期刊
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
卷 12, 期 9, 页码 1455-1460出版社
WILEY-BLACKWELL
DOI: 10.1111/jth.12665
关键词
prospective studies; pulmonary embolism; risk factors; venous thrombosis; vitaminD
资金
- National Heart, Lung, and Blood Institute (NHLBI) [R01 HL59367, R01 HL103706]
- ARIC [HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268 201100009C, HHSN268201100010C, HHSN268201100 011C, HHSN268201100012C]
BackgroundSome evidence suggests that an inadequate vitaminD level may increase the risk for atherosclerotic cardiovascular disease. Whether a low vitaminD level plays a role in venous thromboembolism (VTE), that is, venous thrombosis and pulmonary embolism, is largely unexplored. ObjectivesWe tested prospectively, in the Atherosclerosis Risk in Communities (ARIC) cohort, whether the serum level of 25-hydroxyvitaminD (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 MethodsWe measured 25(OH)D by using mass spectroscopy in stored samples of 12752 ARIC Study participants, and followed them over a median of 19.7years (1990-1992 to 2011) for the incidence of VTE (n=537). ResultsThe 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%CI0.68-1.13), 1.04 (95%CI0.78-1.38), and 0.90 (95%CI0.64-1.27). 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. ConclusionsA 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.
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