Markers of vitamin D metabolism and incidence of clinically diagnosed abdominal aortic aneurysm: The Atherosclerosis Risk in Communities Study

Pamela L Lutsey, Mary R. Rooney, Aaron R Folsom, Erin D. Michos, Alvaro Alonso, Weihong Tang

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Abstract

Little is known about whether markers of vitamin D metabolism are associated with the development of abdominal aortic aneurysm (AAA), though these markers have been linked to other cardiovascular diseases. We tested the hypotheses that risk of AAA is higher among individuals with low serum concentrations of 25-hydroxy vitamin D [25(OH)D], and among those with elevated concentrations of calcium, fibroblast growth factor 23 (FGF23), phosphorus, and parathyroid hormone (PTH) using data from a cohort of black and white individuals with long-term follow-up. Markers of vitamin D metabolism were measured using serum collected in 1990–1992 from ARIC study participants (mean ± SD age 56.9 ± 5.7 years, 43.2% male, 23.9% black). A total of 12,770 participants were followed until 2011 for incident AAA. Multivariable-adjusted Cox regression models were used. A total of 449 incident AAA events occurred over a median follow-up of 19.7 years. For the association between serum calcium and risk of incident AAA there was evidence of interaction by sex (p-interaction 0.02). Among women, in the fully adjusted model, the hazard ratio (95% confidence interval) comparing the highest to lowest quartile was 2.43 (1.25–4.73), whereas in men it was 1.01 (0.72–1.43). Not associated with risk of incident AAA were 25(OH)D, FGF23, phosphorus, and PTH. In this large prospective cohort, there was little evidence that markers of vitamin D metabolism are associated with risk of incident AAA. The positive association of calcium with AAA among women may warrant further investigation and replication in other populations.

Original languageEnglish (US)
Pages (from-to)253-260
Number of pages8
JournalVascular Medicine (United Kingdom)
Volume23
Issue number3
DOIs
StatePublished - Jun 1 2018

Bibliographical note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The National Institutes of Health (NIH) National Heart, Lung, and Blood Institute supported this research through R01 HL103695, R01 HL103706, and ARIC contracts HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201-100008C, HHSN268201100009C, HHSN268201100010C, HHS-N268201100011C, and HHSN268201100012C. The NIH Office of Dietary Supplements also provided support through R01 HL103706-S1.

Keywords

  • Atherosclerosis Risk in Communities (ARIC) study
  • abdominal aortic aneurysm (AAA)
  • calcium
  • epidemiology
  • fibroblast growth factor 23
  • vitamin D

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