Vitamin D Levels Predict All-Cause and Cardiovascular Disease Mortality in Subjects With the Metabolic Syndrome: The Ludwigshafen Risk and Cardiovascular Health (LURIC) study

OBJECTIVE: Optimal vitamin D levels are associated with reduced cardiovascular and all-cause mortality. We investigated whether optimal 25-hydroxyvitamin D (25[OH]D) is protective in individuals with the metabolic syndrome. RESEARCH DESIGN AND METHODS: The Ludwigshafen Risk and Cardiovascular Health...

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Published in:Diabetes care Vol. 35; no. 5; pp. 1158 - 1164
Main Authors: Thomas, G. Neil, ó Hartaigh, Bríain, Bosch, Jos A, Pilz, Stefan, Loerbroks, Adrian, Kleber, Marcus E, Fischer, Joachim E, Grammer, Tanja B, Böhm, Bernhard O, März, Winfried
Format: Journal Article
Language:English
Published: Alexandria, VA American Diabetes Association 01.05.2012
Subjects:
Aged
Alfacalcidol
analogs & derivatives
Biological and medical sciences
blood
Calcifediol
Cardiovascular disease
Cardiovascular Diseases
Cardiovascular Diseases - blood
Cardiovascular Diseases - mortality
cohort studies
complications
death
Diabetes mellitus
Diabetes. Impaired glucose tolerance
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Female
Health aspects
heart failure
Humans
Male
Medical research
Medical sciences
Medicine, Experimental
Metabolic diseases
Metabolic disorders
Metabolic syndrome
Metabolic Syndrome - blood
Metabolic Syndrome - complications
Middle Aged
Miscellaneous
Mortality
Myocardial infarction
Original Research
Other metabolic disorders
Prognosis
Public health. Hygiene
Public health. Hygiene-occupational medicine
Research design
risk
Risk factors
Studies
Survival
Vitamin D
Vitamin D - analogs & derivatives
Vitamin D - blood
vitamin D deficiency
Vitamins
Endocrinopathy
Human
Nutrition
Prediction
Metabolic diseases
Cardiovascular disease
Risk
Metabolic syndrome
Vitamin D
Cause
Risk factor
Circulatory system
Endocrinology
Public health
ISSN:0149-5992, 1935-5548, 1935-5548
Online Access:Get full text
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Summary:OBJECTIVE: Optimal vitamin D levels are associated with reduced cardiovascular and all-cause mortality. We investigated whether optimal 25-hydroxyvitamin D (25[OH]D) is protective in individuals with the metabolic syndrome. RESEARCH DESIGN AND METHODS: The Ludwigshafen Risk and Cardiovascular Health (LURIC) study is a cohort study of subjects referred for coronary angiography between 1997 and 2000, from which 1,801 with the metabolic syndrome were investigated. Mortality was tracked for a median of 7.7 years. Multivariable survival analysis was used to estimate the association between 25(OH)D levels and mortality. RESULTS: Most subjects (92%) had suboptimal levels of 25(OH)D (<75 nmol/L), with 22.2% being severely deficient (<25 nmol/L). During follow-up, 462 deaths were recorded, 267 (57.8%) of which were cardiovascular in origin. After full adjustment, including the metabolic syndrome components, those with optimal 25(OH)D levels showed a substantial reduction in all-cause (hazard ratio [HR] 0.25 [95% CI 0.13–0.46]) and cardiovascular disease mortality (0.33 [0.16–0.66]) compared with those with severe vitamin D deficiency. For specific cardiovascular disease mortality, there was a strong reduction for sudden death (0.15 [0.04–0.63]) and congestive heart failure (0.24 [0.06–1.04]), but not for myocardial infarction. The reduction in mortality was dose-dependent for each of these causes. CONCLUSIONS: Optimal 25(OH)D levels substantially lowered all-cause and cardiovascular disease mortality in subjects with the metabolic syndrome. These observations call for interventional studies that test whether vitamin D supplementation provides a useful adjunct in reducing mortality in these subjects.
Bibliography:http://dx.doi.org/10.2337/dc11-1714
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ISSN:0149-5992
1935-5548
1935-5548
DOI:10.2337/dc11-1714