Vitamin D and racial disparity in albuminuria

NHANES 2001-2006

Kevin A. Fiscella, Paul C. Winters, Gbenga Ogedegbe

Research output: Contribution to journalArticle

Abstract

BackgroundNational data show unexplained racial disparity in albuminuria. We assessed whether low serum vitamin D status contributes to racial disparity in albuminuria.MethodsWe examined the association between race and albuminuria (spot urinary albumin/creatinine ratio (ACR) 30) among non-Hispanic black and white nonpregnant adults who were free of renal impairment in the National Health and Nutrition Examination Survey (NHANES) from 2001-2006. We conducted analyses without and with serum 25(OH)D. We adjusted for age, sex, education level, smoking, body mass index (BMI), diabetes, diagnosis of hypertension, and use of antihypertensive medication.ResultsAlbuminuria was present in 10.0% of non-Hispanic blacks and 6.6% in non-Hispanic whites. Being black (odds ratio (OR) 1.46; 95% confidence interval (CI) 1.23-1.73) was independently associated with albuminuria. There was a graded, inverse association between 25(OH)D level and albuminuria. Notably, the association between race and albuminuria was no longer significant (OR 1.19; 95% CI 0.97-1.47) after accounting for participants' serum 25(OH)D. Similar results were observed when participants with macroalbuminuria (ACR 300mg/g) or elevated parathyroid hormone (74pg/ml) were excluded or when a continuous measure of 25(OH)D was substituted for the categorical measure. There were no interactions between race and vitamin D status though racial disparity in albuminuria was observed among participants with the highest 25(OH)D levels.ConclusionSuboptimal vitamin D status may contribute to racial disparity in albuminuria. Randomized controlled trials are needed to determine whether supplementation with vitamin analogues reduces risk for albuminuria or reduce racial disparity in this outcome.

Original languageEnglish (US)
Pages (from-to)1114-1120
Number of pages7
JournalAmerican Journal of Hypertension
Volume24
Issue number10
DOIs
StatePublished - Oct 2011

Fingerprint

Albuminuria
Nutrition Surveys
Vitamin D
Albumins
Creatinine
Serum
Odds Ratio
Confidence Intervals
Sex Education
Parathyroid Hormone
Vitamins
Antihypertensive Agents
Body Mass Index
Randomized Controlled Trials
Smoking
Hypertension
Kidney

Keywords

  • albuminuria
  • blood pressure
  • health status disparities
  • hypertension
  • vitamin D

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Vitamin D and racial disparity in albuminuria : NHANES 2001-2006. / Fiscella, Kevin A.; Winters, Paul C.; Ogedegbe, Gbenga.

In: American Journal of Hypertension, Vol. 24, No. 10, 10.2011, p. 1114-1120.

Research output: Contribution to journalArticle

Fiscella, Kevin A. ; Winters, Paul C. ; Ogedegbe, Gbenga. / Vitamin D and racial disparity in albuminuria : NHANES 2001-2006. In: American Journal of Hypertension. 2011 ; Vol. 24, No. 10. pp. 1114-1120.
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abstract = "BackgroundNational data show unexplained racial disparity in albuminuria. We assessed whether low serum vitamin D status contributes to racial disparity in albuminuria.MethodsWe examined the association between race and albuminuria (spot urinary albumin/creatinine ratio (ACR) 30) among non-Hispanic black and white nonpregnant adults who were free of renal impairment in the National Health and Nutrition Examination Survey (NHANES) from 2001-2006. We conducted analyses without and with serum 25(OH)D. We adjusted for age, sex, education level, smoking, body mass index (BMI), diabetes, diagnosis of hypertension, and use of antihypertensive medication.ResultsAlbuminuria was present in 10.0{\%} of non-Hispanic blacks and 6.6{\%} in non-Hispanic whites. Being black (odds ratio (OR) 1.46; 95{\%} confidence interval (CI) 1.23-1.73) was independently associated with albuminuria. There was a graded, inverse association between 25(OH)D level and albuminuria. Notably, the association between race and albuminuria was no longer significant (OR 1.19; 95{\%} CI 0.97-1.47) after accounting for participants' serum 25(OH)D. Similar results were observed when participants with macroalbuminuria (ACR 300mg/g) or elevated parathyroid hormone (74pg/ml) were excluded or when a continuous measure of 25(OH)D was substituted for the categorical measure. There were no interactions between race and vitamin D status though racial disparity in albuminuria was observed among participants with the highest 25(OH)D levels.ConclusionSuboptimal vitamin D status may contribute to racial disparity in albuminuria. Randomized controlled trials are needed to determine whether supplementation with vitamin analogues reduces risk for albuminuria or reduce racial disparity in this outcome.",
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