Adult heart problems 2 X more likely low vitamin D 23 years earlier
Childhood 25-hydroxy-vitamin D levels predict early cardiovascular outcomes in adulthood: the Cardiovascular Risk in Young Finns Study
European Journal of Preventive Cardiology, zwaf271, https://doi.org/10.1093/eurjpc/zwaf271
Jussi Niemelä , Tomi T Laitinen , Joel Nuotio , Katja Pahkala , Suvi Rovio , Jorma Viikari , Mika Kähönen , Terho Lehtimäki , Britt-Marie Loo , Tomi P Laitinen
Observational studies among adults have suggested that low serum vitamin D levels are related to increased cardiovascular events.1 We have previously shown that low childhood vitamin D levels associate with increased adult carotid artery intima-media thickness,2 a phenotype strongly associated with conventional risk factors. However, whether low vitamin D levels in childhood predict adult-onset cardiovascular events is unknown. Therefore, we describe the relationship between low childhood vitamin D levels and adult-onset atherosclerotic cardiovascular disease (ASCVD) events.
Subjects (n = 3516) were participants of the prospective cardiovascular risk in Young Finns study with serum concentrations of 25-hydroxy (OH) vitamin D measured in 2010 from stored frozen samples collected in 1980 when aged 3–18 years.2 Conventional childhood risk factors such as body mass index (BMI), LDL cholesterol, HDL cholesterol, triglycerides, systolic blood pressure, consumptions of fruits, vegetables and fish, physical activity, socioeconomic status, and smoking were measured.2 Linkages to national registries covering all Finnish citizens, including the Care Register for Health Care and the National Death Index, were used to ascertain ASCVD outcomes.3 The Cox proportional hazard model was used to analyse the associations of varying cut points of low childhood 25-OH-vitamin D levels and adult ASCVD events, adjusted for age, sex, and childhood risk factors. There was no apparent sex ∗ childhood vitamin D interaction (P = 0.22 for interaction term). Analyses were performed using SAS software version 9.4. Statistical significance was inferred at a two-tailed P-value of <0.05. All participants and/or their legal guardians gave written informed consent, and the study was conducted in compliance with the Declaration of Helsinki and approved by the Joint Commission on Ethics of the University of Turku and the Turku University Central Hospital.
The baseline age of the participants was 10.5 ± 5.0 years, and 50.9% of the participants were females. In childhood, mean BMI was 17.9 ± 3.1 kg/m2, and mean 25-OH-vitamin D concentration was 51.3 ± 15.4 nmol/L. By 2018, 95 individuals (2.7%) had been diagnosed with ≥1 ASCVD event.4 The median age at first ASCVD events was 47 years (range 31–56 years).3 Table 1 (Model A) shows baseline age- and sex-adjusted hazard ratios for adulthood ASCVD events according to different childhood 25-OH-vitamin D level cut points. Significant associations were found using cut points of 37, 35, 33, and 31 nmol/L. The results were similar in a multivariable model further adjusted for multiple conventional childhood factors (Table 1, Model B ). These findings remained essentially similar after propensity score matching, adjustment for adult vitamin D levels or when using vitamin D deficiency (i.e. <30 nmol/L) as a cut point (data not shown).
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