Inke Thiele1, Jakob Linseisen2, Christa Meisinger3, Sigrid Schwab4, Cornelia Huth5, Annette Peters6, Siegfried Perz7, Thomas Meitinger8, Florian Kronenberg9, Claudia Lamina10, Joachim Thiery11, Wolfgang Koenig12, Wolfgang Rathmann13, Stefan Kääb14, Cornelia Then15, Jochen Seissler16, Barbara Thorand17. 1. Institute of Epidemiology II, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. Electronic address: inke.thiele@helmholtz-muenchen.de. 2. Institute of Epidemiology II, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. Electronic address: j.linseisen@helmholtz-muenchen.de. 3. Institute of Epidemiology II, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. Electronic address: christa.meisinger@helmholtz-muenchen.de. 4. Institute of Epidemiology II, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. Electronic address: sigrid.schwab@helmholtz-muenchen.de. 5. Institute of Epidemiology II, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany; German Center for Diabetes Research (DZD), Helmholtz Zentrum München, Neuherberg, Germany. Electronic address: huth@helmholtz-muenchen.de. 6. Institute of Epidemiology II, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany; German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany. Electronic address: peters@helmholtz-muenchen.de. 7. Institute for Biological and Medical Imaging, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. Electronic address: perz@helmholtz-muenchen.de. 8. German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany; Institute of Human Genetics, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. Electronic address: meitinger@helmholtz-muenchen.de. 9. Division of Genetic Epidemiology, Innsbruck Medical University, Schöpfst. 41, 6020 Innsbruck, Austria. Electronic address: Florian.Kronenberg@i-med.ac.at. 10. Division of Genetic Epidemiology, Innsbruck Medical University, Schöpfst. 41, 6020 Innsbruck, Austria. Electronic address: Claudia.Lamina@i-med.ac.at. 11. Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Liebigstr. 27, 04103 Leipzig, Germany. Electronic address: joachim.thiery@uniklinik-leipzig.de. 12. Department of Internal Medicine II - Cardiology, University of Ulm Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany. Electronic address: wolfgang.koenig@uniklinik-ulm.de. 13. Institute for Biometry and Epidemiology, German Diabetes Center (DDZ), Leibniz-Zentrum für Diabetes-Forschung an der Heinrich-Heine-Universität Düsseldorf, Auf'm Hennekamp 65, 40225 Duesseldorf, Germany. Electronic address: rathmann@ddz.uni-duesseldorf.de. 14. German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany; Department of Cardiology, Medical Policlinic and University Clinic I, Marchioninistr. 15, 81377 Munich, Germany. Electronic address: stefan.kaab@med.uni-muenchen.de. 15. Medizinische Klinik und Poliklinik IV - Campus Innenstadt, Diabetes Zentrum, Universität München, Ziemssenstr. 1, 80336 Munich, Germany; Clinical Cooperation Group Diabetes, Ludwig-Maximilians-Universität München and Helmholtz Zentrum München, Germany. Electronic address: cornelia.then@med.uni-muenchen.de. 16. Medizinische Klinik und Poliklinik IV - Campus Innenstadt, Diabetes Zentrum, Universität München, Ziemssenstr. 1, 80336 Munich, Germany; Clinical Cooperation Group Diabetes, Ludwig-Maximilians-Universität München and Helmholtz Zentrum München, Germany. Electronic address: Jochen.Seissler@med.uni-muenchen.de. 17. Institute of Epidemiology II, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. Electronic address: thorand@helmholtz-muenchen.de.
Abstract
BACKGROUND: Supplementation of calcium (Ca) and vitamin D for the prevention of osteoporosis is frequently found in Western countries. Recent re-analyses of clinical trials observed a higher risk of myocardial infarction and stroke in subjects taking Ca (+vitamin D) supplements, although the underlying mechanisms are not clear. OBJECTIVE: Thus, we analyzed the associations between Ca and vitamin D supplementation as well as serum concentrations of Ca and 25-hydroxyvitamin D (25(OH)D) and subclinical cardiovascular disease (CVD) phenotypes, namely intima-media thickness, ankle-brachial-index (ABI), intermittent claudication, and atrial fibrillation (AF). DESIGN: Data of 1601 participants aged 50-81 years of the population-based cross-sectional Cooperative Health Research in the Region of Augsburg (KORA) F4 study in Germany were analyzed. Logistic and linear regression models were used to estimate odds ratios (OR) (95% confidence intervals (CI)) and β-estimates (p-values), respectively. RESULTS: Regular Ca supplementation showed a significant positive association with the presence of AF after multivariable adjustment (OR = 3.89; 95% CI 1.28-11.81). Higher serum 25(OH)D concentrations were independently associated with a lower prevalence of asymptomatic peripheral arterial disease as assessed by ABI measurements (β = 0.007; p = 0.01). No other significant associations between supplementation or serum concentrations of Ca or vitamin D and CVD phenotypes were identified. CONCLUSIONS: Although based on few cases the finding of a significant higher prevalence of AF in Ca supplement users hints at one possible mechanism that may contribute to an increased risk of myocardial infarction and stroke. The observed association between serum 25(OH)D and ABI supports results from other studies.
BACKGROUND: Supplementation of calcium (Ca) and vitamin D for the prevention of osteoporosis is frequently found in Western countries. Recent re-analyses of clinical trials observed a higher risk of myocardial infarction and stroke in subjects taking Ca (+vitamin D) supplements, although the underlying mechanisms are not clear. OBJECTIVE: Thus, we analyzed the associations between Ca and vitamin D supplementation as well as serum concentrations of Ca and 25-hydroxyvitamin D (25(OH)D) and subclinical cardiovascular disease (CVD) phenotypes, namely intima-media thickness, ankle-brachial-index (ABI), intermittent claudication, and atrial fibrillation (AF). DESIGN: Data of 1601 participants aged 50-81 years of the population-based cross-sectional Cooperative Health Research in the Region of Augsburg (KORA) F4 study in Germany were analyzed. Logistic and linear regression models were used to estimate odds ratios (OR) (95% confidence intervals (CI)) and β-estimates (p-values), respectively. RESULTS: Regular Ca supplementation showed a significant positive association with the presence of AF after multivariable adjustment (OR = 3.89; 95% CI 1.28-11.81). Higher serum 25(OH)D concentrations were independently associated with a lower prevalence of asymptomatic peripheral arterial disease as assessed by ABI measurements (β = 0.007; p = 0.01). No other significant associations between supplementation or serum concentrations of Ca or vitamin D and CVD phenotypes were identified. CONCLUSIONS: Although based on few cases the finding of a significant higher prevalence of AF in Ca supplement users hints at one possible mechanism that may contribute to an increased risk of myocardial infarction and stroke. The observed association between serum 25(OH)D and ABI supports results from other studies.
Authors: Angelo Maria Patti; Khalid Al-Rasadi; Rosaria Vincenza Giglio; Dragana Nikolic; Carlo Mannina; Giuseppa Castellino; Roberta Chianetta; Maciej Banach; Arrigo F G Cicero; Giuseppe Lippi; Giuseppe Montalto; Manfredi Rizzo; Peter P Toth Journal: Arch Med Sci Date: 2017-07-19 Impact factor: 3.318
Authors: Adriana J van Ballegooijen; Stefan Pilz; Andreas Tomaschitz; Martin R Grübler; Nicolas Verheyen Journal: Int J Endocrinol Date: 2017-09-12 Impact factor: 3.257