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Yaman AE, Ceylan US. Effects of Vitamin D Levels on Long-Term Coronary Events in Patients with Proven Coronary Artery Disease: Six-Year Follow-Up. J Clin Med 2023; 12:6835. [PMID: 37959300 PMCID: PMC10650784 DOI: 10.3390/jcm12216835] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Although some clinical studies have claimed that low-dose vitamin D (Vit-D) increases the risk of long-term cardiac events, in others, no association was found. To better understand the impact of Vit-D levels on long-term cardiac events in coronary artery disease patients, this study was designed. There were 408 patients with coronary artery disease (CAD). The patients were separated into three groups based on their Vit-D levels: group 1 had levels below 10 ng/mL, group 2 had levels between 10 and 20, and group 3 had levels above 20 ng/mL. Six years were spent monitoring the patients for non-fatal MI, death, vascular revascularization, and stable course data. Mortality was found to be similar between groups (group 1: 24.5%; group 2: 13.8%; group 3: 17.4%; p > 0.05). In group 3, 47.8% of the patients did not experience any cardiac event, while 28.7% in group 2 and 27.6% in group 1 did not experience any cardiac event, and these values were found to be significant in favor of group 3 (p = 0.006). Group 3 was found to have considerably lower rates of non-ST-elevated myocardial infarction (non-STEMI) and unstable angina (UA) than the other groups did (group 1: 49%; group 2: 38%; group 3: 27%; p = 0.001). In conclusion, although vitamin D deficiency does not accompany an increase in mortality, it is associated with an increase in non-STEMI and UA in patients who have previously been diagnosed with CAD.
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Affiliation(s)
- Aysun Erdem Yaman
- Siyami Ersek Thoracic Surgery Research and Training Hospital, Department of Cardiology, 34668 Istanbul, Turkey
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Oinonen L, Tikkakoski A, Koskela J, Eräranta A, Kähönen M, Niemelä O, Mustonen J, Pörsti I. Parathyroid hormone may play a role in the pathophysiology of primary hypertension. Endocr Connect 2021; 10:54-65. [PMID: 33289696 PMCID: PMC7923049 DOI: 10.1530/ec-20-0446] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 12/03/2020] [Indexed: 12/15/2022]
Abstract
Parathyroid hormone has been related with the risk of hypertension, but the matter remains controversial. We examined the association of parathyroid hormone with central blood pressure and its determinants in 622 normotensive or never-treated hypertensive subjects aged 19-72 years without diabetes, cardiovascular or renal disease, or cardiovascular medications. The methods were whole-body impedance cardiography and analyses of pulse wave and heart rate variability. Cardiovascular function was examined in sex-specific tertiles of plasma parathyroid hormone (mean concentrations 3.0, 4.3 and 6.5 pmol/L, respectively) during head-up tilt. Explanatory factors for haemodynamics were further investigated using linear regression analyses. Mean age was 45.0 (s.d. 11.7) years, BMI 26.8 (4.4) kg/m2, seated office blood pressure 141/90 (21/12) mmHg, and 309 subjects (49.7%) were male. Only five participants had elevated plasma parathyroid hormone and calcium concentrations. Highest tertile of parathyroid hormone presented with higher supine and upright aortic diastolic blood pressure (P < 0.01) and augmentation index (P < 0.01), and higher upright systemic vascular resistance (P < 0.05) than the lowest tertile. The tertiles did not present with differences in pulse wave velocity, cardiac output, or measures of heart rate variability. In linear regression analyses, parathyroid hormone was an independent explanatory factor for aortic systolic (P = 0.005) and diastolic (P = 0.002) blood pressure, augmentation index (P = 0.002), and systemic vascular resistance (P = 0.031). To conclude, parathyroid hormone was directly related to central blood pressure, wave reflection, and systemic vascular resistance in subjects without cardiovascular comorbidities and medications. Thus, parathyroid hormone may play a role in the pathophysiology of primary hypertension.
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Affiliation(s)
- Lasse Oinonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Correspondence should be addressed to L Oinonen:
| | - Antti Tikkakoski
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
| | - Jenni Koskela
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Arttu Eräranta
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Mika Kähönen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Jukka Mustonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Ilkka Pörsti
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
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Liu D, Chen L, Dong S, Peng Z, Yang H, Chen Y, Li L, Zhou H, Zhou R. Bone mass density and bone metabolism marker are associated with progression of carotid and cardiac calcified plaque in Chinese elderly population. Osteoporos Int 2019; 30:1807-1815. [PMID: 31190121 DOI: 10.1007/s00198-019-05031-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 05/22/2019] [Indexed: 01/02/2023]
Abstract
UNLABELLED Osteoporosis and cardiovascular diseases often coexist in the same elderly individuals. Does this suggest some potential correlation between the two diseases? Low bone mass and change of bone biomarker are associated with a higher risk of carotid and cardiac calcification plaques. INTRODUCTION Bone mineral density (BMD) and bone metabolism marker may contribute to the progression of carotid and cardiac arterial calcifications. The aim of this study was to investigate whether low bone mass and the change of bone biomarker are associated with the prevalence of calcified atherosclerotic plaque in elderly Chinese. METHODS We conducted a five-year prospective study. BMD was measured by dual-energy X-ray absorptiometry scanning. Carotid and cardiac computed tomography angiography (CTA) was conducted using a 64-multidetector row scanner to assess carotid and cardiac arterial plaque at baseline and during follow-up. RESULTS Of 1571 community residents over 60 years of age, 184 (11.7%) subjects developed carotid calcified plaque, 510 (32.5%) subjects developed cardiac calcified plaque and 97 (6.2%) subjects developed co-existence calcified plaques in carotid and cardiac arteries. After adjustment for age and all relevant confounders, Q1, Q2 quartile of BMD, and osteoprotegerin (OPG), osteocalcin (OC), and C-terminal cross-linked telopeptide of type I collagen (CTX) were associated with increased risk of calcified plaques. CONCLUSION This study suggested that lower BMD and change of bone metabolism biomarker were associated with a higher risk of carotid and cardiac calcified plaque development.
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Affiliation(s)
- D Liu
- Trauma Center, Daping Hospital, Third Military Medical University, Chongqing, China
| | - L Chen
- Postgraduate School, Bengbu Medical College, Bengbu, 233004, Anhui, China
| | - S Dong
- Postgraduate School, Bengbu Medical College, Bengbu, 233004, Anhui, China
| | - Z Peng
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - H Yang
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Y Chen
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - L Li
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - H Zhou
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - R Zhou
- Department of Orthopedics, the Orthopedic Surgery Center of Chinese PLA, Southwest Hospital, Third Military Medical University, Chongqing, 400038, People's Republic of China.
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Norris KC, Edwina Barnett M, Meng YX, Martins D, Nicholas SB, Gibbons GH, Lee JE. Rationale and design of a placebo controlled randomized trial to assess short term, high-dose oral cholecalciferol on select laboratory and genomic responses in African Americans with hypovitaminosis D. Contemp Clin Trials 2018; 72:20-25. [PMID: 30012355 PMCID: PMC6133748 DOI: 10.1016/j.cct.2018.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 06/28/2018] [Accepted: 07/12/2018] [Indexed: 12/25/2022]
Abstract
Cardiovascular Disease (CVD) and related disorders remain a leading cause of health disparities and premature death for African Americans. Hypovitaminosis D is disproportionately prevalent in African Americans and has been linked to CVD and CVD risk factors including hypertension, diabetes and obesity. Thus, hypovitaminosis D may represent a common pathway influencing CV risk factors in a select subgroup of persons. The purpose of this paper is to report the study design of a prospective eight week prospective double-blind randomized, placebo-controlled trial (n = 330 allocated 2:1 to intervention vs. control) to assess the effect of placebo vs. high-dose oral cholecalciferol (100,000 IU vitamin D3 at baseline and week 2) on 6-week change of select biologic cardiometabolic risk factors (including parathyroid hormone to assess biologic activity, pro-inflammatory/pro-thrombotic/fibrotic markers, insulin sensitivity and vitamin D metabolites) and their relationship to vitamin D administration and modification by vitamin D receptor polymorphisms in overweight, hypertensive African Americans with hypovitaminosis D. Findings from this trial will present insights into potential causal links between vitamin D repletion and mechanistic pathways of CV disease, including established and novel genomic markers.
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Affiliation(s)
- Keith C Norris
- University of California Los Angeles, Los Angeles, CA, USA.
| | | | | | - David Martins
- Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | | | - Gary H Gibbons
- National Heart, Lung, and Blood Institute, Bethesda, MD. USA
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Apostolakis M, Armeni E, Bakas P, Lambrinoudaki I. Vitamin D and cardiovascular disease. Maturitas 2018; 115:1-22. [PMID: 30049340 DOI: 10.1016/j.maturitas.2018.05.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/22/2018] [Accepted: 05/30/2018] [Indexed: 02/01/2023]
Abstract
Vitamin D, a soluble steroid hormone synthesized in the skin after sun exposure, plays a crucial role in calcium metabolism and is also involved in cardiovascular pathophysiology. The aim of this review is to summarize the available evidence (a) on the association between endogenous vitamin D status and cardiovascular disease, and (b) on the effect of vitamin D supplementation on cardiovascular outcomes. Most studies have shown an inverse association between vitamin D levels and cardiovascular outcomes. Randomized controlled trials, however, do not consistently support a beneficial effect of vitamin D administration on cardiovascular health. Population characteristics, comorbid conditions such as diabetes, the overall population prevalence of cardiovascular disease, vitamin D status and the regimen of vitamin D supplementation may account for the conflicting results.
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Affiliation(s)
- Michail Apostolakis
- Menopause Clinic, 2nd Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Armeni
- Menopause Clinic, 2nd Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Bakas
- Menopause Clinic, 2nd Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Irene Lambrinoudaki
- Menopause Clinic, 2nd Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
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Independent effects of blood pressure and parathyroid hormone on aortic pulse wave velocity in untreated Chinese patients. J Hypertens 2018; 35:1841-1848. [PMID: 28445206 DOI: 10.1097/hjh.0000000000001395] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Whether or not calcium-regulating hormones stiffen arteries independent of blood pressure (BP) is uncertain. We investigated the independent associations of carotid-femoral pulse wave velocity (PWV) with 25-hydroxy-vitamin D [25(OH)D], parathyroid hormone (PTH) and 24-h ambulatory BP in untreated Chinese patients. METHODS Consecutive untreated patients referred for ambulatory BP monitoring were recruited. PWV was measured with a high-fidelity micromanometer and the SphygmoCor software (AtCor Medical, West Ryde, New South Wales, Australia). Serum 25(OH)D and PTH were determined by electrochemiluminescence immunoassay. Analysis of variance, single and multiple regressions were applied for analyses. RESULTS In 1052 untreated patients (50.7% women; mean age, 51 years), PWV averaged 7.8 m/s, 24-h SBP/DBP 126.5/81.7 mmHg, serum 25(OH)D and PTH 36.0 nmol/l and 61.6 pg/ml, respectively. In multivariable-adjusted analyses, BP (P < 0.001) and PTH (P = 0.012) increased from less than 25th to at least 75th percentile of the PWV distribution. In continuous analyses, PWV independently increased by 0.40/0.23 m/s per 1-SD increment in SBP/DBP (P < 0.001) and by 0.14 m/s for a doubling of serum PTH (P = 0.029). Associations of PWV with BP were tighter than with PTH (P < 0.001). In pathway analysis, the effect of PTH on PWV did not run via serum or urinary calcium (P = 0.65), but PTH had both a direct (P = 0.026) and a BP-mediated indirect effect (P = 0.043) on PWV. In none of our analyses were PWV associated with serum 25(OH)D. CONCLUSION Arterial stiffness, as assessed by PWV, independently increased both with BP and with PTH, but BP remains the main driver of arterial stiffening.
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Jenny NS, Olson NC, Allison MA, Rifkin DE, Daniels LB, de Boer IH, Wassel CL, Tracy RP. Biomarkers of Key Biological Pathways in CVD. Glob Heart 2018; 11:327-336.e3. [PMID: 27741979 DOI: 10.1016/j.gheart.2016.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 07/19/2016] [Accepted: 07/21/2016] [Indexed: 01/30/2023] Open
Abstract
This review provides background on the laboratory design for MESA (Multi-Ethnic Study of Atherosclerosis) as well as the approach used in MESA to select biomarkers for measurement. The research related to the multitude of circulating and urinary biomarkers of inflammation and other novel and emerging biological pathways in MESA is summarized by domain, or pathway, represented by the biomarker. The contributions of MESA biomarkers to our knowledge of these key pathways in the development and progression of atherosclerosis, cardiovascular disease, diabetes, kidney disease, and pulmonary disease are highlighted, as are the contributions of MESA to recommendations for clinical use of several of these biomarkers. In addition, contributions of MESA to multicohort genomics consortia and current collaborations in transomics and metabolomics are noted.
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Affiliation(s)
- Nancy Swords Jenny
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA.
| | - Nels C Olson
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA
| | - Matthew A Allison
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA, USA
| | - Dena E Rifkin
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA, USA
| | - Lori B Daniels
- Department of Medicine, Division of Cardiovascular Medicine, University of California, San Diego, CA, USA
| | - Ian H de Boer
- Kidney Research Institute, University of Washington, Seattle, WA, USA
| | - Christina L Wassel
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA
| | - Russell P Tracy
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA; Department of Biochemistry, University of Vermont College of Medicine, Burlington, VT, USA
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Grübler MR, März W, Pilz S, Grammer TB, Trummer C, Müllner C, Schwetz V, Pandis M, Verheyen N, Tomaschitz A, Fiordelisi A, Laudisio D, Cipolletta E, Iaccarino G. Vitamin-D concentrations, cardiovascular risk and events - a review of epidemiological evidence. Rev Endocr Metab Disord 2017; 18:259-272. [PMID: 28451877 DOI: 10.1007/s11154-017-9417-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Vitamin D has long been established as an elemental factor of bone physiology. Beyond mineral metabolism, the expression of the vitamin D receptor has been identified throughout the cardiovascular (CV) system. Experimental studies showed beneficial effects of vitamin D on heart and vessels, but vitamin D intoxication in animals also led to hypercalcemia and vascular calcification. Our knowledge has been extended by epidemiological studies that showed that 25-hydroxyvitamin D (25(OH)D) levels are inversely associated with an increased CV risk itself, but also with established CV risk factors, such as arterial hypertension, endothelial dysfunction and atherosclerosis. Conversely, randomized controlled trials could not document significant and consistent effects of vitamin D supplementation on CV risk or events. Potential explanations may lie in differences in reference ranges or the possibility that low vitamin D in CV disease is only an epiphenomenon. In the latter case, the key question is why low 25(OH)D levels are such a strong predictor of health. While we wait for new data, the current conclusion is that vitamin D is a strong risk marker for CV risk factors and for CV diseases itself.
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Affiliation(s)
- Martin Robert Grübler
- Swiss Cardiovascular Centre Bern, Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 8, 3010, Bern, Switzerland.
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.
| | - Winfried März
- Vth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, and Rheumatology), Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
- Synlab Academy, Synlab Services GmbH, and Augsburg, Mannheim, Germany
| | - Stefan Pilz
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, Netherlands
| | - Tanja B Grammer
- Mannheim Institute of Public Health, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
| | - Christian Trummer
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Christian Müllner
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Verena Schwetz
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Marlene Pandis
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Nicolas Verheyen
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Graz, Austria
| | - Andreas Tomaschitz
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Graz, Austria
- Bad Gleichenberg Clinic, Schweizereiweg 4, 8344, Bad Gleichenberg, Austria
| | | | | | - Ersilia Cipolletta
- Department of Medicine, Surgery Odontoiatrics-Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Guido Iaccarino
- Department of Medicine, Surgery Odontoiatrics-Scuola Medica Salernitana, University of Salerno, Salerno, Italy
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Lee JH, Suh HS. Association of Serum 25-hydroxy-vitamin D Concentration and Arterial Stiffness among Korean Adults in Single Center. J Bone Metab 2017; 24:51-58. [PMID: 28326301 PMCID: PMC5357612 DOI: 10.11005/jbm.2017.24.1.51] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 02/11/2017] [Accepted: 02/12/2017] [Indexed: 12/22/2022] Open
Abstract
Background There are growing concerns about the role of vitamin D deficiency in cardiovascular diseases. Therefore, we investigated the correlation between serum 25-hydroxy-vitamin D (25[OH]D) and arterial stiffness among Korean adults. Methods We retrospectively reviewed the medical charts of 302 people (115 women and 187 men) who visited a tertiary hospital from January 2015 to December 2016. Serum 25(OH)D was measured using the radioimmunoassay technique, and brachial-ankle pulse wave velocity (baPWV) was measured using an automatic wave analyzer. We obtained the doctor's report on the medical history of the participants, their alcohol consumption and smoking habits, and their exercise status. Metabolic syndrome was diagnosed based on guidelines from the National Cholesterol Education Program (NCEP)-Adult Treatment Panel (ATP III) and the International Diabetes Federation (IDF). Results of basic blood tests and physical assessment were also collected. Results In the Pearson correlation analysis, serum 25(OH)D and baPWV showed a statistically significant inverse relationship (r=-0.279, P<0.001). Using multiple regression analysis, and after adjusting for possible confounders, serum 25(OH)D concentration was found to be significantly associated with baPWV (β=-0.121, P=0.011). Conclusions We observed an association between serum 25(OH)D concentration and arterial stiffness. Further studies involving larger sample sizes will be needed to confirm this associations.
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Affiliation(s)
- Jung Hae Lee
- Department of Family Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Heuy Sun Suh
- Department of Family Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
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Abstract
The aorta is a blood vessel that provides a low-resistance path for blood flow directed from the heart to peripheral organs and tissues. However, the aorta has another central hemodynamic function, whereby the elastic nature of the aortic wall provides a significant biomechanical buffering capacity complementing the pulsatile cardiac blood flow, and this is often referred to as Windkessel function. Stiffening of the arterial wall leads to fundamental alterations in central hemodynamics, with widespread detrimental implications for organ function. In this Recent Highlights article, we describe recent contributions in ATVB that have highlighted the novel mechanisms and consequences of arterial stiffness and the clinical conditions in which arterial stiffness occurs, with a focus on advancements in the field.
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Affiliation(s)
- Alicia N. Lyle
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA, United States of America
| | - Uwe Raaz
- Molecular and Translational Vascular Medicine, Department of Cardiology and Pneumology, Heart Center at the University Medical Center Göttingen, Göttingen, Germany
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Gepner AD, Tedla Y, Colangelo LA, Tattersall MC, Korcarz CE, Kaufman JD, Liu K, Burke GL, Shea S, Greenland P, Stein JH. Progression of Carotid Arterial Stiffness With Treatment of Hypertension Over 10 Years: The Multi-Ethnic Study of Atherosclerosis. Hypertension 2016; 69:87-95. [PMID: 27849564 DOI: 10.1161/hypertensionaha.116.08402] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 09/22/2016] [Accepted: 10/19/2016] [Indexed: 01/23/2023]
Abstract
Associations with antihypertensive medication classes and progression of arterial stiffness have not been studied in a prospective multiethnic cohort. All participants had hypertension at baseline, defined as blood pressure ≥140/90 mm Hg or use of antihypertensive medications. Medication use and blood pressure were assessed at 5 time points. Young's elastic modulus and distensibility coefficient of the right common carotid artery were obtained by ultrasound at baseline and after a mean (SD) follow-up period of 9.4 (0.5) years. Associations with changes in Young's elastic modulus and distensibility coefficient, baseline antihypertensive medication use, number of visits each medication class was reported, and blood pressure control (<140/90 mm Hg) were assessed using multiple linear regression models. At baseline, mean age of participants (n=1206) was 63.2 (9.0) years (55% female; 35% African American, 19% Hispanic, 12% Chinese). Mean systolic blood pressure was 136.5 (20.6) mm Hg. Greater progression of arterial stiffness was associated with older age, African American ethnicity, and baseline calcium channel blocker use. There were no other associations between changes in Young's elastic modulus or distensibility coefficient and use of other medication classes (all P>0.4). Achieving blood pressure control (<140/90 mm Hg) at all visits was associated with slower progression of arterial stiffness (Young's elastic modulus: β=-790.1 mm Hg, P=0.01; distensibility coefficient: β=7.34×10-4 mm Hg-1, P=0.001). Blood pressure control, rather than use of any particular antihypertensive medication class, was associated most strongly with slowing arterial stiffness progression. Over nearly a decade of follow-up, no consistent associations between any specific antihypertensive medication class and progressive carotid arterial stiffening were identified.
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Affiliation(s)
- Adam D Gepner
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.)
| | - Yacob Tedla
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.)
| | - Laura A Colangelo
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.)
| | - Matthew C Tattersall
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.)
| | - Claudia E Korcarz
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.)
| | - Joel D Kaufman
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.)
| | - Kiang Liu
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.)
| | - Gregory L Burke
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.)
| | - Steven Shea
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.)
| | - Philip Greenland
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.)
| | - James H Stein
- From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.).
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Abstract
Vitamin D is a precursor of the steroid hormone calcitriol that is crucial for bone and mineral metabolism. Both the high prevalence of vitamin D deficiency in the general population and the identification of the vitamin D receptor in the heart and blood vessels raised interest in the potential cardiovascular effects of vitamin D. Experimental studies have demonstrated various cardiovascular protective actions of vitamin D, but vitamin D intoxication in animals is known to induce vascular calcification. In meta-analyses of epidemiological studies, vitamin D deficiency is associated with an increased cardiovascular risk. Findings from Mendelian randomization studies and randomized, controlled trials (RCTs) do not indicate significant effects of a general vitamin D supplementation on cardiovascular outcomes. Previous RCTs, however, were not adequately designed to address extraskeletal events, and did not focus on vitamin D-deficient individuals. Therefore, currently available evidence does not support cardiovascular benefits or harms of vitamin D supplementation with the commonly used doses, and whether vitamin D has cardiovascular effects in individuals with overt vitamin D deficiency remains to be evaluated. Here, we provide an update on clinical studies on vitamin D and cardiovascular risk, discuss ongoing vitamin D research, and consider the management of vitamin D deficiency from a cardiovascular health perspective.
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Kang JY, Kim MK, Jung S, Shin J, Choi BY. The cross-sectional relationships of dietary and serum vitamin D with cardiometabolic risk factors: Metabolic components, subclinical atherosclerosis, and arterial stiffness. Nutrition 2016; 32:1048-1056.e1. [PMID: 27179408 DOI: 10.1016/j.nut.2016.02.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/05/2016] [Accepted: 02/22/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE There has been increasing interest in non-skeletal interactions between vitamin D insufficiency, which is common, and cardiovascular event and cardiovascular disease (CVD) risk factors. METHODS To evaluate cross-sectional associations between dietary and serum vitamin D status and metabolic abnormalities and arterial changes among 1054 adults aged ≥40 y (404 men and 650 women) in a rural area of South Korea. Study subjects were divided into three groups according to dietary vitamin D intake (tertiles) measured by food frequency questionnaire and serum 25(OH)D levels (≤20, 21-29, and ≥30 ng/mL). Metabolic components (blood pressure, lipid profiles, and glycemic index) and arterial changes (brachial ankle pulse wave velocity [baPWV] and carotid artery intima-media wall thickness [cIMT]) were measured. RESULTS Dietary vitamin D was inversely associated with diastolic blood pressure (DBP) and baPWV among men, but the association disappeared after multinutrient supplement users were excluded. Among women, there was an inverse association between dietary vitamin D and triacylglycerol (TG) levels. However, serum 25(OH)D showed a significant positive relationship with HDL cholesterol in both men and women, while a positive linear trend or nonlinear trend with serum 25(OH)D levels was shown in TG levels among men and in systolic blood pressure (SBP), DBP, total cholesterol, and baPWV among women. The positive relationship between serum 25(OH)D with baPWV disappeared after adjustment for blood pressure. CONCLUSIONS Serum 25(OH)D may be favorably related to HDL cholesterol. However, serum 25(OH)D may not favorably related to subclinical atherosclerosis and arterial stiffness measured by cIMT and baPWV. The positive relationship between 25(OH)D and baPWV is likely to be mediated by blood pressure.
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Affiliation(s)
- Ji Yeon Kang
- Department of Preventive Medicine, College of Medicine, and Institute for Health and Society, Hanyang University, Seoul, Korea
| | - Mi Kyung Kim
- Department of Preventive Medicine, College of Medicine, and Institute for Health and Society, Hanyang University, Seoul, Korea.
| | - Sukyoung Jung
- Department of Preventive Medicine, College of Medicine, and Institute for Health and Society, Hanyang University, Seoul, Korea
| | - Jinho Shin
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea
| | - Bo Youl Choi
- Department of Preventive Medicine, College of Medicine, and Institute for Health and Society, Hanyang University, Seoul, Korea
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14
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Winckler K, Tarnow L, Lundby-Christensen L, Almdal TP, Wiinberg N, Eiken P, Boesgaard TW. Vitamin D, carotid intima-media thickness and bone structure in patients with type 2 diabetes. Endocr Connect 2015; 4:128-35. [PMID: 25956908 PMCID: PMC4463474 DOI: 10.1530/ec-15-0034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 04/30/2015] [Indexed: 12/21/2022]
Abstract
Despite aggressive treatment of cardiovascular disease (CVD) risk factors individuals with type 2 diabetes (T2D) still have increased risk of cardiovascular morbidity and mortality. The primary aim of this study was to examine the cross-sectional association between total (25-hydroxy vitamin D (25(OH)D)) and risk of CVD in patients with T2D. Secondary objective was to examine the association between 25(OH)D and bone health. A Danish cohort of patients with T2D participating in a randomised clinical trial were analysed. In total 415 patients (68% men, age 60±9 years (mean±s.d.), duration of diabetes 12±6 years), including 294 patients (71%) treated with insulin. Carotid intima-media thickness (IMT) and arterial stiffness (carotid artery distensibility coefficient (DC) and Young's elastic modulus (YEM)) were measured by ultrasound scan as indicators of CVD. Bone health was assessed by bone mineral density and trabecular bone score measured by dual energy X-ray absorptiometry. In this cohort, 214 patients (52%) were vitamin D deficient (25(OH)D <50 nmol/l). Carotid IMT was 0.793±0.137 mm, DC was 0.0030±0.001 mmHg, YEM was 2354±1038 mmHg and 13 (3%) of the patients were diagnosed with osteoporosis. A 25(OH)D level was not associated with carotid IMT or arterial stiffness (P>0.3) or bone health (P>0.6) after adjustment for CVD risk factors. In conclusion, 25(OH)D status was not associated with carotid IMT, arterial stiffness or bone health in this cohort of patients with T2D. To explore these associations and the association with other biomarkers further, multicentre studies with large numbers of patients are required.
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Affiliation(s)
- Karoline Winckler
- Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark
| | - Lise Tarnow
- Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark
| | - Louise Lundby-Christensen
- Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark
| | - Thomas P Almdal
- Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark
| | - Niels Wiinberg
- Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark
| | - Pia Eiken
- Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark
| | - Trine W Boesgaard
- Department of CardiologyNephrology and EndocrinologyDepartment of ResearchNordsjaellands Hospital, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hilleroed, DenmarkInstitute of Clinical StudiesUniversity of Aarhus, Aarhus, DenmarkClinical Research UnitSteno Diabetes Center, Gentofte, DenmarkDepartment of PaediatricsHvidovre Hospital, Copenhagen University Hospital, Hvidovre, DenmarkDepartment of MedicineCopenhagen University Hospital, Gentofte, DenmarkDepartment of Physiology and Nuclear MedicineFrederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, DenmarkInstitute of Clinical MedicineUniversity of Copenhagen, Copenhagen, Denmark
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15
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Goettsch C, Iwata H, Aikawa E. Parathyroid hormone: critical bridge between bone metabolism and cardiovascular disease. Arterioscler Thromb Vasc Biol 2014; 34:1333-5. [PMID: 24951650 DOI: 10.1161/atvbaha.114.303637] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Claudia Goettsch
- From the Center for Interdisciplinary Cardiovascular Sciences (C.G., H.I., E.A.) and Center for Excellence in Vascular Biology (E.A.), Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Hiroshi Iwata
- From the Center for Interdisciplinary Cardiovascular Sciences (C.G., H.I., E.A.) and Center for Excellence in Vascular Biology (E.A.), Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Elena Aikawa
- From the Center for Interdisciplinary Cardiovascular Sciences (C.G., H.I., E.A.) and Center for Excellence in Vascular Biology (E.A.), Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
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