title: Race and Vitamin D Binding Protein Gene Polymorphisms Modify the Association of 25-Hydroxyvitamin D and Incident Heart Failure: The ARIC (Atherosclerosis Risk in Communities) Study.
abstract: OBJECTIVE
  This study sought to determine if low serum 25-hydroxyvitamin D (25[OH]D) is associated with incident heart failure (HF) and if the association is: 1) partly mediated by traditional cardiovascular risk factors; 2) stronger among whites than blacks; and 3) stronger among those genetically predisposed to having high levels of vitamin D binding protein (DBP).
  
  
  BACKGROUND
  Suboptimal 25(OH)D is a potential cardiovascular risk factor.
  
  
  METHODS
  A total of 12,215 ARIC (Atherosclerosis Risk in Communities) study participants free of HF at baseline (1990 to 1992; median age, 56; 24% black) were followed through 2010. Total serum 25(OH)D was measured at baseline using liquid chromatography-mass spectrometry. Incident HF events were identified by a hospital discharge code of ICD9-428 and parallel International Classification of Diseases codes for HF deaths.
  
  
  RESULTS
  During 21 years of follow-up, 1,799 incident HF events accrued. The association between 25(OH)D and HF varied by race (p-interaction = 0.02). Among whites, risk was 2-fold higher for those in the lowest (≤17 ng/ml) versus highest (≥31 ng/ml) quintile of 25(OH)D. The association was attenuated but remained significant with covariate adjustment. In blacks there was no overall association. In both races, those with low 25(OH)D and the rs7041 G allele, which predisposes to high DBP, were at greater risk (p-interaction = 0.01).
  
  
  CONCLUSIONS
  Low serum 25(OH)D was independently associated with incident HF among whites, but not among blacks. However, in both races, low 25(OH)D was associated with HF risk among those genetically predisposed to high DBP. These findings provide novel insight into metabolic differences that may underlie racial variation in the association between 25(OH)D and cardiovascular risk.
authors: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota. Electronic address: lutsey@umn.edu.
authors: Pamela L
authors: PL
authors: Lutsey
authors: Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
authors: Erin D
authors: ED
authors: Michos
authors: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
authors: Jeffrey R
authors: JR
authors: Misialek
authors: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
authors: James S
authors: JS
authors: Pankow
authors: Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina.
authors: Laura
authors: L
authors: Loehr
authors: Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, Maryland.
authors: Elizabeth
authors: E
authors: Selvin
authors: Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland.
authors: Jared P
authors: JP
authors: Reis
authors: Lab Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota.
authors: Myron
authors: M
authors: Gross
authors: Lab Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota.
authors: John H
authors: JH
authors: Eckfeldt
authors: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
authors: Aaron R
authors: AR
authors: Folsom
mesh_terms: D050197:Atherosclerosis / Q000097:blood / Q000208:ethnology* / Q000235:genetics; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000208:ethnology* / Q000235:genetics; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D012313:RNA / Q000235:genetics; D044469:Racial Groups; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014809:Vitamin D-Binding Protein / Q000235:genetics* / Q000378:metabolism
chemical_list: D014809:Vitamin D-Binding Protein; D014807:Vitamin D; D012313:RNA; C104450:25-hydroxyvitamin D
keywords: ARIC; heart failure; race; vitamin D; vitamin D binding protein