Higher vitamin D levels associated with health and lower risk of atrial fibrillation – May 2015

Vitamin D and the Risk of Atrial Fibrillation - The Rotterdam Study

PLOS ONE: May 1, 2015DOI: 10.1371/journal.pone.0125161
Anna Vitezova , Natasha S. Cartolano , Jan Heeringa, M. Carola Zillikens, Albert Hofman, Oscar H. Franco, Jessica C. Kiefte-de Jong

Atrial fibrillation (AF) is the most common chronic arrhythmia and it increases the risk of cardiovascular morbidity and mortality. Still there is not a complete understanding of its etiology and underlying pathways. Vitamin D might regulate renin-angiotensin-aldosterone system and might be involved in inflammation, both implicated in the pathophysiology of AF. The objective of this work was to investigate the association between vitamin D status with the risk of AF in the elderly. This study was conducted within the Rotterdam Study, a community-based cohort of middle-aged and elderly participants in Rotterdam, The Netherlands. We had 3,395 participants who were free of AF diagnosis at the start of our study and who had vitamin D data available. We analyzed the association between serum 25-hydroxivitamin D (25(OH)D) and incidence of AF using Cox regression models. Vitamin D deficiency was defined as serum 25(OH)D concentrations <50nmol/l, insufficiency between 50nmol/l and 75nmol/l, while serum 25(OH)D concentrations equal to and above 75nmol/l were considered as adequate.
After mean follow-up of 12.0 years 263 (7.7%) participants were diagnosed with incident AF. Vitamin D status was not associated with AF in any of the 3 multivariate models tested (model adjusted for socio-demographic factors and life-style factors: HR per 10 unit increment in serum 25(OH)D 0.96, 95% CI: 0.91-1.02; HR for insufficiency: 0.82, 95%CI: 0.60-1.11,and HR for adequate status: 0.76, 95%CI: 0.52-1.12 compared to deficiency). This prospective cohort study does not support the hypothesis that vitamin D status is associated with AF.

VitaminDWiki summary table of data above
Risk reduction per 10 nmol additional vitamin D

Deficiency: < 50 nmol	0 %
Insufficiency: 50-75 nmol	- 4%
Adequate: > 75 nmol	- 24%

Observation:
The data appears to strongly support a reduction in AF with increased vitamin D
How do the authors claim otherwise?
Perhaps because there was not enough data to prove significance of the results?

At baseline:Those with higher levels of vitamin D were healthier

	Deficient	Insufficient	Adequate
	<50nmol/l	50-75nmol/l	>75nmol/l
Serum 25(OH)D nmol/l	31.4	61.1	93.1
AF incidence	8.6%	6.7%	6.4%
Current smokers	17.2%	14.1%	15.7%
Presence of Diabetes	17.2%	11.6%	8.8%
Presence of CVD	16.2%	12.8%	11.7%
Use of lipid lowering drugs	15.7%	14%	14.6%

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