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

基本信息

批准号：
8669138
负责人：
Howard Neil Hodis
金额：
$ 37.27万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-08-21 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8669138
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

项目摘要

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 (US) 女性的第一大杀手。重要的是，非裔美国女性的 CVD 死亡率超过白人女性，尽管男性和女性的 CVD 死亡率总体呈下降趋势，但非裔美国女性的下降速度最为缓慢。随着美国人口老龄化和寿命延长，心血管疾病的发病率将成为非洲裔美国女性面临的一个更大的问题。对 CVD 风险种族差异的解释是多因素且复杂的，维生素 D 不足提供了一个具有争议性且可检验的假设，作为 CVD 风险因素（特别是非裔美国人的高血压）与非裔美国人动脉粥样硬化风险增加之间的可能联系。维生素 D 缺乏与 CVD 之间存在因果关系的可能性得到了许多研究的支持，并且具有很强的生物学合理性。鉴于人口老龄化和肥胖发病率迅速增加，维生素 D 不足正成为一个日益重要的公共卫生问题，可能导致 CVD。这可能与非裔美国女性尤其相关，因为皮肤色素沉着增加会降低皮肤合成维生素 D 的能力，并且由于肥胖导致维生素 D 的生物利用度降低，因此她们患 CVD 的风险尤其大，而肥胖对非裔美国女性的影响尤为严重。尽管数据表明补充维生素 D 对减少 CVD 可能具有有益作用，但随机对照试验的直接抗动脉粥样硬化作用有限。该提案的目标是将动脉粥样硬化成像的辅助研究纳入母试验“老年非裔美国人的维生素 D 和骨质疏松症预防”，这是一项为期 4 年、随机、双盲、安慰剂对照的研究，旨在调查维生素 D 状态对老年非洲裔美国女性的影响。 250 名>65 岁且血清 25-羟基维生素 D (25(OH)D) 水平大于 20 nmol/L 但低于 65 nmol/L 的非裔美国女性将被随机分配，每日一次补充足够的维生素 D3，以提高血清 25(与安慰剂相比，OH)D 水平降至 75 nmol/L 至 172 nmol/L 之间。补充维生素 D3 对亚临床颈动脉粥样硬化进展的影响，以计算机图像处理中颈总动脉 (CCA) 内膜中层厚度 (IMT) 的变化率和 CCA 硬度（扩张性、弹性和顺应性）的变化来衡量将确定 B 型超声图。这项辅助研究提供了一个机会，以经济有效的方式解决补充维生素 D 是否会减少动脉粥样硬化的进展，特别是在一个未经研究的独特老年非裔美国女性群体中。