(P13-068-24) Usual Intake of Vitamin D and CVD-Related Mortality in Statin Users: NHANES 1999–2018

Objectives: This study estimated the association between vitamin D intake and cardiovascular disease (CVD)-related mortality among U.S. adult statin users.

Methods: This analysis included adults (≥20y) who provided at least one reliable dietary recall from 10 NHANES cycles (1999–2000 to 2017–2018). Among adult participants who met the study criteria, 7,191 (17.5%) reported statin medication use. Dietary vitamin D intake was collected from one to two, non-consecutive 24-hour dietary recalls using the automated multiple pass method. Dietary supplements were reported via questionnaire. Mortality data was provided from the Public-Use Linked Mortality file. Usual vitamin D intake from all sources was estimated using the National Cancer Institute method. Cox proportional hazard models were fit to test associations between quartiles of vitamin D intake and CVD-related mortality. Two models were run: model 1 was adjusted for age, race/ethnicity, and gender. Model 2 included model 1 covariates, plus health insurance coverage, poverty-income ratio, BMI, physical activity, cigarette smoking, alcohol use, and comorbidity conditions. All analyses accounted for the NHANES sampling design and used appropriate sample weights.

Results: Statin users were likely to be male (52.6%), older (63.6 y), and non-Hispanic white (77.5%). Statin users had a greater BMI (30.5 vs. 28.6 mm/kg², p < 0.0001) and waist circumference (105.5 vs. 97.4 cm, p < 0.0001) compared to non-statin users. Statin users also had a higher prevalence of cancer, congestive heart failure, coronary heart disease, myocardial infarction, stroke, high cholesterol, hypertension, and diabetes. Statin users reported greater usual vitamin D intake than non-users (21.78 vs. 11.88 µg/d). Quartiles of vitamin D for all participants was 3.63 µg/d (25^th percentile), 9.62 µg/d (median), and 22.90 µg/d (75^th percentile). Vitamin D intakes from all sources was associated with a reduced risk of CVD-related mortality in statin users [Quartile 3 vs Quartile 1, Model 1: HR (95% CI) 0.52 (0.37, 0.73), p < 0.001; Quartile 3 vs Quartile 1, Model 2: HR 0.57 (0.35, 0.92), p = 0.0205; Quartile 4 vs Quartile 1, Model 1: HR 0.73 (0.56, 0.96), p = 0.0227].

Conclusions: The present study suggests that adult statin users may benefit from vitamin D intake in excess of the estimated average requirement.

Funding Sources: None