Vitamin D status, functional decline, and mortality in peripheral artery disease.
Associations of vitamin D levels with prospectively measured functional decline and mortality in people with lower extremity peripheral artery disease (PAD) are unknown. We determined whether lower baseline vitamin D levels are associated with a faster decline in functional performance and higher mortality among people with and without PAD. A total of 658 participants (395 with PAD) underwent baseline measurement of 25-hydroxyvitamin D (DiaSorin radioimmunoassay), a 6-minute walk test, 4-meter walking velocity and the Short Physical Performance Battery (SPPB), and were followed annually for up to 4 years. Analyses were adjusted for age, sex, race, body mass index, comorbidities, the ankle-brachial index, and other confounders. Among participants with PAD, lower baseline vitamin D levels were associated with a faster decline in the 6-minute walk (vitamin D < 30 nmol/L: -70.0 feet/year; vitamin D 30 to < 50 nmol/L: -72.3 feet/year; vitamin D 50 to < 75 nmol/L: -35.5 feet/year; vitamin D 75 to < 120 nmol/L: -35.9 feet/year; p trend=0.012). PAD participants with vitamin D < 30 nmol/L had a faster decline in the SPPB and 6-minute walk compared to those with levels of 50 to < 75 (p=0.034 and p=0.04, respectively). Among participants without PAD, lower vitamin D was associated with a faster decline in the fast 4-meter walking velocity (p trend=0.003). There were no significant associations of baseline vitamin D levels with all-cause or cardiovascular disease mortality in PAD or non-PAD participants. In conclusion, among individuals with and without PAD, low vitamin D status was associated with a faster decline in some measures of functional performance but was not related to mortality.
Northwestern University's Feinberg School of Medicine, Chicago, IL, USA.
Mary M
MM
McDermott
Kiang
K
Liu
Luigi
L
Ferrucci
Lu
L
Tian
Jack
J
Guralnik
Peter
P
Kopp
Linda
L
Van Horn
Yihua
Y
Liao
David
D
Green
Melina
M
Kibbe
Robert
R
Sufit
Lihui
L
Zhao
Michael H
MH
Criqui
D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D015992:Body Mass Index; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000378:metabolism; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000378:metabolism / Q000401:mortality* / Q000503:physiopathology*; D014807:Vitamin D / Q000378:metabolism*; D016138:Walking
D014807:Vitamin D
exercise; intermittent claudication; peripheral arterial disease; peripheral vascular diseases; walking