title: Associations between calcium and vitamin D supplement use as well as their serum concentrations and subclinical cardiovascular disease phenotypes.
abstract: BACKGROUND
  Supplementation of calcium (Ca) and vitamin D for the prevention of osteoporosis is frequently found in Western countries. Recent re-analyses of clinical trials observed a higher risk of myocardial infarction and stroke in subjects taking Ca (+vitamin D) supplements, although the underlying mechanisms are not clear.
  
  
  OBJECTIVE
  Thus, we analyzed the associations between Ca and vitamin D supplementation as well as serum concentrations of Ca and 25-hydroxyvitamin D (25(OH)D) and subclinical cardiovascular disease (CVD) phenotypes, namely intima-media thickness, ankle-brachial-index (ABI), intermittent claudication, and atrial fibrillation (AF).
  
  
  METHODS
  Data of 1601 participants aged 50-81 years of the population-based cross-sectional Cooperative Health Research in the Region of Augsburg (KORA) F4 study in Germany were analyzed. Logistic and linear regression models were used to estimate odds ratios (OR) (95% confidence intervals (CI)) and β-estimates (p-values), respectively.
  
  
  RESULTS
  Regular Ca supplementation showed a significant positive association with the presence of AF after multivariable adjustment (OR = 3.89; 95% CI 1.28-11.81). Higher serum 25(OH)D concentrations were independently associated with a lower prevalence of asymptomatic peripheral arterial disease as assessed by ABI measurements (β = 0.007; p = 0.01). No other significant associations between supplementation or serum concentrations of Ca or vitamin D and CVD phenotypes were identified.
  
  
  CONCLUSIONS
  Although based on few cases the finding of a significant higher prevalence of AF in Ca supplement users hints at one possible mechanism that may contribute to an increased risk of myocardial infarction and stroke. The observed association between serum 25(OH)D and ABI supports results from other studies.
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. Electronic address: inke.thiele@helmholtz-muenchen.de.
authors.forename: Inke
authors.initials: I
authors.lastname: Thiele
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. Electronic address: j.linseisen@helmholtz-muenchen.de.
authors.forename: Jakob
authors.initials: J
authors.lastname: Linseisen
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. Electronic address: christa.meisinger@helmholtz-muenchen.de.
authors.forename: Christa
authors.initials: C
authors.lastname: Meisinger
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. Electronic address: sigrid.schwab@helmholtz-muenchen.de.
authors.forename: Sigrid
authors.initials: S
authors.lastname: Schwab
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany; German Center for Diabetes Research (DZD), Helmholtz Zentrum München, Neuherberg, Germany. Electronic address: huth@helmholtz-muenchen.de.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Huth
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany; German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany. Electronic address: peters@helmholtz-muenchen.de.
authors.forename: Annette
authors.initials: A
authors.lastname: Peters
authors.affiliation: Institute for Biological and Medical Imaging, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. Electronic address: perz@helmholtz-muenchen.de.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Perz
authors.affiliation: German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany; Institute of Human Genetics, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. Electronic address: meitinger@helmholtz-muenchen.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Meitinger
authors.affiliation: Division of Genetic Epidemiology, Innsbruck Medical University, Schöpfst. 41, 6020 Innsbruck, Austria. Electronic address: Florian.Kronenberg@i-med.ac.at.
authors.forename: Florian
authors.initials: F
authors.lastname: Kronenberg
authors.affiliation: Division of Genetic Epidemiology, Innsbruck Medical University, Schöpfst. 41, 6020 Innsbruck, Austria. Electronic address: Claudia.Lamina@i-med.ac.at.
authors.forename: Claudia
authors.initials: C
authors.lastname: Lamina
authors.affiliation: Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Liebigstr. 27, 04103 Leipzig, Germany. Electronic address: joachim.thiery@uniklinik-leipzig.de.
authors.forename: Joachim
authors.initials: J
authors.lastname: Thiery
authors.affiliation: Department of Internal Medicine II - Cardiology, University of Ulm Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany. Electronic address: wolfgang.koenig@uniklinik-ulm.de.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Koenig
authors.affiliation: Institute for Biometry and Epidemiology, German Diabetes Center (DDZ), Leibniz-Zentrum für Diabetes-Forschung an der Heinrich-Heine-Universität Düsseldorf, Auf'm Hennekamp 65, 40225 Duesseldorf, Germany. Electronic address: rathmann@ddz.uni-duesseldorf.de.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rathmann
authors.affiliation: German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany; Department of Cardiology, Medical Policlinic and University Clinic I, Marchioninistr. 15, 81377 Munich, Germany. Electronic address: stefan.kaab@med.uni-muenchen.de.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kääb
authors.affiliation: Medizinische Klinik und Poliklinik IV - Campus Innenstadt, Diabetes Zentrum, Universität München, Ziemssenstr. 1, 80336 Munich, Germany; Clinical Cooperation Group Diabetes, Ludwig-Maximilians-Universität München and Helmholtz Zentrum München, Germany. Electronic address: cornelia.then@med.uni-muenchen.de.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Then
authors.affiliation: Medizinische Klinik und Poliklinik IV - Campus Innenstadt, Diabetes Zentrum, Universität München, Ziemssenstr. 1, 80336 Munich, Germany; Clinical Cooperation Group Diabetes, Ludwig-Maximilians-Universität München and Helmholtz Zentrum München, Germany. Electronic address: Jochen.Seissler@med.uni-muenchen.de.
authors.forename: Jochen
authors.initials: J
authors.lastname: Seissler
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. Electronic address: thorand@helmholtz-muenchen.de.
authors.forename: Barbara
authors.initials: B
authors.lastname: Thorand
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D001281:Atrial Fibrillation; D002118:Calcium / Q000097:blood / Q000627:therapeutic use*; D002136:Calcium, Dietary / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood*; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D005858:Germany; D006801:Humans; D007383:Intermittent Claudication; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood*; D010641:Phenotype; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use
chemical_list: D002136:Calcium, Dietary; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002118:Calcium
keywords: Ankle-brachial index; Atrial fibrillation; Calcium; Intermittent claudication; Intima-media thickness; Vitamin D