8/13/2019 Vitamin D Levels and Mortality in Metabolic Syndrome

http://slidepdf.com/reader/full/vitamin-d-levels-and-mortality-in-metabolic-syndrome 1/6

Vitamin D Levels and

Mortality in MetabolicSyndrome10/3/2012

Gregory A. Plotnikoff, MD, MTS, FACP

 In people with metabolic syndrome, vitamin D levels

 predict all-cause and cardiovascular mortality

Wednesday, October 03, 2012

by: Gregory A. Plotnikoff, MD, MTS, FACP

Section: Abstracts & Commentary

Print  Send

+6 Recomende isto no Google

Tweet 

9This page has been shared 9 times. View these Tweets.

Share

About the Author

8/13/2019 Vitamin D Levels and Mortality in Metabolic Syndrome

http://slidepdf.com/reader/full/vitamin-d-levels-and-mortality-in-metabolic-syndrome 2/6

Gregory A. Plotnikoff, !, "#, $ACP, is a board-certified internist andediatrician !ho has recei"ed international honors for his !ork in cross-c#lt#ral and integrati"e $edicine. %e is a grad#ate of Carleton College,%ar"ard Di"inity School, and the &ni"ersity of Minnesota Medical School.Plotnikoff is the a#thor of '( te)tbook chaters and $ore than *+ first-a#thored articles in the $edical literat#re incl#ding se"eral in aanese. %is'++ article on "ita$in D and chronic ain is one of the $ost highly citedarticles in the history of the Mayo Clinic Proceedings. %e is a Fello! of the&nited States-aan Fo#ndation eadershi rogra$, the /#sh Fo#ndationeadershi Progra$, and the A$erican College of Physicians. Plotnikoffser"es as an integrati"e $edicine hysician at the Penny George 0nstit#te for%ealth and %ealing and as senior cons#ltant, Center for %ealthcare0nno"ation, Allina %ealth Care, Minneaolis, Minn. %e is also an editor of thene! 1o#rnal Global Advances in Health and Medicine.

8/13/2019 Vitamin D Levels and Mortality in Metabolic Syndrome

http://slidepdf.com/reader/full/vitamin-d-levels-and-mortality-in-metabolic-syndrome 3/6

8/13/2019 Vitamin D Levels and Mortality in Metabolic Syndrome

http://slidepdf.com/reader/full/vitamin-d-levels-and-mortality-in-metabolic-syndrome 4/6

2eferenceTho$as G3, %artaigh /4, /osch A, et al. 5ita$in D le"els redict all-ca#seand cardio"asc#lar disease $ortality in s#b1ects !ith $etabolic syndro$e:The #d!igshafen 2isk and Cardio"asc#lar health 6&20C7 st#dy. Diabetes

Care. '+('8*:((*9-((;. 

Design

Prosecti"e cohort st#dy of (,9+( !hite eole in so#th!est Ger$any !ith$etabolic syndro$e !ho #nder!ent electi"e coronary angiograhy bet!een(<<= and '+++. Mortality !as tracked for a $edian of =.= years 6(',*(;erson-years of follo!-#7. 

Methodse"els of '*-4%-"ita$in D !ere obtained the $orning of the angiograhicroced#re and $eas#red by radioi$$#noassay 6DiaSorin7. Classification ofdeath !as erfor$ed #sing reorts on death certificates. Particiants !erecategori>ed based on the follo!ing definitions: oti$al 6? =* n$ol@ , ?+ng@$l 7, ins#fficient 6*+=;.<< n$ol@, '+'<.<< ng@$l7, $oderate deficiency

6'*;<.<< n$ol@, (+(<.<< ng@$l7, or se"ere deficiency 6B'* n$ol@, B(+ng@$l7. Metabolic syndro$e !as defined er the '++< international consens#s

8/13/2019 Vitamin D Levels and Mortality in Metabolic Syndrome

http://slidepdf.com/reader/full/vitamin-d-levels-and-mortality-in-metabolic-syndrome 5/6

state$ent.

ey Findings4f all (,9+( articiants, only 9 had le"els greater than + ng@$l. E#allys#rrising, ;'.9 had le"els bet!een (+ and '+ ng@$l, and ''.' had le"els

less than (+ ng@$l. 0n this !hite, Ger$an 6$edically ins#red7 o#lation, only' reorted taking any "ita$in s#le$ents at all.

The res#lts de$onstrated a ser#$ le"eldeendent red#ction in all-ca#se$ortality 6P B+.++( for trend7 !ith a =* red#ction in the ha>ard ratio in thearticiants !ith oti$al "ita$in D le"els relati"e to those !ith se"eredeficiency after f#ll ad1#st$ent 6%2: +.'*8 <* C0: +.(+.;7. The res#ltsalso de$onstrated a ser#$ le"eldeendent red#ction in cardio"asc#lar$ortality P B+.++( for trend8 %2: +. 6+.(+.7H. 2isk red#ction incl#dedthat by s#dden death 6PB+.++; for trend, %2: +.(*8 <* C0: +.+;+.7 and

congesti"e heart fail#re %2: +.'; 6+.+(.+;7H.

The res#lts did not change $arkedly after re$o"ing articiants !ith tye 00diabetes or glo$er#lar filtration rates B+ $l@$in@(.= $'. The res#lts did notchange !ith seasonality 6s#$$er@!inter7 nor !ith self-reorted acti"ity le"els.The res#lts did not change significantly !hen eli$inating fro$ the analysisany articiant !ho died !ithin ' years of follo!-#. 

Clinical 0$licationsThis st#dyIs rob#st findings confir$ the strong association of lo! "ita$in Dstat#s !ith increased risk of both all-ca#se and cardio"asc#lar $ortality

reorted in $#ltile re"io#s st#dies fro$ other large databases, incl#dingthose of the Centers for Disease Control and Pre"ention CDC 63ational%ealth and 3#trition E)a$ination S#r"ey7 and of 0nter$o#ntain %ealth 6&tah7.

The strengths of this st#dy incl#de the large n#$bers, the biologicalla#sibility of lo! "ita$in D for ad"erse health conse#ences, and thestrength of the association e"en !hen considering significant confo#nders.The o#lation tested 6!hite, ins#red, #ndergoing electi"e angiograhy7 is#ni#e for e)isting large databases. 4ne !o#ld e)ect this o#lation to ha"e$#ch higher "ita$in D le"els.

More than * of the articiants had "ita$in D le"els belo! the '+(+0nstit#te of Medicine 604M7 lo! standard Jnor$alK of '+ ng@$l. Please notethat in '+(( the Endocrine Society reco$$ended achie"e$ent of a ser#$le"el of ;++ ng@$l.( 4nly 9 of the (,9+( articiants achie"ed a le"elgreater than + ng@$l. This $eans that a rather $inisc#le n#$ber ofarticiants achie"ed the reco$$ended le"el of ;+ ng@$l.

A key point for all future studies: Dosing

does not matter. What counts is the serum

8/13/2019 Vitamin D Levels and Mortality in Metabolic Syndrome

http://slidepdf.com/reader/full/vitamin-d-levels-and-mortality-in-metabolic-syndrome 6/6