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Plasma 25-hydroxyvitamin D and mortality in patients with suspected stable angina pectoris.
J Clin Endocrinol Metab. 2018 Jan 09;:
Authors: Degerud E, Nygård O, de Vogel S, Hoff R, Svingen GFT, Pedersen ER, Trygve Nilsen DW, Nordrehaug JE, Midttun Ø, Ueland PM, Dierkes J
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 analysed in plasma samples from 4114 Caucasian patients with suspected stable angina pectoris, and adjusted for seasonal variation. Hazard ratios (HR) for all-cause and cardiovascular mortality were estimated using multivariable Cox models with 25OHD as main exposure variable, while adjusting for study site, age, gender, 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±SD follow-up of 11.9±3.0 years. Compared to the first quartile, HRs in the second, third and fourth 25OHD quartiles were 0.64 (0.54, 0.77), 0.56 (0.46, 0.67) and 0.56 (0.46, 0.67) for all-cause mortality and 0.70 (0.53, 0.91), 0.60 (0.45, 0.79) and 0.57 (0.43, 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 above 100 nmol/l.
Conclusion: Plasma 25OHD concentrations were inversely associated with cardiovascular mortality and non-linearly (U-shaped) associated with all-cause mortality.
PMID: 29325121 [PubMed - as supplied by publisher]
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