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@ARTICLE{Sha:300647,
      author       = {S. Sha$^*$ and R. Xie$^*$ and T. Gwenzi$^*$ and Y. Wang$^*$
                      and H. Brenner$^*$ and B. Schöttker$^*$},
      title        = {{R}eal-world evidence for an association of vitamin {D}
                      supplementation with atherosclerotic cardiovascular disease
                      in the {UK} {B}iobank.},
      journal      = {Clinical nutrition},
      volume       = {49},
      issn         = {0261-5614},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2025-00858},
      pages        = {118 - 127},
      year         = {2025},
      note         = {#EA:C070#LA:C070#},
      abstract     = {Atherosclerotic cardiovascular disease (ASCVD) remains a
                      substantial healthcare burden. The Australian D-Health trial
                      recently showed potential efficacy of vitamin D
                      supplementation (VDS) in reducing major ASCVD events.
                      Whether the efficacy could be translated into real-world
                      effectiveness is unclear.Leveraging data from the UK
                      Biobank, we used Cox regression with competing risk of
                      all-cause mortality to assess the association of
                      self-reported regular VDS (83.3 $\%$ from over-the-counter)
                      and serum 25-hydroxyvitamin D (25[OH]D) levels with ASCVD as
                      a composite endpoint and as separate endpoints including
                      ischemic heart disease (IHD), cerebrovascular disease,
                      peripheral arterial disease, and atherosclerotic
                      disease.Among 409,822 study participants aged 40-69 years,
                      20.7 $\%$ were vitamin D deficient (25[OH]D < 30 nmol/L) and
                      34.4 $\%$ were vitamin D insufficient (25[OH]D 30-<50
                      nmol/L). Regular VDS was reported by 4.3 $\%$ of the study
                      participants. During the follow-up of 15.9 years, 11.6 $\%$
                      of participants developed ASCVD. Compared to vitamin D
                      sufficiency, vitamin D deficiency was associated with a
                      significantly increased risk of the total ASCVD (hazard
                      ratio [95 $\%$ confidence interval]: 1.10 [1.07-1.13]) and
                      all separate ASCVD endpoints in the fully adjusted model
                      with 48 covariates. Consistently, compared to non-users, VDS
                      was associated with a reduced total ASCVD risk in the model
                      fully adjusted for the 50 covariates (0.94[0.90-0.98]).
                      Regarding the individual ASCVD disorders, VDS was associated
                      with reduced IHD risk (0.90[0.86-0.96]).Self-reported
                      regular VDS and being vitamin D sufficient were both
                      associated with reduced ASCVD risk in real-world settings.
                      For people with low 25(OH)D levels, regular VDS may be a
                      beneficial strategy for ASCVD prevention.},
      keywords     = {25-hydroxyvitamin D (Other) / Atherosclerotic
                      cardiovascular disease (Other) / Real-world evidence (Other)
                      / Vitamin D supplement use (Other)},
      cin          = {C070 / C120},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40267517},
      doi          = {10.1016/j.clnu.2025.04.017},
      url          = {https://inrepo02.dkfz.de/record/300647},
}