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Sha S, Degen M, Vlaski T, Fan Z, Brenner H, Schöttker B. The Safety Profile of Vitamin D Supplements Using Real-World Data from 445,493 Participants of the UK Biobank: Slightly Higher Hypercalcemia Prevalence but Neither Increased Risks of Kidney Stones nor Atherosclerosis. Nutrients 2024; 16:2251. [PMID: 39064694 DOI: 10.3390/nu16142251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/05/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
Background: Potential calcium-related adverse events of vitamin D supplement use have not been addressed in large-scale, real-world data so far. Methods: Leveraging data from the UK Biobank, encompassing 445,493 individuals aged 40-69, we examined associations of high 25-hydroxyvitamin (25(OH)D) levels ≥ 100 nmol/L and vitamin D supplementation with hypercalcemia (serum calcium > 2.6 mmol/L), kidney stones, and atherosclerosis assessments (pulse wave arterial stiffness index and carotid intima-medial thickness). Regression models were comprehensively adjusted for 49 covariates. Results: Approximately 1.5% of the participants had high 25(OH)D levels, 4.3% regularly used vitamin D supplements, and 20.4% reported regular multivitamin use. At baseline, the hypercalcemia prevalence was 1.6%, and 1.1% was diagnosed with kidney stones during follow-up. High 25(OH)D levels were neither associated with calcium-related adverse events nor atherosclerosis assessments. Vitamin D and multivitamin supplementation were associated with an increased prevalence of hypercalcemia (odds ratios and 95% confidence intervals: 1.46 [1.32-1.62] and 1.11 [1.04-1.18], respectively) but were neither associated with atherosclerosis nor future kidney stones. Conclusions: High 25(OH)D levels observable in routine care were not associated with any adverse outcome. Vitamin D users have a slightly higher prevalence of hypercalcemia, possibly due to co-supplementation with calcium, but without a higher atherosclerosis prevalence or risk of kidney stones.
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Affiliation(s)
- Sha Sha
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Faculty of Medicine, University of Heidelberg, 69115 Heidelberg, Germany
| | - Miriam Degen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Faculty of Medicine, University of Heidelberg, 69115 Heidelberg, Germany
| | - Tomislav Vlaski
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Faculty of Medicine, University of Heidelberg, 69115 Heidelberg, Germany
| | - Ziwen Fan
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
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Vervloet MG. Can we reverse arterial stiffness by intervening on CKD-MBD biomarkers? Clin Kidney J 2023; 16:1766-1775. [PMID: 37915898 PMCID: PMC10616505 DOI: 10.1093/ckj/sfad112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Indexed: 11/03/2023] Open
Abstract
The increased cardiovascular risk of chronic kidney disease may in part be the consequence of arterial stiffness, a typical feature of kidney failure. Deranged homeostasis of minerals and hormones involved (CKD-MBD), are also strongly associated with this increased risk. It is well established that CKD-MBD is a main driver of vascular calcification, which in turn worsens arterial stiffness. However, there are other contributors to arterial stiffness in CKD than calcification. An overlooked possibility is that CKD-MBD may have detrimental effects on this potentially better modifiable component of arterial stiffness. In this review, the individual contributions of short-term changes in calcium, phosphate, PTH, vitamin D, magnesium, and FGF23 to arterial stiffness, in most studies assessed as pulse wave velocity, is summarized. Indeed, there is evidence from both observational studies and interventional trials that higher calcium concentrations can worsen arterial stiffness. This, however, has not been shown for phosphate, and it seems unlikely that, apart from being a contributor to vascular calcification and having effects on the microcirculation, phosphate has no acute effect on large artery stiffness. Several interventional studies, both by infusing PTH and by abrupt lowering PTH by calcimimetics or surgery, virtually ruled out direct effects on large artery stiffness. A well-designed trial using both active and nutritional vitamin D as intervention found a beneficial effect for the latter. Unfortunately, the study had a baseline imbalance and other studies did not support its finding. Both magnesium and FGF23 do not seem do modify central arterial stiffness.
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Affiliation(s)
- Marc G Vervloet
- Amsterdam University Medical Centres, Nephrology, Amsterdam, The Netherlands
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Sun ZJ, Hsiao HJ, Cheng HJ, Chou CY, Lu FH, Yang YC, Wu JS, Chang CJ. Relationship between Kidney Stone Disease and Arterial Stiffness in a Taiwanese Population. J Clin Med 2020; 9:jcm9061693. [PMID: 32498283 PMCID: PMC7355902 DOI: 10.3390/jcm9061693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 11/28/2022] Open
Abstract
Previous studies examining the association between kidney stone disease (KSD) and arterial stiffness have been limited. Both age and gender have been found to have an impact on KSD, but their influence on the relationship between KSD and increased arterial stiffness is unclear. This study included 6694 subjects from October 2006 to August 2009. The diagnosis of kidney stone was based on the results of ultrasonographic examination. Increased arterial stiffness was defined as right-sided brachial-ankle pulse wave velocity (baPWV) ≥ 14 m/s. Associations between KSD and increased arterial stiffness were analyzed using multiple logistic regression models. KSD was positively related to increased arterial stiffness in both male and female groups (males: odds ratio [OR], 1.306; 95% confidence interval [CI], 1.035–1.649; females: OR, 1.585; 95% CI, 1.038–2.419) after adjusting for confounding factors. Subgroup analysis by age group (<50 and ≥50 years) showed a significant positive relationship only in the groups ≥ 50 years for both genders (males: OR, 1.546; 95% CI, 1.111–2.151; females: OR, 1.783; 95% CI, 1.042–3.054), but not in the groups < 50 years. In conclusion, KSD is associated with a higher risk of increased arterial stiffness in individuals aged ≥ 50 years, but not in those aged < 50 years for both genders.
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Affiliation(s)
- Zih-Jie Sun
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
- Department of Family Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, College of Medicine, National Cheng Kung University, No.345, Zhuangjing Rd., Douliu City, Yunlin 64043, Taiwan
| | - Hsuan-Jung Hsiao
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
| | - Hsiang-Ju Cheng
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
| | - Chieh-Ying Chou
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
| | - Feng-Hwa Lu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
- Department of Family Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, College of Medicine, National Cheng Kung University, No.345, Zhuangjing Rd., Douliu City, Yunlin 64043, Taiwan
- Correspondence: (J.-S.W.); (C.-J.C.); Tel.: +886-6-2353535 (J.-S.W.)
| | - Chih-Jen Chang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
- Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, No.539, Zhongxiao Rd., East Dist., Chiayi 60002, Taiwan
- Correspondence: (J.-S.W.); (C.-J.C.); Tel.: +886-6-2353535 (J.-S.W.)
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Lim ST, Park JK, Park SH, Lee EJ, Kim WN, Min SK. The effects of the elastin polymorphisms on carotid intima-media thickness in women aged 30 - 70. J Exerc Nutrition Biochem 2018; 22:18-22. [PMID: 30149422 PMCID: PMC6058069 DOI: 10.20463/jenb.2018.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/30/2018] [Indexed: 11/22/2022] Open
Abstract
[Purpose] Elastin is one of the major determinants of arterial distensibility of large blood vessels that forms the principal component of elastic fibers from the media of arteries. However, the association between elastin(ELN) genotype and vascular function is still unclear. [Methods] 120women were recruited from the Saha-gu (Busan, Korea) Community Center. Measurements of body composition and vascular function included carotid intima-media thickness (CIMT), carotid artery luminal diameter (CLD), minimum (diastolic) artery luminal diameter (CLDmin) and maximum (systolic) artery luminal diameter (CLDmax). Genotyping for the ELN (rs 2071307) polymorphism was performed using the TaqMan approach. ELN gene distribution of subjects were in the Hardy-Weinberg equilibrium (p=0.402). [Results] The relative CIMT differed significantly among the ELN genotypes. And not significant differences in CLD and CIMT/CLD ratio, but AA genotype was tended higher than other genotypes (AG and GG). The relative CIMT and CLD min differed significantly between the ELN alleles. And not significant differences in CLD max and CIMT/CLD ratio, but A allele was tended higher than G allele. [Conclusion] These results suggest that ELN gene polymorphism might be used a one of the genetic determinants of vascular disease in both pre- and postmenopausal women.
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Cho HS, Lee SW, Shin J, Moon SD, Han JH, Cha BY, Kim ES. Association of serum calcium concentrations with fibrinogen and homocysteine in nondiabetic Korean subjects. Medicine (Baltimore) 2016; 95:e3899. [PMID: 27310988 PMCID: PMC4998474 DOI: 10.1097/md.0000000000003899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Considerable evidence shows that increased serum calcium levels are associated with metabolic disorders, cardiovascular disease, and increased mortality. This study investigated whether serum calcium, within a normal range, is significantly associated with serum fibrinogen and homocysteine, markers of increased cardiovascular disease risk in nondiabetic Korean subjects.A cross-sectional analysis was performed on 1096 subjects (mean age, 55.1 ± 11.1 years; 36.1% women) undergoing a general health checkup. Serum biochemistry was analyzed including serum albumin-corrected calcium (Cac), insulin resistance (IR, using homeostasis model assessment [HOMA]), fibrinogen, and homocysteine.Compared with patients within the lowest Cac quartile, those with higher Cac levels had increased fibrinogen and homocysteine levels as well as an increased proportion of smoking, dyslipidemia, and HOMA-IR. Correlation analyses revealed linear relationships for Cac with fibrinogen and homocysteine in both genders. After adjustment for confounding factors, serum Cac was significantly associated with high fibrinogen (odds ratio [OR] for the highest vs the lowest quartile = 1.76, 95% confidence interval [CI] = 1.09-2.83, P = 0.02) and homocysteine (OR = 1.83, 95% CI = 1.07-3.11, P = 0.027). Multivariate regression models showed that Cac was linearly associated with fibrinogen (standardized β = 0.14, P < 0.001) and homocysteine (standardized β = 0.07, P = 0.009).High normal calcium concentrations were independently associated with increased levels of fibrinogen and homocysteine. Further investigation is needed to validate whether slightly increased calcium levels within the normal range indicate a higher risk of cardiovascular disease.
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Affiliation(s)
- Hyun Sun Cho
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Health Promotion Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung Won Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Division of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Juyoung Shin
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Health Promotion Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung Dae Moon
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Je Ho Han
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bong Yun Cha
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eun Sook Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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