TY - JOUR
T1 - Modifiers of plasma 25-hydroxyvitamin D and chronic kidney disease outcomes in black Americans
T2 - The jackson heart study
AU - Lunyera, Joseph
AU - Davenport, Clemontina A.
AU - Pendergast, Jane
AU - Musani, Solomon K.
AU - Bhavsar, Nrupen A.
AU - Sims, Mario
AU - Mwasongwe, Stanford
AU - Wolf, Myles
AU - Diamantidis, Clarissa J.
AU - Ebony Boulware, L.
AU - Scialla, Julia J.
N1 - Funding Information:
Financial Support: The JHS is supported and conducted in collaboration with Jackson State University (HHSN268201300049C and HHSN268201300050C), Tou-galoo College (HHSN268201300048C), and the University of Mississippi Medical Center (HHSN268201300046C and HHSN268201300047C) contracts from the National Heart, Lung, and Blood Institute (NHLBI) and the National Institute for Minority Health and Health Disparities (NIMHD). Additional support for this work was provided by National Institutes of Health Grant R01DK111952 (to J.J.S.) and Duke O’Brien Center for Kidney Research Grants P30DK096493 and UL1TR001117 (to C.A.D.) from the National Center for Advancing Translational Sciences. A preliminary version of this work was reported in abstract form at the American Society of Nephrology Annual Kidney Week in November 2017. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institutes of Health; or the US Department of Health and Human Services.
Publisher Copyright:
© 2019 Endocrine Society
PY - 2019/6/1
Y1 - 2019/6/1
N2 - Background: 25-hydroxyvitamin D [25(OH)D] is lower in black compared with white Americans but is not consistently associated with outcomes in this group, possibly due to genetic and other biological differences. We examined the association of plasma 25(OH)D and renal outcomes in black Americans with a focus on effect modifiers. Methods: We studied associations between baseline 25(OH)D with (i) annual rate of estimated glomerular filtration rate (eGFR) decline and (ii) incident chronic kidney disease (CKD) in the Jackson Heart Study, a prospective cohort of black Americans. Plasma 25(OH)D levels were corrected for monthly variation in sunlight exposure using the residual method. We used adjusted generalized linear models to evaluate outcomes and assessed potential effect modification by diabetes mellitus, vitamin D binding protein (DBP) genotype, obesity, dietary sodium intake, and use of renin-angiotensin-aldosterone system inhibitors. Results: Among 5164 participants with 25(OH)D available, plasma 25(OH)D was 14.5 6 6.5 ng/mL (mean 6 SD), and eGFR was 94.1 6 22.0 mL/min/1.73 m2. Over a median of 8 years, eGFR decline was 1.3 6 2.0 mL/min/1.73 m2 per year in 3228 participants with complete data, and 220 out of 1803 eligible participants developed incident CKD. Overall, 25(OH)D was not associated with eGFR decline in fully adjusted models. However, higher 25(OH)D was associated with slower eGFR decline among those with diabetes: each 5 ng/mL higher 25(OH)D was associated with a 0.27 mL/ min/1.73 m2/y slower eGFR decline (95% CI, 0.13 to 0.41; P, 0.001). Higher 25(OH)D was not associated with incident CKD overall, but it was associated with lower odds of incident CKD among participants with the GG or GT genotype at rs7041 in the gene encoding DBP [OR, 0.69 per 5 ng/mL higher 25(OH)D; 95% CI, 0.51 to 0.93; P-interaction = 0.005]. Other interactions were not significant. Conclusion: These findings support a potential benefit of higher 25(OH)D for kidney health in black Americans with diabetes or specific variants in DBP.
AB - Background: 25-hydroxyvitamin D [25(OH)D] is lower in black compared with white Americans but is not consistently associated with outcomes in this group, possibly due to genetic and other biological differences. We examined the association of plasma 25(OH)D and renal outcomes in black Americans with a focus on effect modifiers. Methods: We studied associations between baseline 25(OH)D with (i) annual rate of estimated glomerular filtration rate (eGFR) decline and (ii) incident chronic kidney disease (CKD) in the Jackson Heart Study, a prospective cohort of black Americans. Plasma 25(OH)D levels were corrected for monthly variation in sunlight exposure using the residual method. We used adjusted generalized linear models to evaluate outcomes and assessed potential effect modification by diabetes mellitus, vitamin D binding protein (DBP) genotype, obesity, dietary sodium intake, and use of renin-angiotensin-aldosterone system inhibitors. Results: Among 5164 participants with 25(OH)D available, plasma 25(OH)D was 14.5 6 6.5 ng/mL (mean 6 SD), and eGFR was 94.1 6 22.0 mL/min/1.73 m2. Over a median of 8 years, eGFR decline was 1.3 6 2.0 mL/min/1.73 m2 per year in 3228 participants with complete data, and 220 out of 1803 eligible participants developed incident CKD. Overall, 25(OH)D was not associated with eGFR decline in fully adjusted models. However, higher 25(OH)D was associated with slower eGFR decline among those with diabetes: each 5 ng/mL higher 25(OH)D was associated with a 0.27 mL/ min/1.73 m2/y slower eGFR decline (95% CI, 0.13 to 0.41; P, 0.001). Higher 25(OH)D was not associated with incident CKD overall, but it was associated with lower odds of incident CKD among participants with the GG or GT genotype at rs7041 in the gene encoding DBP [OR, 0.69 per 5 ng/mL higher 25(OH)D; 95% CI, 0.51 to 0.93; P-interaction = 0.005]. Other interactions were not significant. Conclusion: These findings support a potential benefit of higher 25(OH)D for kidney health in black Americans with diabetes or specific variants in DBP.
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U2 - 10.1210/jc.2018-01747
DO - 10.1210/jc.2018-01747
M3 - Article
C2 - 30668751
AN - SCOPUS:85065561379
VL - 104
SP - 2267
EP - 2276
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 6
ER -