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All-cause, CVD mortality tied to 25-(OH)D concentrations
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Adults with suspected stable angina pectoris who have serum 25-hydroxyvitamin D levels less than 42.5 nmol/L or more than 100 nmol/L have an increased risk for all-cause and cardiovascular mortality, study data show.
Eirik Degerud, PhD, a postdoctoral fellow at the Norwegian Institute of Public Health in Oslo, and colleagues evaluated data on 4,114 adults aged at least 60 years who underwent elective coronary angiography for suspected stable angina pectoris at two university hospitals in Norway between April 1999 and April 2004. Researchers sought to determine the relationship between concentrations of serum 25-(OH)D and all-cause and CV mortality risks. Follow-up was a mean of 11.9 years.
Participants were divided into groups based on quartiles of 25-(OH)D levels: first (n = 1,029; 8.4-46.2 nmol/L), second (n = 1,028; 46.3-58.1 nmol/L), third (n = 1,028; 58.1-71.4 nmol/L) and fourth (n = 1,029; 71.4-197 nmol/L).
Overall, there were 21.8% deaths from all causes and 9.9% from CVD. Multivariable HRs for all-cause mortality were 0.64 (95% CI, 0.54-0.77) for the second, 0.56 (95% CI, 0.46-0.67) for the third and 0.56 (95% CI, 0.46-0.67) for the fourth quartiles compared with the first. Multivariable HRs for CVD morality were 0.7 (95% CI, 0.53-0.91) for the second, 0.6 (95% CI, 0.45-0.79) for the third and 0.57 (95% CI, 0.43-0.75) for the fourth quartiles compared with the first. Each 10 per nmol/L incremental increase of 25-(OH)D was inversely associated with the risk for all-cause (HR = 0.91; 95% CI, 0.88-0.95) and CVD (HR = 0.9; 95% CI, 0.85-0.95) mortality.
Participants with 25-(OH)D concentrations less than 42.5 nmol/L had increased risks for all-cause and CVD mortality compared with those with higher levels, and participants with 25-(OH)D concentrations near 100 nmol/L had an increased risk for all-cause mortality only compared with those with lower levels.
“There are no clinical implications from this study alone, but for studies investigating high-dose vitamin D supplementation/treatment in patients, we encourage long-term follow-up with regard to mortality so that we can thoroughly assess safety,” Degerud told Endocrine Today. “Ideally, we encourage that they test for interaction or effect modification and by potential candidates, such as statins, as it could reveal relationships that are masked when relationships are analyzed in a full sample.” – by Amber Cox
For more information:
Eirik Degerud, PhD, can be reached at eirikmagnusmeek.degerud@fhi.no.
Disclosures: The authors report no relevant financial disclosures.
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