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Abstract: TH-PO605

Vitamin D Metabolites and Risk of Cardiovascular Disease in CKD

Session Information

Category: Hypertension and CVD

  • 1502 Hypertension and CVD: Clinical‚ Outcomes‚ and Trials

Authors

  • Hsu, Simon, University of Washington, Seattle, Washington, United States
  • Bansal, Nisha, University of Washington, Seattle, Washington, United States
  • Brown, Julia, University of Illinois Chicago, Chicago, Illinois, United States
  • Denburg, Michelle, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
  • Feldman, Harold I., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
  • Ginsberg, Charles, University of California San Diego, La Jolla, California, United States
  • Hoofnagle, Andrew N., University of Washington, Seattle, Washington, United States
  • Isakova, Tamara, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Kestenbaum, Bryan R., University of Washington, Seattle, Washington, United States
  • Lidgard, Benjamin, University of Washington, Seattle, Washington, United States
  • Robinson-Cohen, Cassianne, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Zelnick, Leila R., University of Washington, Seattle, Washington, United States
  • de Boer, Ian H., University of Washington, Seattle, Washington, United States
Background

The ratio of 24,25-dihydroxyvitamin D3 to 25-hydroxyvitamin D3 (vitamin D metabolite ratio, VDMR) is a measure of vitamin D status that may reflect tissue-level vitamin D receptor activation.

Methods

We conducted a longitudinal study to test associations of the VDMR and other vitamin D metabolites with risk of cardiovascular disease (CVD) in a random subset of participants from the Chronic Renal Insufficiency Cohort (CRIC; n=1111). Serum 24,25-dihydroxyvitamin D3, 25-hydroxyvitamin D2 and D3, and 1,25-dihydroxyvitamin D2 and D3 were measured by liquid chromatography-tandem mass spectrometry 1 year after enrollment (baseline for the current analysis). The primary outcome was composite CVD (heart failure, myocardial infarction/revascularization, stroke, and peripheral arterial disease). We used Cox regression to test associations of the VDMR, total 25-hydroxyvitamin D (25(OH)D), and total 1,25-dihydroxyvitamin D (1,25(OH)2D) with risk of CVD in participants without prevalent CVD (n=729). We also examined associations of these metabolites with left ventricular mass index (LVMI) measured at the year 1 study visit using linear regression. Analytic models adjusted for demographics, co-morbidity, medications, estimated glomerular filtration rate (eGFR) and proteinuria.

Results

The mean age of the study cohort was 59 years, 43% were female, and 42% were Black. There were 187 composite CVD events over a mean (standard deviation) follow-up of 9.6 (4.6) years among participants without prevalent CVD. Lower VDMR and 1,25(OH)2D were associated with risk of CVD prior to, but not after adjustment for eGFR and proteinuria (Table 1). Neither 25(OH)D, the VDMR, nor 1,25(OH)2D was associated with LVMI after full covariate adjustments.

Conclusion

The VDMR, 25(OH)D, and 1,25(OH)2D were not significantly associated with risk of incident CVD or with LVMI.

Funding

  • NIDDK Support