Serum 25-Hydroxyvitamin D Concentrations Are Associated with Computed Tomography Markers of Subclinical Interstitial Lung Disease among Community-Dwelling Adults in the Multi-Ethnic Study of Atherosclerosis (MESA)

Samuel M. Kim; Di Zhao; Anna J. Podolanczuk; Pamela L Lutsey; Eliseo Guallar; Steven M. Kawut; R. Graham Barr; Ian H. de Boer; Bryan R. Kestenbaum; David J. Lederer; Erin D. Michos

doi:10.1093/jn/nxy066

Serum 25-Hydroxyvitamin D Concentrations Are Associated with Computed Tomography Markers of Subclinical Interstitial Lung Disease among Community-Dwelling Adults in the Multi-Ethnic Study of Atherosclerosis (MESA)

Samuel M. Kim, Di Zhao, Anna J. Podolanczuk, Pamela L Lutsey, Eliseo Guallar, Steven M. Kawut, R. Graham Barr, Ian H. de Boer, Bryan R. Kestenbaum, David J. Lederer, Erin D. Michos

Epidemiology

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Background: Activated vitamin D has anti-inflammatory properties. 25-Hydroxyvitamin D [25(OH)D] deficiency might contribute to subclinical interstitial lung disease (ILD). Objective: We examined associations between serum 25(OH)D concentrations and subclinical ILD among middle-aged to older adults who were free of cardiovascular disease at baseline. Methods: We studied 6302 Multi-Ethnic Study of Atherosclerosis (MESA) participants who had baseline serum 25(OH)D concentrations and computed tomography (CT) imaging spanning ≤ 10 y. Baseline cardiac CT scans (2000–2002) included partial lung fields. Some participants had follow-up cardiac CT scans at exams 2–5 and a full-lung CT scan at exam 5 (2010–2012), with a mean ± SD of 2.1 ± 1.0 scans. Subclinical ILD was defined quantitatively as high-attenuation areas (HAAs) between –600 and –250 Hounsfield units. We assessed associations of 25(OH)D with adjusted HAA volumes and HAA progression. We also examined associations between baseline 25(OH)D and the presence of interstitial lung abnormalities (ILAs) assessed qualitatively (yes or no) from full-lung CT scans at exam 5. Models were adjusted for sociodemographic characteristics, lifestyle factors (including smoking), and lung volumes. Results: The cohort's mean ± SD characteristics were 62.2 ± 10 y for age, 25.8 ± 10.9 ng/mL for 25(OH)D concentrations, and 28.3 ± 5.4 for body mass index (kg/m²); 53% were women, with 39% white, 27% black, 22% Hispanic, and 12% Chinese race/ethnicities. Thirty-three percent had replete (≥30 ng/mL), 35% intermediate (20 to <30 ng/mL), and 32% deficient (<20 ng/mL) 25(OH)D concentrations. Compared with those with replete concentrations, participants with 25(OH)D deficiency had greater adjusted HAA volume at baseline (2.7 cm³; 95% CI: 0.9, 4.5 cm³) and increased progression over a median of 4.3 y of follow-up (2.7 cm³; 95% CI: 0.9, 4.4 cm³) (P < 0.05). 25(OH)D deficiency was also associated with increased prevalence of ILAs 10 y later (OR: 1.5; 95% CI: 1.1, 2.2). Conclusions: Vitamin D deficiency is independently associated with subclinical ILD and its progression, based on both increased HAAs and ILAs, in a community-based population. Further studies are needed to examine whether vitamin D repletion can prevent ILD or slow its progression. The MESA cohort design is registered at www.clinicaltrials.gov as NCT00005487.

Original language	English (US)
Pages (from-to)	1126-1134
Number of pages	9
Journal	Journal of Nutrition
Volume	148
Issue number	7
DOIs	https://doi.org/10.1093/jn/nxy066
State	Published - Jul 2018

Bibliographical note

Funding Information:
EDM was supported by NIH/National Institute of Neurological Disorders and Stroke grant R01NS072243. EDM and DZ were also supported by the Blumenthal Scholars Fund for Preventive Cardiology. Funding for 25-hydroxyvitamin D measurements was provided by R01HL096875 from the NIH (to IHdB and BRK). The Multi-Ethnic Study of Atherosclerosis (MESA) study was funded by contracts HHSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169 from the National Heart, Lung, and Blood Institute, and by grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420 from the National Center for Advancing Translational Sciences. The MESA Lung and Lung Fibrosis funding was funded by R01-HL077612, R01-HL093081, RC1-HL100543, R01-HL-103676, T32-HL-105323, and K24-HL-131937. The MESA Air ancillary, which supported the computed tomography scans at exam 5, was developed under a Science to Achieve Results (STAR) research assistance agreement, no. RD831697, awarded by the US Environmental Protection Agency (EPA). It has not been formally reviewed by the EPA.

Funding Information:
SMK, DZ, AJP, PLL, EG, SMK, and BRK, no conflicts of interest. EDM received an honorarium from Siemens Healthcare Diagnostics in 2016, unrelated to this work. IHdB has the following disclosures: Ironwood Pharma and Boehringer-Ingelheim (consulting) and Medtronic and Abbott (equipment and supplies donated to institution for research), all of which are unrelated to this work. DJL has been a consultant for Roche, Veracyte, Philips Respironics, Fibrogen, Global Blood Therapeutics, Sanofi Genzyme, and Immuneworks. RGB has funding from the COPD Foundation.

Publisher Copyright:
© 2018 American Society for Nutrition.

Keywords

CT scan
epidemiology
interstitial lung disease
risk factors
vitamin D

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Kim, S. M., Zhao, D., Podolanczuk, A. J., Lutsey, P. L., Guallar, E., Kawut, S. M., Barr, R. G., de Boer, I. H., Kestenbaum, B. R., Lederer, D. J., & Michos, E. D. (2018). Serum 25-Hydroxyvitamin D Concentrations Are Associated with Computed Tomography Markers of Subclinical Interstitial Lung Disease among Community-Dwelling Adults in the Multi-Ethnic Study of Atherosclerosis (MESA). Journal of Nutrition, 148(7), 1126-1134. https://doi.org/10.1093/jn/nxy066

Serum 25-Hydroxyvitamin D Concentrations Are Associated with Computed Tomography Markers of Subclinical Interstitial Lung Disease among Community-Dwelling Adults in the Multi-Ethnic Study of Atherosclerosis (MESA). / Kim, Samuel M.; Zhao, Di; Podolanczuk, Anna J. et al.
In: Journal of Nutrition, Vol. 148, No. 7, 07.2018, p. 1126-1134.

Research output: Contribution to journal › Article › peer-review

Kim, SM, Zhao, D, Podolanczuk, AJ, Lutsey, PL, Guallar, E, Kawut, SM, Barr, RG, de Boer, IH, Kestenbaum, BR, Lederer, DJ & Michos, ED 2018, 'Serum 25-Hydroxyvitamin D Concentrations Are Associated with Computed Tomography Markers of Subclinical Interstitial Lung Disease among Community-Dwelling Adults in the Multi-Ethnic Study of Atherosclerosis (MESA)', Journal of Nutrition, vol. 148, no. 7, pp. 1126-1134. https://doi.org/10.1093/jn/nxy066

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title = "Serum 25-Hydroxyvitamin D Concentrations Are Associated with Computed Tomography Markers of Subclinical Interstitial Lung Disease among Community-Dwelling Adults in the Multi-Ethnic Study of Atherosclerosis (MESA)",

abstract = "Background: Activated vitamin D has anti-inflammatory properties. 25-Hydroxyvitamin D [25(OH)D] deficiency might contribute to subclinical interstitial lung disease (ILD). Objective: We examined associations between serum 25(OH)D concentrations and subclinical ILD among middle-aged to older adults who were free of cardiovascular disease at baseline. Methods: We studied 6302 Multi-Ethnic Study of Atherosclerosis (MESA) participants who had baseline serum 25(OH)D concentrations and computed tomography (CT) imaging spanning ≤ 10 y. Baseline cardiac CT scans (2000–2002) included partial lung fields. Some participants had follow-up cardiac CT scans at exams 2–5 and a full-lung CT scan at exam 5 (2010–2012), with a mean ± SD of 2.1 ± 1.0 scans. Subclinical ILD was defined quantitatively as high-attenuation areas (HAAs) between –600 and –250 Hounsfield units. We assessed associations of 25(OH)D with adjusted HAA volumes and HAA progression. We also examined associations between baseline 25(OH)D and the presence of interstitial lung abnormalities (ILAs) assessed qualitatively (yes or no) from full-lung CT scans at exam 5. Models were adjusted for sociodemographic characteristics, lifestyle factors (including smoking), and lung volumes. Results: The cohort's mean ± SD characteristics were 62.2 ± 10 y for age, 25.8 ± 10.9 ng/mL for 25(OH)D concentrations, and 28.3 ± 5.4 for body mass index (kg/m2); 53% were women, with 39% white, 27% black, 22% Hispanic, and 12% Chinese race/ethnicities. Thirty-three percent had replete (≥30 ng/mL), 35% intermediate (20 to <30 ng/mL), and 32% deficient (<20 ng/mL) 25(OH)D concentrations. Compared with those with replete concentrations, participants with 25(OH)D deficiency had greater adjusted HAA volume at baseline (2.7 cm3; 95% CI: 0.9, 4.5 cm3) and increased progression over a median of 4.3 y of follow-up (2.7 cm3; 95% CI: 0.9, 4.4 cm3) (P < 0.05). 25(OH)D deficiency was also associated with increased prevalence of ILAs 10 y later (OR: 1.5; 95% CI: 1.1, 2.2). Conclusions: Vitamin D deficiency is independently associated with subclinical ILD and its progression, based on both increased HAAs and ILAs, in a community-based population. Further studies are needed to examine whether vitamin D repletion can prevent ILD or slow its progression. The MESA cohort design is registered at www.clinicaltrials.gov as NCT00005487.",

keywords = "CT scan, epidemiology, interstitial lung disease, risk factors, vitamin D",

author = "Kim, {Samuel M.} and Di Zhao and Podolanczuk, {Anna J.} and Lutsey, {Pamela L} and Eliseo Guallar and Kawut, {Steven M.} and Barr, {R. Graham} and {de Boer}, {Ian H.} and Kestenbaum, {Bryan R.} and Lederer, {David J.} and Michos, {Erin D.}",

note = "Funding Information: EDM was supported by NIH/National Institute of Neurological Disorders and Stroke grant R01NS072243. EDM and DZ were also supported by the Blumenthal Scholars Fund for Preventive Cardiology. Funding for 25-hydroxyvitamin D measurements was provided by R01HL096875 from the NIH (to IHdB and BRK). The Multi-Ethnic Study of Atherosclerosis (MESA) study was funded by contracts HHSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169 from the National Heart, Lung, and Blood Institute, and by grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420 from the National Center for Advancing Translational Sciences. The MESA Lung and Lung Fibrosis funding was funded by R01-HL077612, R01-HL093081, RC1-HL100543, R01-HL-103676, T32-HL-105323, and K24-HL-131937. The MESA Air ancillary, which supported the computed tomography scans at exam 5, was developed under a Science to Achieve Results (STAR) research assistance agreement, no. RD831697, awarded by the US Environmental Protection Agency (EPA). It has not been formally reviewed by the EPA. Funding Information: SMK, DZ, AJP, PLL, EG, SMK, and BRK, no conflicts of interest. EDM received an honorarium from Siemens Healthcare Diagnostics in 2016, unrelated to this work. IHdB has the following disclosures: Ironwood Pharma and Boehringer-Ingelheim (consulting) and Medtronic and Abbott (equipment and supplies donated to institution for research), all of which are unrelated to this work. DJL has been a consultant for Roche, Veracyte, Philips Respironics, Fibrogen, Global Blood Therapeutics, Sanofi Genzyme, and Immuneworks. RGB has funding from the COPD Foundation. Publisher Copyright: {\textcopyright} 2018 American Society for Nutrition.",

year = "2018",

month = jul,

doi = "10.1093/jn/nxy066",

language = "English (US)",

volume = "148",

pages = "1126--1134",

journal = "Journal of Nutrition",

issn = "0022-3166",

publisher = "American Society for Nutrition",

number = "7",

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TY - JOUR

T1 - Serum 25-Hydroxyvitamin D Concentrations Are Associated with Computed Tomography Markers of Subclinical Interstitial Lung Disease among Community-Dwelling Adults in the Multi-Ethnic Study of Atherosclerosis (MESA)

AU - Kim, Samuel M.

AU - Zhao, Di

AU - Podolanczuk, Anna J.

AU - Lutsey, Pamela L

AU - Guallar, Eliseo

AU - Kawut, Steven M.

AU - Barr, R. Graham

AU - de Boer, Ian H.

AU - Kestenbaum, Bryan R.

AU - Lederer, David J.

AU - Michos, Erin D.

N1 - Funding Information: EDM was supported by NIH/National Institute of Neurological Disorders and Stroke grant R01NS072243. EDM and DZ were also supported by the Blumenthal Scholars Fund for Preventive Cardiology. Funding for 25-hydroxyvitamin D measurements was provided by R01HL096875 from the NIH (to IHdB and BRK). The Multi-Ethnic Study of Atherosclerosis (MESA) study was funded by contracts HHSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169 from the National Heart, Lung, and Blood Institute, and by grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420 from the National Center for Advancing Translational Sciences. The MESA Lung and Lung Fibrosis funding was funded by R01-HL077612, R01-HL093081, RC1-HL100543, R01-HL-103676, T32-HL-105323, and K24-HL-131937. The MESA Air ancillary, which supported the computed tomography scans at exam 5, was developed under a Science to Achieve Results (STAR) research assistance agreement, no. RD831697, awarded by the US Environmental Protection Agency (EPA). It has not been formally reviewed by the EPA. Funding Information: SMK, DZ, AJP, PLL, EG, SMK, and BRK, no conflicts of interest. EDM received an honorarium from Siemens Healthcare Diagnostics in 2016, unrelated to this work. IHdB has the following disclosures: Ironwood Pharma and Boehringer-Ingelheim (consulting) and Medtronic and Abbott (equipment and supplies donated to institution for research), all of which are unrelated to this work. DJL has been a consultant for Roche, Veracyte, Philips Respironics, Fibrogen, Global Blood Therapeutics, Sanofi Genzyme, and Immuneworks. RGB has funding from the COPD Foundation. Publisher Copyright: © 2018 American Society for Nutrition.

PY - 2018/7

Y1 - 2018/7

N2 - Background: Activated vitamin D has anti-inflammatory properties. 25-Hydroxyvitamin D [25(OH)D] deficiency might contribute to subclinical interstitial lung disease (ILD). Objective: We examined associations between serum 25(OH)D concentrations and subclinical ILD among middle-aged to older adults who were free of cardiovascular disease at baseline. Methods: We studied 6302 Multi-Ethnic Study of Atherosclerosis (MESA) participants who had baseline serum 25(OH)D concentrations and computed tomography (CT) imaging spanning ≤ 10 y. Baseline cardiac CT scans (2000–2002) included partial lung fields. Some participants had follow-up cardiac CT scans at exams 2–5 and a full-lung CT scan at exam 5 (2010–2012), with a mean ± SD of 2.1 ± 1.0 scans. Subclinical ILD was defined quantitatively as high-attenuation areas (HAAs) between –600 and –250 Hounsfield units. We assessed associations of 25(OH)D with adjusted HAA volumes and HAA progression. We also examined associations between baseline 25(OH)D and the presence of interstitial lung abnormalities (ILAs) assessed qualitatively (yes or no) from full-lung CT scans at exam 5. Models were adjusted for sociodemographic characteristics, lifestyle factors (including smoking), and lung volumes. Results: The cohort's mean ± SD characteristics were 62.2 ± 10 y for age, 25.8 ± 10.9 ng/mL for 25(OH)D concentrations, and 28.3 ± 5.4 for body mass index (kg/m2); 53% were women, with 39% white, 27% black, 22% Hispanic, and 12% Chinese race/ethnicities. Thirty-three percent had replete (≥30 ng/mL), 35% intermediate (20 to <30 ng/mL), and 32% deficient (<20 ng/mL) 25(OH)D concentrations. Compared with those with replete concentrations, participants with 25(OH)D deficiency had greater adjusted HAA volume at baseline (2.7 cm3; 95% CI: 0.9, 4.5 cm3) and increased progression over a median of 4.3 y of follow-up (2.7 cm3; 95% CI: 0.9, 4.4 cm3) (P < 0.05). 25(OH)D deficiency was also associated with increased prevalence of ILAs 10 y later (OR: 1.5; 95% CI: 1.1, 2.2). Conclusions: Vitamin D deficiency is independently associated with subclinical ILD and its progression, based on both increased HAAs and ILAs, in a community-based population. Further studies are needed to examine whether vitamin D repletion can prevent ILD or slow its progression. The MESA cohort design is registered at www.clinicaltrials.gov as NCT00005487.

AB - Background: Activated vitamin D has anti-inflammatory properties. 25-Hydroxyvitamin D [25(OH)D] deficiency might contribute to subclinical interstitial lung disease (ILD). Objective: We examined associations between serum 25(OH)D concentrations and subclinical ILD among middle-aged to older adults who were free of cardiovascular disease at baseline. Methods: We studied 6302 Multi-Ethnic Study of Atherosclerosis (MESA) participants who had baseline serum 25(OH)D concentrations and computed tomography (CT) imaging spanning ≤ 10 y. Baseline cardiac CT scans (2000–2002) included partial lung fields. Some participants had follow-up cardiac CT scans at exams 2–5 and a full-lung CT scan at exam 5 (2010–2012), with a mean ± SD of 2.1 ± 1.0 scans. Subclinical ILD was defined quantitatively as high-attenuation areas (HAAs) between –600 and –250 Hounsfield units. We assessed associations of 25(OH)D with adjusted HAA volumes and HAA progression. We also examined associations between baseline 25(OH)D and the presence of interstitial lung abnormalities (ILAs) assessed qualitatively (yes or no) from full-lung CT scans at exam 5. Models were adjusted for sociodemographic characteristics, lifestyle factors (including smoking), and lung volumes. Results: The cohort's mean ± SD characteristics were 62.2 ± 10 y for age, 25.8 ± 10.9 ng/mL for 25(OH)D concentrations, and 28.3 ± 5.4 for body mass index (kg/m2); 53% were women, with 39% white, 27% black, 22% Hispanic, and 12% Chinese race/ethnicities. Thirty-three percent had replete (≥30 ng/mL), 35% intermediate (20 to <30 ng/mL), and 32% deficient (<20 ng/mL) 25(OH)D concentrations. Compared with those with replete concentrations, participants with 25(OH)D deficiency had greater adjusted HAA volume at baseline (2.7 cm3; 95% CI: 0.9, 4.5 cm3) and increased progression over a median of 4.3 y of follow-up (2.7 cm3; 95% CI: 0.9, 4.4 cm3) (P < 0.05). 25(OH)D deficiency was also associated with increased prevalence of ILAs 10 y later (OR: 1.5; 95% CI: 1.1, 2.2). Conclusions: Vitamin D deficiency is independently associated with subclinical ILD and its progression, based on both increased HAAs and ILAs, in a community-based population. Further studies are needed to examine whether vitamin D repletion can prevent ILD or slow its progression. The MESA cohort design is registered at www.clinicaltrials.gov as NCT00005487.

KW - CT scan

KW - epidemiology

KW - interstitial lung disease

KW - risk factors

KW - vitamin D

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Serum 25-Hydroxyvitamin D Concentrations Are Associated with Computed Tomography Markers of Subclinical Interstitial Lung Disease among Community-Dwelling Adults in the Multi-Ethnic Study of Atherosclerosis (MESA)

Abstract

Bibliographical note

Keywords

UN SDGs

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