Serum 25-hydroxyvitamin D is associated with incident peripheral artery disease among white and black adults in the ARIC study cohort

• Type of Material: Article
• Authors: Ian R Rapson, University of Minnesota; Erin D. Michos, Johns Hopkins Bloomberg; Alvaro Alonso, Emory University; Alan T. Hirsch, University of Minnesota; Kunihiro Matsushita, Johns Hopkins Bloomberg; Jared P. Reis, National Heart, Lung and Blood Institute; Pamela L Lutsey, University of Minnesota
• Language: English
• Date: 2017-02-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 Elsevier B.V.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.atherosclerosis.2017.01.016
• Title of Journal or Parent Work: Atherosclerosis
• ISSN: 0021-9150
• Volume: 257
• Start Page: 123
• End Page: 129
• Grant/Funding Information: This research was further supported by grants from the NIH National Heart, Lung, and Blood Institute (R01 HL103706 to Dr. Lutsey) and the NIH Office of Dietary Supplements (R01 HL103706-S1 to Dr. Lutsey).; The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C).; Genotyping was supported through the NHLBI CARe (Candidate Gene Resource) grant (N01-HC-65226).
• Keywords: Peripheral arterial disease; Science & Technology; RACIAL-DIFFERENCES; CARDIOVASCULAR-DISEASE; ATHEROSCLEROSIS RISK; VITAMIN-D SUPPLEMENTATION; PROTEIN GENE POLYMORPHISMS; NATIONAL-HEALTH; Life Sciences & Biomedicine; D DEFICIENCY; Cardiac & Cardiovascular Systems; Epidemiology; CORONARY-HEART-DISEASE; Peripheral Vascular Disease; ARIC; Vitamin D; PARATHYROID-HORMONE; Cardiovascular System & Cardiology; Race; NUTRITION EXAMINATION SURVEY; Cohort study
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Public Health

Abstract

Background and aims Low 25-hydroxyvitamin D [25(OH)D] concentrations have been associated with peripheral artery disease (PAD). Prevalence of low 25(OH)D and PAD differ between whites and blacks. However, these associations have not been studied prospectively or in a population based cohort. We tested the hypothesis that low 25(OH)D is associated with greater risk of incident PAD in white and black adults. Methods 25(OH)D was measured in serum collected at ARIC visit 2 (1990–1992). We followed 11,789 ARIC participants free of PAD at visit 2 through 2011 for incident PAD events. 25(OH)D (ng/mL) was categorized as deficient ( < 20), insufficient (20 to < 30) or sufficient (≥30). PAD was defined by an ankle brachial index (ABI) of < 0.9 at ARIC visits 3 or 4 or a hospital diagnosis with an ICD-9 code indicating PAD during follow-up. Analysis used multivariable-adjusted Cox proportional hazards regressions. Results Over a mean follow-up of 17.1 years, 1250 incident PAD events were identified. 22% of whites and 61% of blacks were 25(OH)D deficient. After adjustment for demographic characteristics, the hazard ratio (95% CI) of PAD in participants with deficient versus sufficient 25(OH)D was 1.49 (1.26, 1.76). Inclusion of BMI, physical activity, and smoking status attenuated the association [1.25 (1.06, 1.48)]. The association between 25(OH)D and PAD was qualitatively stronger in blacks (p for interaction = 0.20). Conclusions Deficient 25(OH)D was associated with increased risk of PAD in black and white participants. Whether treatment of low vitamin D through supplementation or modest sunlight exposure prevents PAD is unknown.