Vitamin D Intervention and Atherosclerosis Progression in African American Women

非洲裔美国女性的维生素 D 干预和动脉粥样硬化进展

• 批准号: 8534252
• 负责人: Howard Neil Hodis
• 金额: $ 35.89万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-21 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8534252
• 关键词: 25-hydroxyvitamin D; Address; Affect; African American; Age; Ancillary Study; Antiatherogenic; Atherosclerosis; Biological; Biological Availability; Blood Pressure; Cardiovascular Diseases; Carotid Arteries; Cholecalciferol; Clinical; Common carotid artery; Complex; Data; Double-Blind Method; Elasticity; Elderly; Glucose; Goals; Hypertension; Image; Incidence; Individual; Intervention; Link; Measures; Mediating; Mortality Decline; Obesity; Osteoporosis prevention; Outcome; Parents; Placebos; Population; Public Health; Randomized; Randomized Controlled Trials; Relative (related person); Research Design; Risk; Risk Factors; Serum; Skin; Skin Pigmentation; Sun Exposure; Supplementation; Thick; Ultrasonography; United States; Vitamin D; Vitamin D Deficiency; Woman; aging population; cardiovascular disorder prevention; cardiovascular disorder risk; clinical practice; cohort; cost; digital imaging; double-blind placebo controlled trial; ethnic difference; human old age (65+); image processing; intima media; men; mortality; placebo controlled study

DESCRIPTION (provided by applicant): Cardiovascular disease (CVD) remains the number 1 killer of women in the United States (US). Importantly, CVD mortality of African American women exceeds that of white women and although the rates of CVD mortality are declining overall in men and women, they are declining most slowly in African American women. As the US population ages and lives longer the incidence of CVD will become a disproportionately greater problem for African American women. The explanation for ethnic differences in CVD risk is multifactorial and complex with insufficiency of vitamin D providing a provocative and testable hypothesis as a possible link between CVD risk factors (particularly hypertension in African Americans) and increased risk of atherosclerosis in African Americans. The possibility of a causal link between vitamin D deficiency and CVD is supported by many studies as well as strong biological plausibility. Given the aging population and rapidly increasing incidence of obesity, vitamin D insufficiency is becoming an increasingly important public health issue that may contribute to CVD. This may be particularly relevant for African American women, who are at particular risk for CVD since increased skin pigmentation reduces the capacity of skin to synthesize vitamin D and due to decreased bioavailability of vitamin D in obesity, which disproportionately affects African American women. Although data suggest a possible beneficial effect of vitamin D supplementation in reducing CVD, a direct anti- atherogenic effect from randomized controlled trials is limited. The goal of this proposal is to integrate an ancillary stuy of atherosclerosis imaging into the parent trial, "Vitamin D and Osteoporosis Prevention in Elderly African Americans," a 4-year, randomized, double-blind, placebo-controlled study designed to investigate the effect of vitamin D status in elderly African American women. 250 African American women >65 years old with serum 25-hydroxyvitamin D (25(OH)D) levels greater than 20 nmol/L but less than 65 nmol/L will be randomized to sufficient vitamin D3 supplementation once daily to raise serum 25(OH)D levels to between 75 nmol/L and 172 nmol/L versus placebo. The effect of vitamin D3 supplementation on the progression of subclinical carotid artery atherosclerosis measured as the rate of change of common carotid artery (CCA) intima-media thickness (IMT) and change of CCA stiffness (distensibility, elasticity and compliance) in computer image processed B-mode ultrasonograms will be determined. This ancillary study provides the opportunity to cost-effectively address whether vitamin D supplementation reduces the progression of atherosclerosis, specifically in an understudied unique cohort of elderly African American women.

描述（由申请人提供）：心血管疾病（CVD）仍然是美国妇女（美国）的第1名杀手。重要的是，非裔美国人妇女的CVD死亡率超过了白人妇女的死亡率，尽管男性和女性的CVD死亡率总体上下降了，但在非裔美国人妇女中，她们的下降速度最大。随着美国人口的年龄和寿命更长，对于非裔美国妇女来说，CVD的发生率将成为一个不成比例的问题。 CVD风险中种族差异的解释是多因素和复杂的，维生素D不足，提供了一种挑衅和可检验的假设，这是CVD危险因素（尤其是非裔美国人的高血压）之间的可能联系，而非裔美国人的动脉粥样硬化风险增加。许多研究以及强大的生物学合理性支持维生素D缺乏症与CVD之间因果关系的可能性。鉴于人口老龄化并迅速增加了肥胖的发生率，维生素D的不足正成为可能导致CVD的越来越重要的公共卫生问题。这可能与非洲裔美国妇女特别相关，非裔美国妇女特别有CVD的风险，因为增加了皮肤色素沉着会降低皮肤合成维生素D的能力，并且由于肥胖症中维生素D的生物利用度降低，这对肥胖症中的生物利用度降低，这对非裔美国妇女产生了不成比例的影响。尽管数据表明补充维生素D在减少CVD中可能产生有益作用，但随机对照试验的直接抗动脉粥样硬化作用受到限制。该提案的目的是将动脉粥样硬化成像的辅助Stuy纳入父母试验：“维生素D和骨质疏松症预防老年人美国人”，这是一项为期4年，随机，双盲，安慰剂对照的研究，旨在研究维生素D地位在非洲非裔美国人老年人中的影响。 250名非洲裔美国妇女> 65岁，血清25-羟基维生素D（25（OH）D）水平大于20 nmol/l，但小于65 nmol/l的水平将随机分配到每天补充足够的维生素D3，以提高血清25（OH）25（OH）D水平，至75 Nmol/l和172 Nmol/L和172 Nmol/l和172 Nmol/l和172 Nmol/l和172 Nmol/l versbo。维生素D3补充对亚临床颈动脉动脉粥样硬化进展的影响是根据公共颈动脉（CCA）内膜膜厚度（IMT）的变化速率（IMT）和CCA刚度的变化（膨胀性，弹性和合规性）在计算机图像处理的B模式超声超量图中都将确定。这项辅助研究提供了一个机会，可以成本效率地解决维生素D补充是否会降低动脉粥样硬化的进展，特别是在一项研究的独特的非洲裔美国妇女中。