Back to Search
Start Over
Strong associations of 25-hydroxyvitamin D concentrations with all-cause, cardiovascular, cancer, and respiratory disease mortality in a large cohort study.
- Source :
- American Journal of Clinical Nutrition; Apr2013, Vol. 97 Issue 4, p782-793, 12p, 3 Charts, 2 Graphs
- Publication Year :
- 2013
-
Abstract
- Background: Serum 25-hydroxyvitamin D [25(OH)D] concentration has been linked to mortality in several studies, but appropriate cutoffs to define risk categories are under debate. Objective: We aimed to conduct a repeated-measurements analysis on the association of serum 25(OH)D concentrations with all-cause and cause-specific mortality, with particular attention given to the shape of dose-response relations. Design: Concentrations of 25(OH)D were measured in n = 9578 baseline and n = 5469 5-y follow-up participants of the ESTHER study, which is a German population-based cohort aged 50-74 y at baseline. Deaths were recorded during 9.5 y of follow-up (median). Restricted cubic splines were used to assess dose-response relations, and Cox regression with time-dependent variables was used to estimate hazard ratios. Results: During follow-up, 1083 study participants died; of those, 350 individuals died of cardiovascular diseases, 433 individuals died of cancer, and 55 individuals died of respiratory diseases. The overall mortality [HR (95% CI)] of subjects with vitamin D deficiency [25(OH)D concentrations <30 nmol/L] or vitamin D insufficiency [25(OH)D concentrations from 30 to 50 nmol/L) was significantly increased [1.71 (1.43, 2.03) and 1.17 (1.02, 1.35), respectively] compared with that of subjects with sufficient 25(OH)D concentrations (>50 nmol/L)]. Vitamin D deficiency was also associated with increased cardiovascular mortality [1.39 (95% CI: 1.02, 1.89)], cancer mortality [1.42 (95% CI: 1.08, 1.88)] and respiratory disease mortality [2.50 (95% CI: 1.12, 5.56)]. The association of 25(OH)D concentrations with all-cause mortality proved to be a nonlinear inverse association with risk that started to increase at 25(OH)D concentrations <75 nmol/L. Conclusions: In this large cohort study, serum 25(OH)D concentrations were inversely associated with all-cause and cause-specific mortality. In particular, vitamin D deficiency [25(OH)D concentration <30 nmol/L] was strongly associated with mortality from all causes, cardiovascular diseases, cancer, and respiratory diseases. [ABSTRACT FROM AUTHOR]
- Subjects :
- CARDIOVASCULAR disease related mortality
ANTHROPOMETRY
BLOOD testing
CHI-squared test
CONFIDENCE intervals
REPORTING of diseases
DOSE-response relationship in biochemistry
EPIDEMIOLOGY
EPIDEMIOLOGICAL research
HEALTH behavior
HEALTH status indicators
LIQUID chromatography
LONGITUDINAL method
LUNG diseases
MASS spectrometry
MATHEMATICS
MORTALITY
QUESTIONNAIRES
RESEARCH funding
STATISTICAL hypothesis testing
STATISTICS
SURVIVAL analysis (Biometry)
TUMORS
VITAMIN D
VITAMIN D deficiency
DEATH certificates
DATA analysis
LIFESTYLES
PROPORTIONAL hazards models
DATA analysis software
DESCRIPTIVE statistics
KAPLAN-Meier estimator
Subjects
Details
- Language :
- English
- ISSN :
- 00029165
- Volume :
- 97
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- American Journal of Clinical Nutrition
- Publication Type :
- Academic Journal
- Accession number :
- 86654758
- Full Text :
- https://doi.org/10.3945/ajcn.112.047712