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摘要
Vitamin D protects against cognitive decline in animals but evidence in humans has been inconsistent. Fibroblast growth factor 23 (FGF23) is a hormone that inhibits vitamin D activation yet few studies examined whether FGF23 is associated with cognitive impairment. The objective of this study was to examine associations of 25(OH) D and FGF23 with incident cognitive impairment in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a cohort of black and white adults >= 45 years old. FGF23 and 25(OH) D were measured in 474 incident impairment cases and 561 controls. In multivariable-adjusted models, there were no significant associations of FGF23 with incident cognitive impairment. In analyses using clinically-relevant categories of 25(OH) D (<20 ng/ml, 20-29.9 ng/ml, >= 30 ng/ml), there was no statistically significant association of lower 25(OH) D concentrations with odds of incident cognitive impairment in models adjusted for demographic, clinical, and laboratory variables and season of blood draw (tertile 1 [>= 30 ng/ml] reference; tertile 2 [20-29.9 ng/ml], odds ratio [OR] 0.96, 95% CI 0.67, 1.38; tertile 3 [<20 ng/ml] OR 1.26, 95% CI 0.83, 1.91). When 25(OH) D was modeled as race-specific tertiles, there were no significant associations of 25(OH) D with incident cognitive impairment in whites, whereas lower 25(OH) D was associated with higher odds in blacks (tertile 1 [>23 ng/ml] reference; tertile 2 [15-23 ng/ml], OR 2.96, 95% CI 1.48,5.94; tertile 3 [<15 ng/ml] OR 2.40, 95% CI 1.07,5.40) in the fully adjusted model. In this cohort of older adults, lower race-specific tertiles of 25(OH) D were associated with higher incidence of cognitive impairment in black individuals but not white individuals. These data suggest that treating low 25(OH) D may be a novel strategy for addressing racial disparities in neurocognitive outcomes.
- 出版日期2016-11-3
