title: Serum parathyroid hormone and 25-hydroxyvitamin D concentrations and risk of incident heart failure: the Multi-Ethnic Study of Atherosclerosis.
abstract: BACKGROUND
  Heart failure (HF) is common and is associated with high mortality. We aimed to determine associations of serum parathyroid hormone (PTH) and 25-hydroxyvitamin D (25[OH]D) with incident HF and left ventricular mass.
  
  
  RESULTS
  Among 6459 participants in the community-based Multi-Ethnic Study of Atherosclerosis, all of whom were free of prevalent clinical cardiovascular disease, we measured serum concentrations of PTH and 25(OH)D at the baseline examination. In longitudinal analyses, we tested associations of PTH and 25(OH)D with incident HF events, adjudicated by a panel of physicians. In cross-sectional analyses of a subset of 4763 participants, we tested associations of PTH and 25(OH)D with left ventricular mass, measured by cardiac magnetic resonance imaging at baseline. Multivariable Cox proportional hazard and linear regression models were adjusted for demographics, physical examination measures, comorbidity, kidney function, and other mineral metabolism markers. Mean age was 62 years and 53% of participants were female. There were 180 incident HF events over a median (interquartile range) follow-up time of 8.46 (7.67 to 8.63) years. Compared with participants with PTH <65 pg/mL, PTH ≥65 pg/mL was associated with a 50% greater risk of incident HF (95% CI: 3% to 210%) and a 5.3 g higher left ventricular mass (95% CI: 2.6, 7.9 g). In contrast, there was no association of 25(OH)D with risk of incident HF or elevated left ventricular mass.
  
  
  CONCLUSIONS
  In a racially/ethnically diverse population without prevalent cardiovascular disease, higher serum PTH concentration was associated with increased left ventricular mass and increased risk of incident HF. Further studies should be pursued to determine whether PTH excess may be a modifiable risk factor for HF.
authors.affiliation: Kidney Research Institute, University of Washington, Seattle, WA (N.B., L.Z., C.R.C., A.N.H., B.K., I.H.B.).
authors.forename: Nisha
authors.initials: N
authors.lastname: Bansal
authors.affiliation: Kidney Research Institute, University of Washington, Seattle, WA (N.B., L.Z., C.R.C., A.N.H., B.K., I.H.B.).
authors.forename: Leila
authors.initials: L
authors.lastname: Zelnick
authors.affiliation: Kidney Research Institute, University of Washington, Seattle, WA (N.B., L.Z., C.R.C., A.N.H., B.K., I.H.B.).
authors.forename: Cassianne
authors.initials: C
authors.lastname: Robinson-Cohen
authors.affiliation: Kidney Research Institute, University of Washington, Seattle, WA (N.B., L.Z., C.R.C., A.N.H., B.K., I.H.B.).
authors.forename: Andy N
authors.initials: AN
authors.lastname: Hoofnagle
authors.affiliation: University of California, San Diego, CA (J.H.I.).
authors.forename: Joachim H
authors.initials: JH
authors.lastname: Ix
authors.affiliation: Johns Hopkins University, Baltimore, MD (J.A.L.).
authors.forename: Joao A
authors.initials: JA
authors.lastname: Lima
authors.affiliation: Ohio State University, Columbus, OH (A.B.S.).
authors.forename: Abigail B
authors.initials: AB
authors.lastname: Shoben
authors.affiliation: University of California, San Francisco, CA (C.A.P.).
authors.forename: Carmen A
authors.initials: CA
authors.lastname: Peralta
authors.affiliation: New York Academy of Sciences, New York (D.S.S.).
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
authors.affiliation: Kidney Research Institute, University of Washington, Seattle, WA (N.B., L.Z., C.R.C., A.N.H., B.K., I.H.B.).
authors.forename: Bryan
authors.initials: B
authors.lastname: Kestenbaum
authors.affiliation: Kidney Research Institute, University of Washington, Seattle, WA (N.B., L.Z., C.R.C., A.N.H., B.K., I.H.B.).
authors.forename: Ian H
authors.initials: IH
authors.lastname: de Boer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology; D015415:Biomarkers / Q000097:blood; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000175:diagnosis / Q000208:ethnology; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010281:Parathyroid Hormone / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D015854:Up-Regulation; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D015415:Biomarkers; C470125:PTH protein, human; D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: heart failure; hypertrophy; risk factors