據(jù)7月10日發(fā)表在《美國(guó)醫(yī)學(xué)會(huì)雜志》上的一則研究披露,，在一個(gè)多族裔的成人組中，白人及華裔參與者的血清25 - 羥維生素D濃度低與冠心病事件風(fēng)險(xiǎn)的增加有關(guān)，但在黑人或西語(yǔ)裔中則不存在這種關(guān)系；這些結(jié)果表明,，維生素D補(bǔ)充劑的風(fēng)險(xiǎn)和裨益應(yīng)該在各種族與族裔中進(jìn)行仔細(xì)的評(píng)估,。
“大多數(shù)的有關(guān)25 - 羥維生素D（25[OH] D）與冠心病（CHD）風(fēng)險(xiǎn)的研究所檢查的是大體或完全由白人參與者組成的人群。這些研究的結(jié)果常常被類推至多種族人群。這樣做可能是不恰當(dāng)?shù)模驗(yàn)榫S生素D代謝和循環(huán)中的25（OH）D濃度會(huì)因?yàn)榉N族/族裔而有很大的差別,。”
華盛頓大學(xué)西雅圖分校的Cassianne Robinson-Cohen, Ph.D.及其同事在一個(gè)大型的、基于社區(qū)的多族裔成年人群中對(duì)血清25(OH)D濃度與事件性CHD發(fā)作之間的關(guān)系進(jìn)行了檢查,。該分析中包括了參與多族裔動(dòng)脈粥樣硬化研究（MESA）的6436位參與者,，他們是在2000年7月至2002年9月間被招募的。研究人員檢測(cè)了基線血清25(OH)D濃度,，而25(OH)D與判定的CHD事件的關(guān)系的評(píng)估一直持續(xù)到2012年5月,。判定的CHD事件被定義為心肌梗塞（心臟病發(fā)作）、心絞痛,、心臟驟停,，或CHD死亡。
在本研究開始的時(shí)候,，參與者的平均年齡為62歲,，其中53%為婦女。血清25(OH)D平均濃度隨著種族/族裔的不同而有相當(dāng)大的變化,。在中位數(shù)（中點(diǎn)）為8.5年的隨訪中,，有361位參與者出現(xiàn)過一次CHD事件。
研究人員發(fā)現(xiàn)25(OH)D與CHD風(fēng)險(xiǎn)之間的關(guān)系會(huì)因種族/族裔而存在明顯的異質(zhì)性,。在白人參與者中,，血清25(OH)D濃度較低與CHD風(fēng)險(xiǎn)的顯著增高有關(guān)系，25(OH)D濃度每降低10 ng/mL,，其風(fēng)險(xiǎn)會(huì)增加26%,；而在華裔參與者中,，其風(fēng)險(xiǎn)會(huì)增加67%。“然而,，沒有證據(jù)顯示在黑人或西語(yǔ)裔中有這種關(guān)系,。”
“我們的研究表明，維生素D補(bǔ)充劑的風(fēng)險(xiǎn)和裨益應(yīng)該在各個(gè)種族及族裔中進(jìn)行仔細(xì)評(píng)估,，而正在進(jìn)行中的維生素D臨床試驗(yàn)的結(jié)果應(yīng)該謹(jǐn)慎地運(yùn)用于非白人的個(gè)體,。”（生物谷 Bioon.com）
生物谷推薦的英文摘要
JAMA doi:10.1001/jama.2013.7228
Racial Differences in the Association of Serum 25-Hydroxyvitamin D Concentration With Coronary Heart Disease Events
Cassianne Robinson-Cohen, PhD1; Andrew N. Hoofnagle, MD, PhD2; Joachim H. Ix, MD, MAS3; Michael C. Sachs, PhD1; Russell P. Tracy, PhD4; David S. Siscovick, MD, MPH5; Bryan R. Kestenbaum, MD, MS1,6; Ian H. de Boer, MD, MS1,6
Importance Low circulating concentrations of 25-hydroxyvitamin D (25[OH]D) have been consistently associated with an increased risk of coronary heart disease (CHD) in white populations. This association has not been rigorously evaluated in other races or ethnicities, in which the distributions of 25(OH)D concentration and possibly other aspects of 25(OH)D metabolism differ.
Objective To examine the association of serum 25(OH)D concentration with risk of CHD in a multiethnic population.
Design, Setting, and Participants We studied 6436 participants in the Multi-Ethnic Study of Atherosclerosis (MESA), recruited from July 2000 through September 2002, who were free of known cardiovascular disease at baseline. We measured baseline serum 25(OH)D concentrations using a mass spectrometry assay calibrated to established standards. We tested associations of 25(OH)D with adjudicated CHD events assessed through May 2012.
Main Outcome and Measures Primary outcome measure was time to first adjudicated CHD event, defined as myocardial infarction, angina, cardiac arrest, or CHD death.
Results During a median follow-up of 8.5 years, 361 participants had an incident CHD event (7.38 events per 1000 person-years). Associations of 25(OH)D with CHD differed by race/ethnicity (P for interaction < .05). After adjustment, lower 25(OH)D concentration was associated with a greater risk of incident CHD among participants who were white (n = 167 events; hazard ratio [HR], 1.26 [95% CI, 1.06-1.49] for each 10-ng/mL decrement in 25(OH)D) or Chinese (HR, 1.67 [95% CI, 1.07-2.61]; n = 27). In contrast, 25(OH)D was not associated with risk of CHD in participants who were black (HR, 0.93 [95% CI, 0.73-1.20]; n = 94) or Hispanic (HR, 1.01 [95% CI, 0.77-1.33]; n = 73).
Conclusions and Relevance Lower serum 25(OH)D concentration was associated with an increased risk of incident CHD events among participants who were white or Chinese but not black or Hispanic. Results evaluating 25(OH)D in ethnically homogeneous populations may not be broadly generalizable to other racial or ethnic groups.
