C0110 Serum levels of vitamin D is not associated with future risk of venous thromboembolism–the Tromsø Study

Brodin, Ellen; Lerstad, Gunhild; Grimnes, Guri; Brækkan, Sigrid Kufaas; Svartberg, Johan; Jorde, Rolf; Hansen, John‐Bjarne

doi:10.1016/j.thromres.2012.08.226

Cited by 10 publications

(14 citation statements)

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“…In this case, it is important to note that vitamin D supplementation was started after the diagnosis of VTE. It should also be noted that supplementation in patients with normal vitamin D levels was not associated with improved rates of VTE, as our results for individuals in the NVitD group with supplementation (NVitDSuppPositive) versus no supplementation (NVitDSuppNegative) group, are consistent with studies that have demonstrated that increasing vitamin D levels from normal does not lower the risk of VTE …”

Section: Discussionsupporting

confidence: 91%

Venous Thromboembolism is Associated With Lack of Vitamin D Supplementation in Patients With Spinal Cord Injury and Low Vitamin D Levels

Ehsanian

Timmerman

Wright

et al. 2019

PM&R

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Background: The role of vitamin D in the pathogenesis of venous thromboembolism (VTE) and prevalence of low vitamin D (LVitD) in spinal cord injury (SCI) has motivated vitamin D testing and supplementation. This is an exploratory study of data collected at a time before the routine clinical practice of vitamin D supplementation, allowing for evaluation of the natural history of vitamin D levels in patients with SCI. Objective: To determine if vitamin D supplementation in persons with SCI and LVitD levels is associated with decreased prevalence of VTE. Design: Retrospective cohort study. Setting: Rehabilitation Center at a Level I Trauma Center. Participants: Patients with SCI admitted to acute inpatient rehabilitation (N = 282). Main Outcome Measures: VTE prevalence in patients with LVitD levels, grouped by presence or absence of vitamin D supplementation. Results: Of the acute inpatient SCI population, 80% (227/282) of patients demonstrated vitamin D levels <30 ng/mL (LVitD). Although the incidence of VTE was almost double in the LVitD group, 19% (43/227) of the patients in the LVitD group had VTE versus 9% (5/55) of patients with vitamin D levels ≥30 ng/mL (normal VitD [NVitD]); this difference was not statistically significant (P = .108, Cramer's V = .104). When the role of vitamin D supplementation was analyzed, individuals in the LVitD group who received no vitamin D supplementation (LVitDSuppNegative) had a higher incidence of VTE (statistically significant) compared to the LVitD group with vitamin D supplementation (LVitDSuppPositive) (24% [42/178] vs. 2% [1/49]) (P < .001, Cramer's V = .226). In post hoc exploratory analyses, the VTE rate of patients in the LVitDSuppNegative group was noted to be significantly higher than that in all other patient groups combined (P < .001, Cramer's V = .229). A binary logistic regression model incorporating clinical covariates also showed this grouping to be significant. Conclusion: A significant association appears to exist between lack of vitamin D supplementation and VTE occurrence in persons with acute SCI and LVitD levels.

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Section: Discussionsupporting

confidence: 91%

Venous Thromboembolism is Associated With Lack of Vitamin D Supplementation in Patients With Spinal Cord Injury and Low Vitamin D Levels

Ehsanian

Timmerman

Wright

et al. 2019

PM&R

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“…Our results showing no association are consistent with the Tromsø Study, with 201 VTEs . They are less consistent with the Copenhagen Study (950 VTEs), which reported a weak inverse association between 25(OH)D level and VTE .…”

Section: Discussioncontrasting

confidence: 87%

“…A large prospective study from Copenhagen reported an inverse association of seasonally adjusted plasma 25(OH)D level with VTE, with a relative risk of 1.28 (95% confidence interval [CI] 1.06–1.53) for the lowest vs. the highest 25(OH)D tertile . However, the Tromsø Study found no association of serum 25(OH)D level with VTE, but was underpowered for low vs. high 25(OH)D quartiles (relative risk of 1.32, 95% CI 0.78–2.22) . Administration of calcitriol, the active hormone form of vitamin D, was shown to reduce VTE occurrence in chronic kidney disease and cancer patients .…”

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confidence: 99%

Serum 25‐hydroxyvitamin D and risk of venous thromboembolism: the Atherosclerosis Risk in Communities (ARIC) Study

Folsom

Roetker

Rosamond

et al. 2014

Journal of Thrombosis and Haemostasis

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Summary Background Some evidence suggests that an inadequate vitamin D level may increase the risk atherosclerotic cardiovascular disease. Whether low vitamin D has a role in venous thromboembolism (VTE), i.e., venous thrombosis and pulmonary embolism, is largely unexplored. Objectives We tested prospectively in the Atherosclerosis Risk in Communities (ARIC) cohort whether the serum concentration of 25-hydroxyvitamin D (25(OH)D) is inversely associated with VTE incidence and whether it partly explains the African American excess of VTE in ARIC. Patients and Methods We measured 25(OH)D using mass spectroscopy in stored samples of 12,752 ARIC study participants and followed them over a median of 19.7 years (1990-92 through 2011) for incidence of VTE (n = 537). Results The seasonally-adjusted 25(OH)D concentration was not associated with VTE incidence. In a model adjusted for age, race, sex, hormone replacement therapy, and body mass index, the hazard ratios of VTE across 25(OH)D quintiles 5 (high) to 1 (low) were: 1 (Ref.), 0.84 (0.65, 1.08), 0.88 (0.68, 1.13), 1.04 (0.78, 1.38), and 0.90 (0.64, 1.27). The lowest 25(OH)D quintile comprised 59% African Americans, whereas the highest quintile comprised 7% African Americans. Yet, lower 25(OH)D concentrations explained little of the 63% greater VTE risk of African Americans over whites in this cohort. Conclusions Low 25(OH)D was not a risk factor for VTE in this prospective study. Yet, the totality of literature (three studies) suggests that low 25(OH)D might modestly increase VTE risk in whites, but this needs further confirmation.

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“…Further, both the vitamin D and the placebo group were given daily supplements with 500 mg calcium, thus if the effect of vitamin D in the coagulation system is mediated by its effect on calcium, obviously no difference would be expected between placebo and vitamin D. The results of our study are not in line with the results of 2 large cohort studies, the Tromsø and the Atherosclerosis Risk in Communities (ARIC) study that found no association between vitamin D status and venous thromboembolism. 6,27 However, these studies are not comparable to our study as we assessed a laboratory outcome, whereas these 2 cohorts assessed a clinical outcome. Furthermore, according to Virchow, thrombosis is caused by change in blood flow (stasis), change in the state of vessel wall (endothelial activation), and/or change in blood composition (hypercoagulability).…”

Section: Discussionmentioning

confidence: 81%

The Effect of Vitamin D Supplementation on Thrombin Generation Assessed by the Calibrated Automated Thrombogram

Saliba

Awad

Gilat

et al. 2014

Clin Appl Thromb Hemost

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Observational and in vitro studies suggest that vitamin D may have antithrombotic activity. This study aimed to examine the relationship between vitamin D supplementation and thrombin generation. Serum 25-hydroxyvitamin D (25(OH)D) and thrombin generation parameters were measured in 73 healthy volunteers. Participants with serum 25(OH)D <50 nmol/L (n = 53) were treated with vitamin D3and tested for 25(OH)D and thrombin generation at the end of treatment. Lag time and time to peak decreased after treatment by a mean of -0.49 ± 0.51 minute (P< .001) and -0.76 ± 0.70 minute (P< .001), respectively, whereas endogenous thrombin potential and peak height increased after treatment by a mean of 170.1 ± 339.8 nmol/L minute (P= .001) and 34.2 ± 47.8 nmol/L (P< .001), respectively. Treatment with vitamin D supplementation seems to have prothrombotic effect in patients with vitamin D insufficiency. These findings should be interpreted with caution and need to be replicated in future studies.

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C0110 Serum levels of vitamin D is not associated with future risk of venous thromboembolism–the Tromsø Study

Cited by 10 publications

References 0 publications

Venous Thromboembolism is Associated With Lack of Vitamin D Supplementation in Patients With Spinal Cord Injury and Low Vitamin D Levels

Venous Thromboembolism is Associated With Lack of Vitamin D Supplementation in Patients With Spinal Cord Injury and Low Vitamin D Levels

Serum 25‐hydroxyvitamin D and risk of venous thromboembolism: the Atherosclerosis Risk in Communities (ARIC) Study

The Effect of Vitamin D Supplementation on Thrombin Generation Assessed by the Calibrated Automated Thrombogram

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