医学
内科学
四分位间距
危险系数
肾脏疾病
维生素D与神经学
比例危险模型
前瞻性队列研究
入射(几何)
心肌梗塞
糖尿病
胃肠病学
维生素D缺乏
内分泌学
置信区间
物理
光学
作者
Shiyu Zhao,Xue Chen,Zhenzhen Wan,Tingting Geng,Qi Lu,Hancheng Yu,Xiaoyu Lin,An Pan,Gang Liu
标识
DOI:10.1016/j.ajcnut.2024.04.001
摘要
Evidence regarding the relationships of serum 25-hydroxyvitamin D (25[OH]D) with cardiovascular diseases (CVD) and mortality among patients with chronic kidney disease (CKD) is limited and inconsistent. This study aimed to investigate the associations between serum 25(OH)D and CVD incidence and mortality among patients with CKD. This prospective study included 21,507 participants with CKD and free of CVD in the UK Biobank. Incidences of total and subtypes of CVD and mortality were ascertained via electronic health records. Cox proportional hazards regression models were used to estimate the hazard ratios (HRs) and 95% confidential intervals (CIs) for CVD incidence and mortality. The median serum 25(OH)D concentration was 44.0 nmol/L (interquartile range: 30.1, 60.6 nmol/L). After multivariable adjustment, compared with CKD patients with serum 25(OH)D <25 nmol/L, those with serum 25(OH)D ≥75 nmol/L had HRs (95% CIs) of 0.80 (0.71, 0.90) for total CVD incidence, 0.82 (0.69, 0.97) for ischemic heart disease, 0.56 (0.41, 0.77) for stroke, 0.64 (0.46, 0.88) for myocardial infarction, 0.62 (0.49, 0.80) for heart failure, 0.60 (0.43, 0.85) for CVD mortality, and 0.62 (0.52, 0.74) for all-cause mortality. In addition, these associations were not modified by VDR polymorphisms, with no significant interaction was detected. Higher serum 25(OH)D concentrations were significantly associated with lower risks of total and subtypes of CVD incidence and mortality among individuals with CKD. These findings highlight the importance of maintaining adequate vitamin D status in the prevention of CVD and mortality in patients with CKD.
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