Association between serum 25( OH)D3 and cardiovascular morbidity and mortality in people with Type 2 diabetes: a community-based cohort study.

Autor:	Samefors, M., Scragg, R., Länne, T., Nyström, F. H., Östgren, C. J.
Předmět:	CARDIOVASCULAR disease related mortality TYPE 2 diabetes complications STROKE risk factors ANALYSIS of variance CARDIOVASCULAR diseases risk factors CHI-squared test CONFIDENCE intervals CAUSES of death LONGITUDINAL method MYOCARDIAL infarction PARATHYROID hormone REGRESSION analysis RESEARCH funding T-test (Statistics) VITAMIN D VITAMIN D deficiency RESIDENTIAL patterns BODY mass index PROPORTIONAL hazards models DATA analysis software DISEASE complications
Zdroj:	Diabetic Medicine; Mar2017, Vol. 34 Issue 3, p372-379, 8p
Abstrakt:	Aim We aimed to explore the association between vitamin D and cardiovascular morbidity and mortality in people with Type 2 diabetes recruited from a community-based study because there is limited and inconsistent research of this group. Methods A prospective community-based cohort study among people aged 55-66 years with Type 2 diabetes as part of The Cardiovascular Risk in Type 2 Diabetes - A Prospective Study in Primary Care ( CARDIPP). We analysed serum 25-hydroxyvitamin D3 [25( OH)D3] at baseline. Cox regression analyses were used to calculate hazard ratios ( HR) for the first myocardial infarction, stroke or cardiovascular mortality according to 25( OH)D3. Results We examined 698 people with a mean follow-up of 7.3 years. Serum 25( OH)D3 was inversely associated with the risk of cardiovascular morbidity and mortality: HR 0.98 [95% confidence interval ( CI) 0.96 to 0.99, P = 0.001]. Compared with the fourth quartile (Q4) [25( OH)D3 > 61.8 nmol/l], HR (with 95% CI) was 3.46 (1.60 to 7.47) in Q1 [25( OH)D3 < 35.5 nmol/l] ( P = 0.002); 2.26 (1.01 to 5.06) in Q2 [25( OH)D3 35.5-47.5 nmol/l] ( P = 0.047); and 1.62 (0.70 to 3.76) in Q3 [25( OH)D3 47.5-61.8 nmol/l] ( P = 0.26) when adjusting for age, sex and season. The results remained significant after adjusting also for cardiovascular risk factors, physiological variables including parathyroid hormone and previous cardiovascular disease ( P = 0.027). Conclusions Low 25( OH)D3 is associated with an increased risk of cardiovascular morbidity and mortality in people with Type 2 diabetes independent of parathyroid hormone. Vitamin D could be considered as a prognostic factor. Future studies are needed to explore whether vitamin D deficiency is a modifiable risk factor in Type 2 diabetes. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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