Parathormone, vitamin D and the risk of atrial fibrillation in older adults: A prospective study.
Aged
Aged, 80 and over
Atrial Fibrillation
/ blood
Biomarkers
/ blood
Female
Humans
Hyperparathyroidism
/ blood
Incidence
Italy
/ epidemiology
Male
Parathyroid Hormone
/ blood
Prognosis
Prospective Studies
Risk Assessment
Risk Factors
Time Factors
Vitamin D
/ analogs & derivatives
Vitamin D Deficiency
/ blood
Atrial fibrillation
Older age
Parathyroid hormone
Vitamin D
Journal
Nutrition, metabolism, and cardiovascular diseases : NMCD
ISSN: 1590-3729
Titre abrégé: Nutr Metab Cardiovasc Dis
Pays: Netherlands
ID NLM: 9111474
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
15
02
2019
revised:
24
04
2019
accepted:
20
05
2019
pubmed:
16
7
2019
medline:
3
3
2020
entrez:
16
7
2019
Statut:
ppublish
Résumé
Vitamin D and parathormone (PTH) have been associated with cardiovascular outcomes, but their impact on atrial fibrillation (AF) onset is still unclear. We explored the influence of serum 25-hydroxyvitamin D (25[OH]D) and PTH on AF risk in older adults. Data come from 2418 participants enrolled in the Progetto Veneto Anziani study. Serum 25(OH)D and intact PTH were measured using radioimmunoassay and two-site immunoassay, respectively. The associations between 25(OH)D, PTH and adjudicated AF cases over 4-years were explored by Cox regression. Over the follow-up, 134 incident cases of AF were assessed. The incidence rate of the sample was 13.5 (95%CI 11.4-15.9) per 1000 person-years, and was higher among those with high PTH levels (high: 16.4 [95%CI 11.3-24.0] per 1000 person-years), especially when associated to low 25(OH)D (20.3 [95%CI 12.9-32.3] per 1000 person-years). At Cox regression, only high PTH was significantly associated to an increased risk of AF (HR = 1.90, 95%CI 1.27-2.84). A marginal significant interaction (p = 0.06) was found between 25[OH]D and PTH concentrations in influencing AF risk. When exploring the risk of AF for combined categories of 25(OH)D and PTH, we found that those with high PTH and low 25(OH)D levels had an AF risk twice as high as that of people with normal values (HR = 2.09, 95%CI 1.28-3.42). The risk of AF may be increased by high PTH levels, especially when associated with 25(OH)D deficiency. The identification and treatment of high PTH or vitamin D deficiency may thus contribute to lower the risk of AF.
Sections du résumé
BACKGROUND & AIMS
Vitamin D and parathormone (PTH) have been associated with cardiovascular outcomes, but their impact on atrial fibrillation (AF) onset is still unclear. We explored the influence of serum 25-hydroxyvitamin D (25[OH]D) and PTH on AF risk in older adults.
METHODS AND RESULTS
Data come from 2418 participants enrolled in the Progetto Veneto Anziani study. Serum 25(OH)D and intact PTH were measured using radioimmunoassay and two-site immunoassay, respectively. The associations between 25(OH)D, PTH and adjudicated AF cases over 4-years were explored by Cox regression. Over the follow-up, 134 incident cases of AF were assessed. The incidence rate of the sample was 13.5 (95%CI 11.4-15.9) per 1000 person-years, and was higher among those with high PTH levels (high: 16.4 [95%CI 11.3-24.0] per 1000 person-years), especially when associated to low 25(OH)D (20.3 [95%CI 12.9-32.3] per 1000 person-years). At Cox regression, only high PTH was significantly associated to an increased risk of AF (HR = 1.90, 95%CI 1.27-2.84). A marginal significant interaction (p = 0.06) was found between 25[OH]D and PTH concentrations in influencing AF risk. When exploring the risk of AF for combined categories of 25(OH)D and PTH, we found that those with high PTH and low 25(OH)D levels had an AF risk twice as high as that of people with normal values (HR = 2.09, 95%CI 1.28-3.42).
CONCLUSION
The risk of AF may be increased by high PTH levels, especially when associated with 25(OH)D deficiency. The identification and treatment of high PTH or vitamin D deficiency may thus contribute to lower the risk of AF.
Identifiants
pubmed: 31303477
pii: S0939-4753(19)30214-5
doi: 10.1016/j.numecd.2019.05.064
pii:
doi:
Substances chimiques
Biomarkers
0
PTH protein, human
0
Parathyroid Hormone
0
Vitamin D
1406-16-2
25-hydroxyvitamin D
A288AR3C9H
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
939-945Informations de copyright
Copyright © 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.