title: Vitamin D status and 5-year changes in urine albumin creatinine ratio and parathyroid hormone in a general population.
abstract: Vitamin D is associated with cardiovascular disease and renal function but the mechanisms are as yet unexplained. Microalbuminuria is associated with a higher risk of kidney function loss, cardiovascular disease, and mortality. Parathyroid hormone is a predictor of cardiovascular mortality and negatively correlated with glomerular filtration rate. We investigated the association between vitamin D status and 5-year changes in urine albumin creatinine ratio (UACR) and parathyroid hormone (PTH). A random sample of 6,784 individuals aged 30-60 years from a general population participated in the Inter99 study in 1999-2001. Vitamin D (serum-25-hydroxyvitamin D) was measured at baseline by high-performance liquid chromatography. UACR and PTH were measured at baseline and follow-up. Increased UACR was defined as UACR >4.0 mg/g reflecting the upper quartile at baseline. We included 4,330 individuals who participated at 5-year follow-up. In multivariable linear regression analysis, a 10-nmol/l higher baseline level of vitamin D was associated with a 5-year decrease in UACR by 0.92 % (95 % confidence interval, CI 0.13, 1.71). In multivariable logistic regression analysis, the odds ratio of developing increased UACR during follow-up was 0.96 (95 % CI 0.92, 0.98) per 10 nmol/l higher baseline vitamin D level. We found a significant inverse cross-sectional (p < 0.0001) but no prospective association (p = 0.6) between baseline vitamin D status and parathyroid hormone. We found low vitamin D status to be a predictor of long-term development of increased UACR. It remains to be proven whether vitamin D deficiency is a causal and reversible factor in the development of albuminuria.
authors: Research Centre for Prevention and Health, Glostrup Hospital, Nordre Ringvej 57, 2600, Glostrup, Denmark, tea.skaaby.01@regionh.dk.
authors: Tea
authors: T
authors: Skaaby
authors: Lise Lotte Nystrup
authors: LL
authors: Husemoen
authors: Charlotta
authors: C
authors: Pisinger
authors: Torben
authors: T
authors: Jørgensen
authors: Betina Heinsbæk
authors: BH
authors: Thuesen
authors: Knud
authors: K
authors: Rasmussen
authors: Mogens
authors: M
authors: Fenger
authors: Peter
authors: P
authors: Rossing
authors: Allan
authors: A
authors: Linneberg
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000097:blood* / Q000453:epidemiology / Q000652:urine*; D003404:Creatinine / Q000652:urine*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology / Q000652:urine
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D003404:Creatinine
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