{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T23:27:35Z","timestamp":1767828455934,"version":"3.49.0"},"reference-count":55,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,7,18]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The ratio of 24,25\u2010dihydroxyvitamin D\n              <jats:sub>3<\/jats:sub>\n              \/25\u2010hydroxyvitamin D\n              <jats:sub>3<\/jats:sub>\n              (vitamin D metabolite ratio [VDMR]) may reflect functional vitamin D activity. We examined associations of the VDMR, 25\u2010hydroxyvitamin D (25[OH]D), and 1,25\u2010dihydroxyvitamin D (1,25[OH]\n              <jats:sub>2<\/jats:sub>\n              D) with cardiovascular disease (CVD) in patients with chronic kidney disease.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This study included longitudinal and cross\u2010sectional analyses of 1786 participants from the CRIC (Chronic Renal Insufficiency Cohort) Study. Serum 24,25\u2010dihydroxyvitamin D\n              <jats:sub>3<\/jats:sub>\n              , 25(OH)D, and 1,25(OH)\n              <jats:sub>2<\/jats:sub>\n              D were measured by liquid chromatography\u2013tandem mass spectrometry 1\u2009year after enrollment. The primary outcome was composite CVD (heart failure, myocardial infarction, stroke, and peripheral arterial disease). We used Cox regression with regression\u2010calibrated weights to test associations of the VDMR, 25(OH)D, and 1,25(OH)\n              <jats:sub>2<\/jats:sub>\n              D with incident CVD. We examined cross\u2010sectional associations of these metabolites with left ventricular mass index using linear regression. Analytic models adjusted for demographics, comorbidity, medications, estimated glomerular filtration rate, and proteinuria. The cohort was 42% non\u2010Hispanic White race and ethnicity, 42% non\u2010Hispanic Black race and ethnicity, and 12% Hispanic ethnicity. Mean age was 59\u2009years, and 43% were women. Among 1066 participants without prevalent CVD, there were 298 composite first CVD events over a mean follow\u2010up of 8.6\u2009years. Lower VDMR and 1,25(OH)\n              <jats:sub>2<\/jats:sub>\n              D were associated with incident CVD before, but not after, adjustment for estimated glomerular filtration rate and proteinuria (hazard ratio, 1.11 per 1 SD lower VDMR [95% CI, 0.95\u20131.31]). Only 25(OH)D was associated with left ventricular mass index after full covariate adjustment (0.6\u2009g\/m\n              <jats:sup>2.7<\/jats:sup>\n              per 10\u2009ng\/mL lower [95% CI, 0.0\u20131.3]).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Despite modest associations of 25(OH)D with left ventricular mass index, 25(OH)D, the VDMR, and 1,25(OH)\n              <jats:sub>2<\/jats:sub>\n              D were not associated with incident CVD in chronic kidney disease.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.028561","type":"journal-article","created":{"date-parts":[[2023,7,8]],"date-time":"2023-07-08T11:22:01Z","timestamp":1688815321000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Vitamin D Metabolites and Risk of Cardiovascular Disease in Chronic Kidney Disease: The CRIC Study"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3780-294X","authenticated-orcid":false,"given":"Simon","family":"Hsu","sequence":"first","affiliation":[{"name":"Division of Nephrology and Kidney Research Institute, Department of Medicine University of Washington Seattle WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8461-5111","authenticated-orcid":false,"given":"Leila R.","family":"Zelnick","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Kidney Research Institute, Department of Medicine University of Washington Seattle WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9583-8628","authenticated-orcid":false,"given":"Nisha","family":"Bansal","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Kidney Research Institute, Department of 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