Circulating vitamin d metabolites and subclinical atherosclerosis in type 1 diabetes

Michael C. Sachs, John D. Brunzell, Patricia A. Cleary, Andrew N. Hoofnagle, John M. Lachin, Mark E. Molitch, Michael W Steffes, Bernard Zinman, Ian H. De Boer

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Abstract

OBJECTIVE-People with type 1 diabetes are at high risk of premature atherosclerosis. Existing evidence suggests that impaired vitamin D metabolism may contribute to the development of atherosclerosis. We tested associations of circulating vitamin D metabolite concentrations with subclinical atherosclerosis among 1,193 participants with type 1 diabetes in the DCCT/EDIC study. RESEARCH DESIGN AND METHODSdWe measured plasma concentrations of 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D, and 24,25-dihydroxyvitamin D by mass spectrometry at the end of the DCCT. In a staggered cross-sectional design, we tested associations with coronary artery calcium (CAC), measured by computed tomography a median of 10 years later, and with common and internal carotid intima-media thickness (IMT), measured by B-mode ultrasonography on two occasions a median of 4 years later and a median of 10 years later. We hypothesized that lower concentrations of each vitamin D metabolite would be associated with increased risk of CAC and greater carotid IMT. RESULTS-At the time metabolites were measured, mean age was 32.4 years and mean duration of diabetes was 7.5 years. The prevalence and severity of CAC tended to be lowerdnot higherdwith lower concentrations of each vitamin Dmetabolite. For instance, in a fully adjusted multinomial logistic model, a 25 nmol/L lower 25-hydroxyvitamin D was associated with a 0.8- fold decrease in the odds of having higher CAC (95% CI 0.68-0.96, P = 0.01). No vitamin D metabolite was associated with either common or internal mean IMT. CONCLUSIONS-We did not find evidence linking impaired vitamin D metabolism with increased subclinical atherosclerosis in type 1 diabetes.

Original languageEnglish (US)
Pages (from-to)2423-2429
Number of pages7
JournalDiabetes care
Volume36
Issue number8
DOIs
StatePublished - Oct 28 2013

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Type 1 Diabetes Mellitus
Vitamin D
Vitamins
Atherosclerosis
Coronary Vessels
Calcium
Carotid Intima-Media Thickness
Dihydroxycholecalciferols
Ultrasonography
Mass Spectrometry
Logistic Models
Tomography
25-hydroxyvitamin D

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Sachs, M. C., Brunzell, J. D., Cleary, P. A., Hoofnagle, A. N., Lachin, J. M., Molitch, M. E., ... De Boer, I. H. (2013). Circulating vitamin d metabolites and subclinical atherosclerosis in type 1 diabetes. Diabetes care, 36(8), 2423-2429. https://doi.org/10.2337/dc12-2020

Circulating vitamin d metabolites and subclinical atherosclerosis in type 1 diabetes. / Sachs, Michael C.; Brunzell, John D.; Cleary, Patricia A.; Hoofnagle, Andrew N.; Lachin, John M.; Molitch, Mark E.; Steffes, Michael W; Zinman, Bernard; De Boer, Ian H.

In: Diabetes care, Vol. 36, No. 8, 28.10.2013, p. 2423-2429.

Research output: Contribution to journalArticle

Sachs, MC, Brunzell, JD, Cleary, PA, Hoofnagle, AN, Lachin, JM, Molitch, ME, Steffes, MW, Zinman, B & De Boer, IH 2013, 'Circulating vitamin d metabolites and subclinical atherosclerosis in type 1 diabetes', Diabetes care, vol. 36, no. 8, pp. 2423-2429. https://doi.org/10.2337/dc12-2020
Sachs MC, Brunzell JD, Cleary PA, Hoofnagle AN, Lachin JM, Molitch ME et al. Circulating vitamin d metabolites and subclinical atherosclerosis in type 1 diabetes. Diabetes care. 2013 Oct 28;36(8):2423-2429. https://doi.org/10.2337/dc12-2020
Sachs, Michael C. ; Brunzell, John D. ; Cleary, Patricia A. ; Hoofnagle, Andrew N. ; Lachin, John M. ; Molitch, Mark E. ; Steffes, Michael W ; Zinman, Bernard ; De Boer, Ian H. / Circulating vitamin d metabolites and subclinical atherosclerosis in type 1 diabetes. In: Diabetes care. 2013 ; Vol. 36, No. 8. pp. 2423-2429.
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abstract = "OBJECTIVE-People with type 1 diabetes are at high risk of premature atherosclerosis. Existing evidence suggests that impaired vitamin D metabolism may contribute to the development of atherosclerosis. We tested associations of circulating vitamin D metabolite concentrations with subclinical atherosclerosis among 1,193 participants with type 1 diabetes in the DCCT/EDIC study. RESEARCH DESIGN AND METHODSdWe measured plasma concentrations of 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D, and 24,25-dihydroxyvitamin D by mass spectrometry at the end of the DCCT. In a staggered cross-sectional design, we tested associations with coronary artery calcium (CAC), measured by computed tomography a median of 10 years later, and with common and internal carotid intima-media thickness (IMT), measured by B-mode ultrasonography on two occasions a median of 4 years later and a median of 10 years later. We hypothesized that lower concentrations of each vitamin D metabolite would be associated with increased risk of CAC and greater carotid IMT. RESULTS-At the time metabolites were measured, mean age was 32.4 years and mean duration of diabetes was 7.5 years. The prevalence and severity of CAC tended to be lowerdnot higherdwith lower concentrations of each vitamin Dmetabolite. For instance, in a fully adjusted multinomial logistic model, a 25 nmol/L lower 25-hydroxyvitamin D was associated with a 0.8- fold decrease in the odds of having higher CAC (95{\%} CI 0.68-0.96, P = 0.01). No vitamin D metabolite was associated with either common or internal mean IMT. CONCLUSIONS-We did not find evidence linking impaired vitamin D metabolism with increased subclinical atherosclerosis in type 1 diabetes.",
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T1 - Circulating vitamin d metabolites and subclinical atherosclerosis in type 1 diabetes

AU - Sachs, Michael C.

AU - Brunzell, John D.

AU - Cleary, Patricia A.

AU - Hoofnagle, Andrew N.

AU - Lachin, John M.

AU - Molitch, Mark E.

AU - Steffes, Michael W

AU - Zinman, Bernard

AU - De Boer, Ian H.

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N2 - OBJECTIVE-People with type 1 diabetes are at high risk of premature atherosclerosis. Existing evidence suggests that impaired vitamin D metabolism may contribute to the development of atherosclerosis. We tested associations of circulating vitamin D metabolite concentrations with subclinical atherosclerosis among 1,193 participants with type 1 diabetes in the DCCT/EDIC study. RESEARCH DESIGN AND METHODSdWe measured plasma concentrations of 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D, and 24,25-dihydroxyvitamin D by mass spectrometry at the end of the DCCT. In a staggered cross-sectional design, we tested associations with coronary artery calcium (CAC), measured by computed tomography a median of 10 years later, and with common and internal carotid intima-media thickness (IMT), measured by B-mode ultrasonography on two occasions a median of 4 years later and a median of 10 years later. We hypothesized that lower concentrations of each vitamin D metabolite would be associated with increased risk of CAC and greater carotid IMT. RESULTS-At the time metabolites were measured, mean age was 32.4 years and mean duration of diabetes was 7.5 years. The prevalence and severity of CAC tended to be lowerdnot higherdwith lower concentrations of each vitamin Dmetabolite. For instance, in a fully adjusted multinomial logistic model, a 25 nmol/L lower 25-hydroxyvitamin D was associated with a 0.8- fold decrease in the odds of having higher CAC (95% CI 0.68-0.96, P = 0.01). No vitamin D metabolite was associated with either common or internal mean IMT. CONCLUSIONS-We did not find evidence linking impaired vitamin D metabolism with increased subclinical atherosclerosis in type 1 diabetes.

AB - OBJECTIVE-People with type 1 diabetes are at high risk of premature atherosclerosis. Existing evidence suggests that impaired vitamin D metabolism may contribute to the development of atherosclerosis. We tested associations of circulating vitamin D metabolite concentrations with subclinical atherosclerosis among 1,193 participants with type 1 diabetes in the DCCT/EDIC study. RESEARCH DESIGN AND METHODSdWe measured plasma concentrations of 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D, and 24,25-dihydroxyvitamin D by mass spectrometry at the end of the DCCT. In a staggered cross-sectional design, we tested associations with coronary artery calcium (CAC), measured by computed tomography a median of 10 years later, and with common and internal carotid intima-media thickness (IMT), measured by B-mode ultrasonography on two occasions a median of 4 years later and a median of 10 years later. We hypothesized that lower concentrations of each vitamin D metabolite would be associated with increased risk of CAC and greater carotid IMT. RESULTS-At the time metabolites were measured, mean age was 32.4 years and mean duration of diabetes was 7.5 years. The prevalence and severity of CAC tended to be lowerdnot higherdwith lower concentrations of each vitamin Dmetabolite. For instance, in a fully adjusted multinomial logistic model, a 25 nmol/L lower 25-hydroxyvitamin D was associated with a 0.8- fold decrease in the odds of having higher CAC (95% CI 0.68-0.96, P = 0.01). No vitamin D metabolite was associated with either common or internal mean IMT. CONCLUSIONS-We did not find evidence linking impaired vitamin D metabolism with increased subclinical atherosclerosis in type 1 diabetes.

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