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25‐Hydroxyvitamin D concentrations and risk of venous thromboembolism in the general population with 18 791 participants
Author(s) -
BrøndumJacobsen P.,
Benn M.,
TybjærgHansen A.,
Nordestgaard B. G.
Publication year - 2013
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/jth.12118
Subject(s) - medicine , vitamin d and neurology , antithrombotic , body mass index , population , confidence interval , incidence (geometry) , venous thromboembolism , relative risk , proportional hazards model , thrombosis , physics , environmental health , optics
Summary Background Vitamin D has potential antithrombotic effects, suggesting that vitamin D analogs could be used as adjunctive antithrombotic agents. However, epidemiologic evidence of an association between reduced 25‐hydroxyvitamin D concentrations and the risk of venous thromboembolism is lacking. Objectives To test the hypothesis that reduced plasma 25‐hydroxyvitamin D concentrations are associated with an increased risk of venous thromboembolism in the general population. Methods We prospectively studied 18 791 participants from the C openhagen C ity H eart S tudy and the C openhagen G eneral P opulation S tudy. During up to 30 years of follow‐up, 950 participants were diagnosed with venous thromboembolism. Plasma 25‐hydroxyvitamin D concentrations were adjusted for seasonal variation. Results The cumulative incidence of venous thromboembolism as a function of age increased with decreasing tertiles of seasonally adjusted plasma 25‐hydroxyvitamin D (log‐rank trend: P = 4 × 10 −4 ). On comparison of participants in the lowest and the highest tertile of plasma 25‐hydroxyvitamin D concentrations, the crude risk estimate in a model adjusted for age and sex was a 37% (95% confidence interval [CI] 15–64%) increased risk of venous thromboembolism. The corresponding risk increase in a model adjusted for age, sex, body mass index, smoking and cancer was 26% (95% CI 5–51%), and in a multivariable‐adjusted model also including physical activity, hormone replacement therapy, menopausal status, oral contraception use and lipid‐lowering therapy it was 28% (95% CI 6–53%). Furthermore, corresponding risk increases with attempts to correct for regression dilution bias were 103% (95% CI 37–202%), 70% (95% CI 14–155%) and 73% (95% CI 15–160%) in the three models, respectively. Conclusion In these large general population studies, we observed a stepwise increasing risk of venous thromboembolism with decreasing tertiles of seasonally adjusted plasma 25‐hydroxyvitamin D concentrations.