title: Serum 25-hydroxyvitamin D and the incidence of atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) study.
abstract: OBJECTIVE
  To assess the prospective association between circulating 25-hydroxyvitamin D [25(OH)D] and atrial fibrillation (AF) risk.
  
  
  RESULTS
  We studied 12 303 participants from the Atherosclerosis Risk in Communities study without baseline AF (1990-92). Baseline serum total 25(OH)D was measured using mass spectrometry. Incident AF cases were identified from electrocardiograms, hospital discharge codes, and death certificates through 2012. We estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) of AF across clinical categories of serum 25(OH)D concentrations with multivariable Cox models, and tested interactions by age, race, and sex. We meta-analysed our results with those from published prospective studies that reported associations between 25(OH)D and AF risk. During a median follow-up of 21 years, we identified 1866 AF events. In multivariable models, deficient 25(OH)D status (<20 ng/mL), compared with optimal levels (≥30 ng/mL), was not associated with AF risk (HR, 95% CI: 1.10, 0.96-1.26). A significant interaction of 25(OH)D concentrations with age (P = 0.01), but not with race or sex (P > 0.40), was identified, with higher risk of AF among those with deficient 25(OH)D status in younger (HR, 95% CI: 1.35, 1.05-1.73) but not older individuals (HR, 95% CI: 1.02, 0.86-1.21). A meta-analysis of these results and four prospective studies did not support a clinically relevant association of circulating 25(OH)D with AF risk [pooled HR, 95%CI: 1.04, 1.00-1.08, per 1 SD lower 25(OH)D].
  
  
  CONCLUSIONS
  Low serum 25(OH)D was not associated with incident AF in a community-based cohort and in a meta-analysis of prospective studies. A possible association in younger individuals warrants further investigation.
authors: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1200 S 2nd St., Suite 300, Minneapolis, MN 55454, USA alonso@umn.edu.
authors: Alvaro
authors: A
authors: Alonso
authors: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1200 S 2nd St., Suite 300, Minneapolis, MN 55454, USA.
authors: Jeffrey R
authors: JR
authors: Misialek
authors: Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors: Erin D
authors: ED
authors: Michos
authors: Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN, USA.
authors: John
authors: J
authors: Eckfeldt
authors: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors: Elizabeth
authors: E
authors: Selvin
authors: Epidemiological Cardiology Research Center (EPICARE), Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors: Elsayed Z
authors: EZ
authors: Soliman
authors: Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
authors: Lin Y
authors: LY
authors: Chen
authors: Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN, USA.
authors: Myron D
authors: MD
authors: Gross
authors: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1200 S 2nd St., Suite 300, Minneapolis, MN 55454, USA.
authors: Pamela L
authors: PL
authors: Lutsey
mesh_terms: D001281:Atrial Fibrillation / Q000097:blood* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012307:Risk Factors; D014481:United States; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Atrial fibrillation; Cohort; Epidemiology; Meta-analysis; Vitamin D