Serum 25-hydroxyvitamin D and risk of venous thromboembolism: The Atherosclerosis Risk in Communities (ARIC) Studyz

A. R. Folsom, N. S. Roetker, W. D. Rosamond, S. R. Heckbert, S. Basu, M. Cushman, P. L. Lutsey

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20 Scopus citations


Background: Some evidence suggests that an inadequate vitamin D level may increase the risk for atherosclerotic cardiovascular disease. Whether a low vitamin D level plays a role in venous thromboembolism (VTE), that is, venous thrombosis and pulmonary embolism, is largely unexplored. Objectives: We tested prospectively, in the Atherosclerosis Risk in Communities (ARIC) cohort, whether the serum level of 25-hydroxyvitamin D (25[OH]D) is inversely associated with VTE incidence, and whether it partly explains the African American excess of VTE in the ARIC Study. Patients and Methods: We measured 25(OH)D by using mass spectroscopy in stored samples of 12 752 ARIC Study participants, and followed them over a median of 19.7 years (1990-1992 to 2011) for the incidence of VTE (n = 537). Results: The seasonally adjusted 25(OH)D level was not associated with VTE incidence. In a model adjusted for age, race, sex, hormone replacement therapy, and body mass index, the hazard ratios of VTE across 25(OH)D quintiles 5 (high) to 1 (low) were: 1 (ref.), 0.84 (95% confidence interval [CI] 0.65-1.08), 0.88 (95% CI 0.68-1.13), 1.04 (95% CI 0.78-1.38), and 0.90 (95% CI 0.64-1.27). The lowest 25(OH)D quintile contained 59% African Americans, whereas the highest quintile contained 7% African Americans. However, lower 25(OH)D levels explained little of the 63% greater VTE risk of African Americans over whites in this cohort. Conclusions: A low 25(OH)D level was not a risk factor for VTE in this prospective study. However, the totality of the literature (three studies) suggests that a low 25(OH)D level might modestly increase VTE risk in whites, but this needs further confirmation.

Original languageEnglish (US)
Pages (from-to)1455-1460
Number of pages6
JournalJournal of Thrombosis and Haemostasis
Issue number9
StatePublished - 2014

Bibliographical note

Publisher Copyright:
© 2014 International Society on Thrombosis and Haemostasis.


  • Prospective studies
  • Pulmonary embolism
  • Risk factors
  • Venous thrombosis
  • Vitamin D


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