title: Relationship between vitamin D status and incidence of vascular events in the Veterans Affairs Diabetes Trial.
abstract: OBJECTIVE
  Few studies have examined the relationship between vitamin D levels and incident cardiovascular events in large well-characterized patient cohorts. Therefore, our objective was to determine if low vitamin D levels predicted vascular complications of diabetes.
  
  
  METHODS
  Prospective analysis of 936 veterans with type 2 diabetes (59.7 ± 8.4 years, 96.9% male) who participated in the Veteran Affairs Diabetes Trial (VADT) was conducted. 25(OH)-vitamin D was measured a median of two years after entry and participants were subsequently followed 3.7 years. Hazard ratios (HRs) were calculated for cardiovascular endpoints in relation to 25(OH)-vitamin D quartile. For microvascular endpoints, logistic regression was used to calculate odds ratios.
  
  
  RESULTS
  After adjusting for age, minority status, treatment arm and history of prior event, individuals in the lowest vitamin D quartile (i.e., 1-15.9 ng/ml) were at similar risk of MI [HR = 1.13 (95% CI: 0.53, 2.42)], CHD [HR = 0.87 (95% CI: 0.49, 1.55)], congestive heart failure [HR = 1.44 (95% CI: 0.67, 3.06)], and death from any cause [HR = 1.04 (95% CI: 0.53, 2.04)] as individuals in the highest vitamin D quartile (i.e., 29.9-77.2 ng/ml). Similarly, there were no differences in the odds associated with retinopathy or renal disease onset or progression in the lowest versus highest vitamin D quartile.
  
  
  CONCLUSIONS
  These data indicate that vitamin D status had no significant impact on the incidence of vascular events in a cohort of high-risk veterans with diabetes in which traditional risk factors were managed according to current treatment guidelines.
authors.affiliation: Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
authors.forename: Jimmy D
authors.initials: JD
authors.lastname: Alele
authors.forename: Louis M
authors.initials: LM
authors.lastname: Luttrell
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Hollis
authors.forename: Deirdre K
authors.initials: DK
authors.lastname: Luttrell
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Hunt
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D014807:Vitamin D; C517652:hemoglobin A1c protein, human; C104450:25-hydroxyvitamin D