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Cardiovascular disease is the major cause of death
in the Western world, but the association between
25-hydroxyvitamin D [25(OH)D] levels and the risk of
cardiovascular disease mortality remains unclear.
The objective of a new study was to determine the
association between cardiovascular, stroke, and
acute myocardial infarct mortality and serum levels
of 25(OH)D.
This was an observational cohort study, the
Copenhagen vitamin D study, data from a single
laboratory center in Copenhagen, Denmark. Follow-up
was from 2004 to 2011.
Serum 25(OH)D was analyzed from 247 574 subjects
from the Copenhagen general practice sector.
Examination of the association 25(OH)D levels and
mortality from cardiovascular disease, stroke, and
acute myocardial infarct was performed among 161 428
women and 86 146 men.
A multivariate Cox regression analysis was used to
compute hazard ratios for cardiovascular, stroke,
and acute myocardial infarct mortality.
Of 247 574 subjects, a total of 16 645 subjects died
in the ensuing 0–7 years.
A total of 5454 died from cardiovascular disease
including 1574 from stroke and 702 from acute
myocardial infarct.
The 25(OH)D level of 70 nmol/L was associated with
the lowest cardiovascular disease mortality risk.
Compared with that level, the hazard ratio for
cardiovascular disease mortality was 2.0 at the
lower extreme with a higher risk for men (2.5) than
for women (1.7).
At the higher extreme (125 nmol/L), the hazard ratio
of cardiovascular disease mortality was 1.3, with a
similar risk among men and women. Results were
similar for stroke and acute myocardial subgroups.
In this large observational study, low and high
levels of 25(OH)D were associated with
cardiovascular disease, stroke, and acute myocardial
mortality in a nonlinear, reverse J-shaped manner,
with the highest risk at lower levels.
Whether this was a causal or associational finding
cannot be determined from our data. There is a need
for randomized clinical trials that include
information on the effects of 25(OH)D levels greater
than 100 nmol/L.
See also
Vitamin D supplements and quality of life in chronic
spontaneous urticaria patients (2015-09-15)
link...
For more information
CA Reverse J-Shaped Association Between Serum
25-Hydroxyvitamin D and Cardiovascular Disease
Mortality: The CopD Study
http://press.endocrine.org/doi/10.1210/jc.2014-4551
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