Effect of race and genetics on vitamin D metabolism, bone and vascular health

  title={Effect of race and genetics on vitamin D metabolism, bone and vascular health},
  author={Barry I. Freedman and Thomas C. Register},
  journal={Nature Reviews Nephrology},
The pathophysiology of chronic kidney disease–mineral and bone disorder accounts for an inverse relationship between bone mineralization and vascular calcification in progressive nephropathy. Inverse associations between bone mineral density (BMD) and calcified atherosclerotic plaque are also observed in individuals of European and African ancestry without nephropathy, suggesting a mechanistic link between these processes that is independent of kidney disease. Despite lower dietary calcium… 

Vitamin D Associations With Renal, Bone, and Cardiovascular Phenotypes: African American-Diabetes Heart Study.

Only 1,25OH2D levels were significantly and inversely associated with changes in subclinical atherosclerosis and albuminuria in African Americans, suggesting potential beneficial effects.

Race/ethnicity differences in vitamin D levels and impact on cardiovascular disease, bone health, and oral health

The results point to a lack of significant protection with rising OH(D) levels in AAs, even after their low base levels, and some harmful impact from those higher levels should trigger a closer look at the single population-wide vitamin D threshold currently recommended in the US.

Ethnic differences in bone and mineral metabolism in healthy people and patients with CKD.

Examination of ethnic differences in bone and mineral metabolism in normal individuals and in patients with chronic kidney disease finds that blacks progress more quickly to advanced stages of kidney disease than whites, and have lower serum calcium concentrations, less hyperphosphatemia, low levels of 25(OH)D, higher levels of PTH, andLow levels of FGF-23 compared with white patients.

Plasma FGF23 and Calcified Atherosclerotic Plaque in African Americans with Type 2 Diabetes Mellitus

Plasma FGF23 concentrations were independently associated with subclinical coronary artery disease, albuminuria, and kidney function in the understudied African American population with T2D.

Sclerostin is positively associated with bone mineral density in men and women and negatively associated with carotid calcified atherosclerotic plaque in men from the African American-Diabetes Heart Study.

In this cross-sectional study of AA men and women with type 2 diabetes, circulating sclerostin was positively associated with vBMD in the spine in both sexes and inversely associated with carotid artery CP in men.

Bone Mineral Density and Progression of Subclinical Atherosclerosis in African-Americans With Type 2 Diabetes.

In this longitudinal study, lower baseline thoracic and lumbar vBMD and estimated glomerular filtration rate and higher pericardial adipose volumes were associated with increases in CP in AAs with T2D.

Osteoporosis: Modern Paradigms for Last Century’s Bones †

Two studies have revealed significant differences in genetic phenotypes between Caucasian, Asian, African, and other phenotypes, debunking long-held beliefs and leading to new paradigms in study design.

Plasma Dickkopf1 (DKK1) concentrations negatively associate with atherosclerotic calcified plaque in African-Americans with type 2 diabetes.

Plasma DKK1 levels were inversely associated with coronary artery and aortoiliac CP, but not vBMD, in this cross-sectional study of AAs with type 2 diabetes and may play a role in vascular mineral metabolism in this clinical setting.

Vitamin D and cardiovascular disease.

This review summarizes the clinical studies showing associations between vitamin D status and cardiovascular disease and the experimental studies that explore the mechanistic basis for these associations.

Albuminuria Associates With Calcified Atherosclerotic Plaque in African Americans With Diabetes

It remains unclear whether ethnic differences exist in the effect of albuminuria on risk for development and progression of CP.



Relationships between calcified atherosclerotic plaque and bone mineral density in African Americans with type 2 diabetes

  • J. DiversT. Register B. Freedman
  • Medicine, Biology
    Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
  • 2011
Inverse associations exist between vertebral BMD and calcified atherosclerotic plaque in African‐American men and women with type 2 diabetes, and this relationship was independent of conventional CVD risk factors and supports the hypothesis that bone metabolism and atherosclerosis plaque mineralization are related processes.

Vitamin d, adiposity, and calcified atherosclerotic plaque in african-americans.

An inverse association between vitamin D and visceral adiposity in African-Americans with type 2 diabetes is confirmed and positive associations exist between 25-hydroxyvitamin D and aorta and carotid artery CP inAfrican-Americans.

Association of the Vitamin D Metabolism Gene CYP24A1 With Coronary Artery Calcification

A common SNP in the CYP24A1 gene was associated with CAC quantity in 3 independent populations, suggesting a role for vitamin D metabolism in the development of CAC quantities.

Racial differences in postprandial mineral ion handling in health and in chronic kidney disease.

Blacks had lower fractional excretion of phosphate than whites despite similar levels of PTH and FGF23 in health and in CKD, suggesting racial variability in renal sensitivity to phosphaturic hormones.

The dualistic role of vitamin D in vascular calcifications.

Evidence is provided of vitamin D-dependent and -independent vascular calcification, a phenomenon that is very similar to the vascular pathology seen in patients with CKD and genetic studies have shown that vascular calcifying can be prevented by reducing serum phosphate levels, even in the presence of extremely high serum 1,25-dihydroxyvitamin D and calcium levels.

Vascular calcification and osteoporosis—from clinical observation towards molecular understanding

A unifying hypothesis of vascular calcification is proposed that combines both active and passive mechanisms of vascular mineralization with aspects of bone resorption and age-related changes.

Cardiovascular risk in chronic kidney disease (CKD): the CKD-mineral bone disorder (CKD-MBD)

As a new necessity, cardiovascular function issues are incorporated into the CKD-MBD, and new advances in knowledge of this critical component of the disorder will lead to improved outcomes in CKD.