title: Vitamin D deficiency in postmenopausal, healthy women predicts increased cardiovascular events: a 16-year follow-up study.
abstract: OBJECTIVE
  To investigate the relationship between vitamin D status in healthy women and cardiovascular outcome.
  
  
  METHODS
  Between 1990 and 1993, 2016 healthy, recently postmenopausal women were enrolled in the Danish Osteoporosis Prevention Study. Serum levels of 25-hydroxyvitamin D (25(OH)D, nmol/l) were measured at baseline. Participants were followed for 16 years. The primary end point was a combination of death, heart failure, myocardial infarction (MI) and stroke. Vitamin D deficiency was defined as serum 25(OH)D<50 nmol/l. The primary end point was adjusted for other risk factors of adverse cardiovascular events (age, smoking, blood pressure, hip-waist ratio, education and family history of MI).
  
  
  RESULTS
  At baseline, mean age was 50 years and BMI 25. Women with vitamin D deficiency (n=788) had more cardiovascular risk factors than vitamin D-replete women (n=1225). Compared with vitamin D-replete women, women with low 25(OH)D levels had significantly higher BMI and triglycerides, lower HDL and hip-waist ratio and less education. More were smokers among the vitamin D deficient (47 vs 38%). A primary end point was experienced by 118 (15%) with vitamin D deficiency and by 125 (10%) of the vitamin D replete. Hazard ratio (HR) was 1.49 (95% confidence interval: 1.16-1.92; P=0.002) in the vitamin D deficient. Adjusted HR was 1.32 (1.02-1.71; P=0.03). In total, 135 women died; of these, 65 (8%) were of the vitamin D deficient and 70 (6%) in the vitamin D-replete group; unadjusted HR was 1.44 (1.02-2.01; P=0.04) for vitamin D deficiency.
  
  
  CONCLUSIONS
  Healthy women with vitamin D deficiency have increased risk of adverse cardiovascular outcome.
authors.affiliation: Department of Endocrinology, Hvidovre Hospital, afd. 541, Kettegård alle 30, 2650 Hvidovre, Denmark. louise.schierbeck@gmail.com
authors.forename: Louise Lind
authors.initials: LL
authors.lastname: Schierbeck
authors.forename: Lars
authors.initials: L
authors.lastname: Rejnmark
authors.forename: Charlotte Landbo
authors.initials: CL
authors.lastname: Tofteng
authors.forename: Lis
authors.initials: L
authors.lastname: Stilgren
authors.forename: Pia
authors.initials: P
authors.lastname: Eiken
authors.forename: Leif
authors.initials: L
authors.lastname: Mosekilde
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.forename: Jens-Erik Beck
authors.initials: JE
authors.lastname: Jensen
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D002986:Clinical Trials as Topic; D015914:Estrogen Replacement Therapy; D005260:Female; D005500:Follow-Up Studies; D006262:Health; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D017698:Postmenopause / Q000502:physiology; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications* / Q000453:epidemiology
chemical_list: D014807:Vitamin D