models for age, gender, race, physical activity, BMI, smoking, diabetes, blood pressure condition and medication use, C-reactive protein, cholesterol levels and medication use, triglycerides, kidney function, parathyroid hormone, fibroblast growth factor 23, calcium, and phosphate. Results: The study participants had a mean age of 62, with 53% of them being female. The cohort was 38% White, 28% Black, 22% Hispanic, and 12% Chinese. The mean (SD) 25(OH)D level was 22.7 (11.0) ng/mL, and the mean VMR was 15.2 (5.0). In fully adjusted models, a two-fold increase in VMR was associated with a 24% reduction in incident CVD (HR: 0.76, 95% CI: 0.65-0.88). However, there was no association between the VMR and HF (0.98, 0.78-1.24), or cardiovascular mortality (0.96, 0.77-1.21). 25(OH)D was not significantly associated with any CVD outcome. Conclusions: In a multi-ethnic cohort, VMR was significantly associated with reduced incident CVD, but not HF or cardiovascular mortality over 15 years of follow-up. The results suggest that VMR may provide greater insight into vitamin D metabolism compared with 25(OH)D levels alone. Funding: NIDDK Support, Veterans Affairs Support - Association of VMR and 25(OH)D with Cardiovascular Outcomes: Fully Adjusted Model Outcome HR (95% CI) N Events / N at Risk Mean Follow Up Times (Years) p-value VMR* CVD 0.76 (0.65, 0.88) 800 / 6,303 14.5 <0.001 HF 0.98 (0.78, 1.24) 398 / 6,301 14.7 0.891 Cardiovascular Mortality 0.96 (0.77, 1.21) 413 / 6,310 16.0 0.754 25(OH)D* CVD 0.95 (0.85, 1.06) 801 / 6,306 14.5 0.395 HF 1.03 (0.88, 1.2) 398 / 6,304 14.7 0.748 Cardiovascular Mortality 0.91 (0.78, 1.06 414 / 6,313 16.0 0.237 *Per two-fold increase
Language: English
Topic: Vitamin D Research Studies
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4397045635