Kidney Week

Abstract: FR-PO835

The Vitamin D Metabolite Ratio and Incident Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis

Session Information

• Health Maintenance, Nutrition, Metabolism - II
  November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1500 Health Maintenance, Nutrition, and Metabolism

Authors

• Cheng, Jonathan, University of California San Diego, La Jolla, California, United States

Jonathan Cheng,

• Hoofnagle, Andrew N., University of Washington, Seattle, Washington, United States

Andrew N. Hoofnagle,

• Katz, Ronit, University of Washington, Seattle, Washington, United States

Ronit Katz,

• Hsu, Simon, University of Washington, Seattle, Washington, United States

Simon Hsu,

• Kado, Deborah M., Stanford Medicine, Stanford, California, United States

Deborah M. Kado,

• Budoff, Matthew Jay, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States

Matthew Jay Budoff,

• Kestenbaum, Bryan R., University of Washington, Seattle, Washington, United States

Bryan R. Kestenbaum,

• Michos, Erin D., Johns Hopkins Medicine, Baltimore, Maryland, United States

Erin D. Michos,

• Miller, Lindsay M., University of California San Diego, La Jolla, California, United States

Lindsay M. Miller,

• Ix, Joachim H., University of California San Diego, La Jolla, California, United States

Joachim H. Ix,

• de Boer, Ian H., University of Washington, Seattle, Washington, United States

Ian H. de Boer,

• Ginsberg, Charles, University of California San Diego, La Jolla, California, United States

Charles Ginsberg,

Background

Vitamin D deficiency has been linked to cardiovascular disease (CVD) with mixed results. The vitamin D metabolite ratio (VMR), the ratio of 24,25(OH)₂D to 25(OH)D, has shown stronger associations with bone health and mortality than 25(OH)D alone. Our study assessed the association between the VMR and CVD outcomes.

Methods

We evaluated 6,313 Multi-Ethnic Study of Atherosclerosis (MESA) participants without CVD using Cox regression to test the associations of both VMR and 25(OH)D with incident CVD (including myocardial infarction, resuscitated cardiac arrest, stroke, coronary heart disease death, and stroke death), heart failure (HF), and cardiovascular mortality. We adjusted models for age, gender, race, physical activity, BMI, smoking, diabetes, blood pressure condition and medication use, C-reactive protein, cholesterol levels and medication use, triglycerides, kidney function, parathyroid hormone, fibroblast growth factor 23, calcium, and phosphate.

Results

The study participants had a mean age of 62, with 53% of them being female. The cohort was 38% White, 28% Black, 22% Hispanic, and 12% Chinese. The mean (SD) 25(OH)D level was 22.7 (11.0) ng/mL, and the mean VMR was 15.2 (5.0). In fully adjusted models, a two-fold increase in VMR was associated with a 24% reduction in incident CVD (HR: 0.76, 95% CI: 0.65-0.88). However, there was no association between the VMR and HF (0.98, 0.78-1.24), or cardiovascular mortality (0.96, 0.77-1.21). 25(OH)D was not significantly associated with any CVD outcome.

Conclusion

In a multi-ethnic cohort, VMR was significantly associated with reduced incident CVD, but not HF or cardiovascular mortality over 15 years of follow-up. The results suggest that VMR may provide greater insight into vitamin D metabolism compared with 25(OH)D levels alone.

Association of VMR and 25(OH)D with Cardiovascular Outcomes: Fully Adjusted Model

*Per two-fold increase

Funding

• NIDDK Support