Abstract P212: The Association Between Serum Vitamin D and Valvular Calcification in the Multi-Ethnic Study of Altherosclerosis

Abstract

Background: Serum 25-hydroxyvitamin D [25(OH)D] levels have been identified as a possible modifiable risk factor for cardiovascular disease (CVD) but the association may not be linear. Whether 25(OH)D is associated with valvular calcification is unknown. We examined the association of 25(OH)D with Aortic Valve Calcification (AVC) and Mitral Annular Calcification (MAC) in a multi-ethnic cohort. We hypothesized that both deficient and excess 25(OH)D levels are associated with increased calcification (i.e. U-shaped distribution of risk). Methods: We studied 5,392 MESA participants who had 25(OH)D levels and a cardiac CT performed at baseline (2000-2002) and a follow-up CT scan at the 2 nd or 3rd Exam. AVC and MAC were quantified by the Agatston score. Using relative risk regression, we evaluated the multivariable adjusted risk of prevalent and incident AVC and MAC by 25(OH)D quintiles with median quintile as reference. Results: The mean age of participants was 62 ±10 yrs; 53% were women and 26% black. Prevalent AVC and MAC were observed in 12% and 9%, respectively. There was no statistically significant association between 25(OH)D and prevalent AVC or MAC in cross-sectional analyses. Over a mean follow-up of 2.5 yrs, 4.1% developed incident AVC and 4.5% developed incident MAC. After adjusting for demographic variables, the 5 th quintile of 25(OH)D was associated with a 33% [RR 0.67 (95% CI 0.45, 0.99)] lower risk of incident MAC compared to the 3 rd quintile. However, this association was no longer significant after adjusting for lifestyle and CVD risk factors [ TABLE ]. There was no association of 25(OH)D with incident AVC [0.89 (0.59, 1.36) for 5 th vs. 3 rd quintile, Model 1]. Conclusion: Low 25(OH)D levels were not associated with increased likelihood of prevalent valvular calcification. Higher 25(OH)D were associated with reduced risk of incident MAC independent of demographics, but not with incident AVC. In sum, 25(OH)D may be associated with progression of mitral calcification, but future studies with longer follow-up are needed.