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. 2012 May;35(5):1158-64.
doi: 10.2337/dc11-1714. Epub 2012 Mar 7.

Vitamin D levels predict all-cause and cardiovascular disease mortality in subjects with the metabolic syndrome: the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study

G Neil Thomas  1 , Bríain ó Hartaigh, Jos A Bosch, Stefan Pilz, Adrian Loerbroks, Marcus E Kleber, Joachim E Fischer, Tanja B Grammer, Bernhard O Böhm, Winfried März
Affiliations

Vitamin D levels predict all-cause and cardiovascular disease mortality in subjects with the metabolic syndrome: the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study

G Neil Thomas et al. Diabetes Care. 2012 May.

Abstract

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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Figures

Figure 1
Figure 1
Kaplan-Meier plots for all-cause (left) and cardiovascular mortality (right) according to 25(OH)D groups in those with the metabolic syndrome. Log-rank analysis indicated a significant difference between all 25(OH)D groups (P < 0.001).
See this image and copyright information in PMC

References

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