Vitamin D Metabolites and Risk of Cardiovascular Disease in Chronic Kidney Disease: The CRIC Study-Reference-Cited by-同舟云学术

Vitamin D Metabolites and Risk of Cardiovascular Disease in Chronic Kidney Disease: The CRIC Study

Published:2023-07-18 Issue:14 Volume:12 Page:
ISSN:2047-9980
Container-title:Journal of the American Heart Association
language:en
Short-container-title:JAHA

Author:

Hsu Simon¹^ORCID,Zelnick Leila R.¹^ORCID,Bansal Nisha¹^ORCID,Brown Julia²^ORCID,Denburg Michelle³⁴,Feldman Harold I.⁴⁵^ORCID,Ginsberg Charles⁶,Hoofnagle Andrew N.⁷^ORCID,Isakova Tamara⁸^ORCID,Leonard Mary B.⁹,Lidgard Benjamin¹^ORCID,Robinson‐Cohen Cassianne¹⁰^ORCID,Wolf Myles¹¹^ORCID,Xie Dawei⁴⁵,Kestenbaum Bryan R.¹,de Boer Ian H.¹^ORCID,Appel Lawrence J.,Chen Jing,Cohen Debbie L.,Go Alan S.,Lash James P.,Nelson Robert G.,Rahman Mahboob,Rao Panduranga S.,Shah Vallabh O.,Unruh Mark L.

Affiliation:

1. Division of Nephrology and Kidney Research Institute, Department of Medicine University of Washington Seattle WA

2. Division of Nephrology and Hypertension, Department of Medicine Loyola University of Chicago Maywood IL

3. Division of Pediatric Nephrology Department of Pediatrics, The Children’s Hospital of Philadelphia Philadelphia PA

4. Department of Biostatistics, Epidemiology, and Informatics Perelman School of Medicine at the University of Pennsylvania Philadelphia PA

5. Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine at the University of Pennsylvania Philadelphia PA

6. Division of Nephrology‐Hypertension University of California, San Diego San Diego CA

7. Department of Laboratory Medicine University of Washington Seattle WA

8. Division of Nephrology and Hypertension, Center for Translational Metabolism and Health, Institute for Public Health and Medicine Northwestern University Feinberg School of Medicine Chicago IL

9. Division of Nephrology, Lucile Packard Children’s Hospital Stanford University School of Medicine Palo Alto CA

10. Division of Nephrology Vanderbilt University Medical Center Nashville TN

11. Division of Nephrology, Department of Medicine, Duke Clinical Research Institute Duke University School of Medicine Durham NC USA

Abstract

Background The ratio of 24,25‐dihydroxyvitamin D 3 /25‐hydroxyvitamin D 3 (vitamin D metabolite ratio [VDMR]) may reflect functional vitamin D activity. We examined associations of the VDMR, 25‐hydroxyvitamin D (25[OH]D), and 1,25‐dihydroxyvitamin D (1,25[OH] 2 D) with cardiovascular disease (CVD) in patients with chronic kidney disease. Methods and Results This study included longitudinal and cross‐sectional analyses of 1786 participants from the CRIC (Chronic Renal Insufficiency Cohort) Study. Serum 24,25‐dihydroxyvitamin D 3 , 25(OH)D, and 1,25(OH) 2 D were measured by liquid chromatography–tandem mass spectrometry 1 year after enrollment. The primary outcome was composite CVD (heart failure, myocardial infarction, stroke, and peripheral arterial disease). We used Cox regression with regression‐calibrated weights to test associations of the VDMR, 25(OH)D, and 1,25(OH) 2 D with incident CVD. We examined cross‐sectional associations of these metabolites with left ventricular mass index using linear regression. Analytic models adjusted for demographics, comorbidity, medications, estimated glomerular filtration rate, and proteinuria. The cohort was 42% non‐Hispanic White race and ethnicity, 42% non‐Hispanic Black race and ethnicity, and 12% Hispanic ethnicity. Mean age was 59 years, and 43% were women. Among 1066 participants without prevalent CVD, there were 298 composite first CVD events over a mean follow‐up of 8.6 years. Lower VDMR and 1,25(OH) 2 D were associated with incident CVD before, but not after, adjustment for estimated glomerular filtration rate and proteinuria (hazard ratio, 1.11 per 1 SD lower VDMR [95% CI, 0.95–1.31]). Only 25(OH)D was associated with left ventricular mass index after full covariate adjustment (0.6 g/m 2.7 per 10 ng/mL lower [95% CI, 0.0–1.3]). Conclusions Despite modest associations of 25(OH)D with left ventricular mass index, 25(OH)D, the VDMR, and 1,25(OH) 2 D were not associated with incident CVD in chronic kidney disease.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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