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Racial differences in the association of serum 25-hydroxyvitamin D concentration with coronary heart disease events.

ABSTRACT: Low circulating concentrations of 25-hydroxyvitamin D (25[OH]D) have been consistently associated with an increased risk of coronary heart disease (CHD) in white populations. This association has not been rigorously evaluated in other races or ethnicities, in which the distributions of 25(OH)D concentration and possibly other aspects of 25(OH)D metabolism differ.To examine the association of serum 25(OH)D concentration with risk of CHD in a multiethnic population.We studied 6436 participants in the Multi-Ethnic Study of Atherosclerosis (MESA), recruited from July 2000 through September 2002, who were free of known cardiovascular disease at baseline. We measured baseline serum 25(OH)D concentrations using a mass spectrometry assay calibrated to established standards. We tested associations of 25(OH)D with adjudicated CHD events assessed through May 2012.Primary outcome measure was time to first adjudicated CHD event, defined as myocardial infarction, angina, cardiac arrest, or CHD death.During a median follow-up of 8.5 years, 361 participants had an incident CHD event (7.38 events per 1000 person-years). Associations of 25(OH)D with CHD differed by race/ethnicity (P for interaction

SUBMITTER: Robinson-Cohen C

PROVIDER: S-EPMC4150653 | biostudies-literature | 2013 Jul

REPOSITORIES: biostudies-literature

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Racial differences in the association of serum 25-hydroxyvitamin D concentration with coronary heart disease events.

Robinson-Cohen Cassianne C Hoofnagle Andrew N AN Ix Joachim H JH Sachs Michael C MC Tracy Russell P RP Siscovick David S DS Kestenbaum Bryan R BR de Boer Ian H IH

JAMA 20130701 2

<h4>Importance</h4>Low circulating concentrations of 25-hydroxyvitamin D (25[OH]D) have been consistently associated with an increased risk of coronary heart disease (CHD) in white populations. This association has not been rigorously evaluated in other races or ethnicities, in which the distributions of 25(OH)D concentration and possibly other aspects of 25(OH)D metabolism differ.<h4>Objective</h4>To examine the association of serum 25(OH)D concentration with risk of CHD in a multiethnic popula ...[more]

PMID: 23839752

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Project description:BackgroundCirculating concentrations of 25-hydroxyvitamin D [25-(OH)D] are used to define vitamin D deficiency. Current clinical 25-(OH)D targets based on associations with intermediate markers of bone metabolism may not reflect optimal levels for other chronic diseases and do not account for known seasonal variation in 25-(OH)D concentration.ObjectiveTo evaluate the relationship of 25-(OH)D concentration with the incidence of major clinical disease events that are pathophysiologically relevant to vitamin D.DesignCohort study.SettingThe Cardiovascular Health Study conducted in 4 U.S. communities. Data from 1992 to 2006 were included in this analysis.Participants1621 white older adults.MeasurementsSerum 25-(OH)D concentration (using a high-performance liquid chromatography-tandem mass spectrometry assay that conforms to National Institute of Standards and Technology reference standards) and associations with time to a composite outcome of incident hip fracture, myocardial infarction, cancer, or death.ResultsOver a median 11-year follow-up, the composite outcome occurred in 1018 participants (63%). Defining events included 137 hip fractures, 186 myocardial infarctions, 335 incidences of cancer, and 360 deaths. The association of low 25-(OH)D concentration with risk for the composite outcome varied by season (P = 0.057). A concentration lower than a season-specific Z score of -0.54 best discriminated risk for the composite outcome and was associated with a 24% higher risk in adjusted analyses (95% CI, 9% to 42%). Corresponding season-specific 25-(OH)D concentrations were 43, 50, 61, and 55 nmol/L (17, 20, 24, and 22 ng/mL) in winter, spring, summer, and autumn, respectively.LimitationThe observational study was restricted to white participants.ConclusionThreshold concentrations of 25-(OH)D associated with increased risk for relevant clinical disease events center near 50 nmol/L (20 ng/mL). Season-specific targets for 25-(OH)D concentration may be more appropriate than static targets when evaluating health risk.Primary funding sourceNational Institutes of Health.

Dataset Information

Racial differences in the association of serum 25-hydroxyvitamin D concentration with coronary heart disease events.

Publications

Racial differences in the association of serum 25-hydroxyvitamin D concentration with coronary heart disease events.

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