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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Hauptverfasser: Thomas, G. Neil (VerfasserIn) , Bosch, Jos A. (VerfasserIn) , Loerbroks, Adrian (VerfasserIn) , Kleber, Marcus E. (VerfasserIn) , Fischer, Joachim E. (VerfasserIn) , Grammer, Tanja B. (VerfasserIn) , März, Winfried (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2012
In: Diabetes care
Year: 2012, Jahrgang: 35, Heft: 5, Pages: 1158-1164
ISSN:1935-5548
DOI:10.2337/dc11-1714
Online-Zugang:Verlag, kostenfrei, Volltext: http://dx.doi.org/10.2337/dc11-1714
Verlag, kostenfrei, Volltext: http://care.diabetesjournals.org/content/35/5/1158
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Verfasserangaben:G. Neil Thomas, Bríain ó Hartaigh, Jos A. Bosch, Stefan Pilz, Adrian Loerbroks, Marcus E. Kleber, Joachim E. Fischer, Tanja B. Grammer, Bernhard O. Böhm, Winfried März

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520 |a 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. 
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