{"title":"维生素D缺乏与静脉血栓栓塞风险之间的关系：139,690例患者的匹配队列研究","authors":"Kuo-Chuan Hung, Li-Chen Chang, Chih-Wei Hsu, Jheng-Yan Wu, Chia-Hung Yu, Chun-Ning Ho, Ming Yew, I-Wen Chen","doi":"10.3389/fnut.2025.1639257","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Vitamin D deficiency (VDD) may contribute to venous thromboembolism (VTE) through effects on coagulation and endothelial function, but existing studies show inconsistent results. We investigated the association between VDD and VTE risk using a large matched cohort design.</p><p><strong>Methods: </strong>We conducted a retrospective matched cohort study using the TriNetX database, including patients aged ≥45 years with serum 25-hydroxyvitamin D (25(OH)D) measurements between 2010 and 2023. VDD was defined as serum 25(OH)D < 20 ng/mL, while controls had levels ≥30 ng/mL. After 1:1 propensity score matching, the final cohort comprised 69,845 patients in each group. Primary outcomes were deep vein thrombosis (DVT) and pulmonary embolism (PE) occurring 3-12 months after the index date. Secondary outcomes included all-cause mortality and intensive care unit (ICU) admission.</p><p><strong>Results: </strong>During one-year follow-up, VDD was significantly associated with increased risk of DVT (Hazard ratio [HR] 1.62, 95% confidence interval [CI]: 1.37-1.92; <i>p</i> < 0.001) and PE (HR 1.62, 95% CI: 1.34-1.96; <i>p</i> < 0.001) compared to controls. The association persisted over 2 years with modest attenuation (DVT: HR 1.49; PE: HR 1.61). A dose-response relationship was observed, with vitamin D insufficiency (20-30 ng/mL) showing intermediate risk levels (DVT: HR 1.36; PE: HR 1.43). VDD was also associated with higher mortality (HR 2.20, 95% CI: 1.99-2.43) and ICU admission risks (HR 1.47, 95% CI: 1.33-1.62). Subgroup analyses revealed consistent associations across demographic groups, with diabetes mellitus significantly modifying the DVT association.</p><p><strong>Conclusion: </strong>Vitamin D deficiency is independently associated with increased VTE risk in a dose-dependent manner, with effects extending to mortality and healthcare utilization. These findings support vitamin D optimization for VTE prevention, though randomized trials are needed to establish causality.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"12 ","pages":"1639257"},"PeriodicalIF":4.0000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483857/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association between vitamin D deficiency and risk of venous thromboembolism: a matched cohort study of 139,690 patients.\",\"authors\":\"Kuo-Chuan Hung, Li-Chen Chang, Chih-Wei Hsu, Jheng-Yan Wu, Chia-Hung Yu, Chun-Ning Ho, Ming Yew, I-Wen Chen\",\"doi\":\"10.3389/fnut.2025.1639257\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Vitamin D deficiency (VDD) may contribute to venous thromboembolism (VTE) through effects on coagulation and endothelial function, but existing studies show inconsistent results. We investigated the association between VDD and VTE risk using a large matched cohort design.</p><p><strong>Methods: </strong>We conducted a retrospective matched cohort study using the TriNetX database, including patients aged ≥45 years with serum 25-hydroxyvitamin D (25(OH)D) measurements between 2010 and 2023. VDD was defined as serum 25(OH)D < 20 ng/mL, while controls had levels ≥30 ng/mL. After 1:1 propensity score matching, the final cohort comprised 69,845 patients in each group. Primary outcomes were deep vein thrombosis (DVT) and pulmonary embolism (PE) occurring 3-12 months after the index date. Secondary outcomes included all-cause mortality and intensive care unit (ICU) admission.</p><p><strong>Results: </strong>During one-year follow-up, VDD was significantly associated with increased risk of DVT (Hazard ratio [HR] 1.62, 95% confidence interval [CI]: 1.37-1.92; <i>p</i> < 0.001) and PE (HR 1.62, 95% CI: 1.34-1.96; <i>p</i> < 0.001) compared to controls. The association persisted over 2 years with modest attenuation (DVT: HR 1.49; PE: HR 1.61). A dose-response relationship was observed, with vitamin D insufficiency (20-30 ng/mL) showing intermediate risk levels (DVT: HR 1.36; PE: HR 1.43). VDD was also associated with higher mortality (HR 2.20, 95% CI: 1.99-2.43) and ICU admission risks (HR 1.47, 95% CI: 1.33-1.62). Subgroup analyses revealed consistent associations across demographic groups, with diabetes mellitus significantly modifying the DVT association.</p><p><strong>Conclusion: </strong>Vitamin D deficiency is independently associated with increased VTE risk in a dose-dependent manner, with effects extending to mortality and healthcare utilization. These findings support vitamin D optimization for VTE prevention, though randomized trials are needed to establish causality.</p>\",\"PeriodicalId\":12473,\"journal\":{\"name\":\"Frontiers in Nutrition\",\"volume\":\"12 \",\"pages\":\"1639257\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2025-09-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483857/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Nutrition\",\"FirstCategoryId\":\"97\",\"ListUrlMain\":\"https://doi.org/10.3389/fnut.2025.1639257\",\"RegionNum\":2,\"RegionCategory\":\"农林科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Nutrition","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.3389/fnut.2025.1639257","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0
摘要
背景：维生素D缺乏（VDD）可能通过影响凝血和内皮功能导致静脉血栓栓塞（VTE），但现有研究结果不一致。我们使用大型匹配队列设计调查了VDD和VTE风险之间的关系。方法：我们使用TriNetX数据库进行了一项回顾性匹配队列研究，纳入了年龄≥45 岁、2010年至2023年间血清25-羟基维生素D （25(OH)D）测量的患者。VDD定义为血清25(OH)D 结果：在为期一年的随访中，VDD与DVT风险增加显著相关(风险比[HR] 1.62, 95%可信区间[CI]: 1.37-1.92； p p 结论：维生素D缺乏与VTE风险增加独立相关，且呈剂量依赖性，其影响延伸至死亡率和医疗保健使用率。这些发现支持维生素D优化预防静脉血栓栓塞，尽管需要随机试验来确定因果关系。
Association between vitamin D deficiency and risk of venous thromboembolism: a matched cohort study of 139,690 patients.
Background: Vitamin D deficiency (VDD) may contribute to venous thromboembolism (VTE) through effects on coagulation and endothelial function, but existing studies show inconsistent results. We investigated the association between VDD and VTE risk using a large matched cohort design.
Methods: We conducted a retrospective matched cohort study using the TriNetX database, including patients aged ≥45 years with serum 25-hydroxyvitamin D (25(OH)D) measurements between 2010 and 2023. VDD was defined as serum 25(OH)D < 20 ng/mL, while controls had levels ≥30 ng/mL. After 1:1 propensity score matching, the final cohort comprised 69,845 patients in each group. Primary outcomes were deep vein thrombosis (DVT) and pulmonary embolism (PE) occurring 3-12 months after the index date. Secondary outcomes included all-cause mortality and intensive care unit (ICU) admission.
Results: During one-year follow-up, VDD was significantly associated with increased risk of DVT (Hazard ratio [HR] 1.62, 95% confidence interval [CI]: 1.37-1.92; p < 0.001) and PE (HR 1.62, 95% CI: 1.34-1.96; p < 0.001) compared to controls. The association persisted over 2 years with modest attenuation (DVT: HR 1.49; PE: HR 1.61). A dose-response relationship was observed, with vitamin D insufficiency (20-30 ng/mL) showing intermediate risk levels (DVT: HR 1.36; PE: HR 1.43). VDD was also associated with higher mortality (HR 2.20, 95% CI: 1.99-2.43) and ICU admission risks (HR 1.47, 95% CI: 1.33-1.62). Subgroup analyses revealed consistent associations across demographic groups, with diabetes mellitus significantly modifying the DVT association.
Conclusion: Vitamin D deficiency is independently associated with increased VTE risk in a dose-dependent manner, with effects extending to mortality and healthcare utilization. These findings support vitamin D optimization for VTE prevention, though randomized trials are needed to establish causality.
期刊介绍：
No subject pertains more to human life than nutrition. The aim of Frontiers in Nutrition is to integrate major scientific disciplines in this vast field in order to address the most relevant and pertinent questions and developments. Our ambition is to create an integrated podium based on original research, clinical trials, and contemporary reviews to build a reputable knowledge forum in the domains of human health, dietary behaviors, agronomy & 21st century food science. Through the recognized open-access Frontiers platform we welcome manuscripts to our dedicated sections relating to different areas in the field of nutrition with a focus on human health.
Specialty sections in Frontiers in Nutrition include, for example, Clinical Nutrition, Nutrition & Sustainable Diets, Nutrition and Food Science Technology, Nutrition Methodology, Sport & Exercise Nutrition, Food Chemistry, and Nutritional Immunology. Based on the publication of rigorous scientific research, we thrive to achieve a visible impact on the global nutrition agenda addressing the grand challenges of our time, including obesity, malnutrition, hunger, food waste, sustainability and consumer health.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
