25-hydroxyvitamin D levels inversely associate with risk for developing coronary artery calcification.
Vitamin D deficiency associates with increased risk for cardiovascular events and mortality, but the mechanism driving this association is unknown. Here, we tested whether circulating 25-hydroxyvitamin D concentration associates with coronary artery calcification (CAC), a measure of coronary atherosclerosis, in the Multi-Ethnic Study of Atherosclerosis. We included 1370 participants: 394 with and 976 without chronic kidney disease (estimated GFR <60 ml/min per 1.73 m(2)). At baseline, CAC was prevalent among 723 (53%) participants. Among participants free of CAC at baseline, 135 (21%) developed incident CAC during 3 yr of follow-up. Lower 25-hydroxyvitamin D concentration did not associate with prevalent CAC but did associate with increased risk for developing incident CAC, adjusting for age, gender, race/ethnicity, site, season, physical activity, smoking, body mass index, and kidney function. Further adjustment for BP, diabetes, C-reactive protein, and lipids did not alter this finding. The association of 25-hydroxyvitamin D with incident CAC seemed to be stronger among participants with lower estimated GFR. Circulating 1,25-dihydroxyvitamin D concentrations among participants with chronic kidney disease did not significantly associate with prevalent or incident CAC in adjusted models. In conclusion, lower 25-hydroxyvitamin D concentrations associate with increased risk for incident CAC. Accelerated development of atherosclerosis may underlie, in part, the increased cardiovascular risk associated with vitamin D deficiency.
de Boer
Ian H
IH
Department of Medicine, Division of Nephrology, University of Washington, Seattle, WA 98195, USA. deboer@u.washington.edu
Kestenbaum
Bryan
B
Shoben
Abigail B
AB
Michos
Erin D
ED
Sarnak
Mark J
MJ
Siscovick
David S
DS
D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D002114:Calcinosis / Q000097:blood* / Q000000981:diagnostic imaging; D002117:Calcitriol / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D051436:Renal Insufficiency, Chronic / Q000150:complications; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002117:Calcitriol