J Clin Endocrinol Metab. 2012 May 30.
Saliba W, Barnett O, Rennert HS, Rennert G.
Department of Community Medicine and Epidemiology (W.S., O.B., H.S.R., G.R.), Carmel Medical Center, Clalit Health Services, and Bruce Rappaport Faculty of Medicine (W.S., O.B., H.S.R., G.R.), Technion-Israel Institute of Technology, Haifa 34362, Israel; Department of Internal Medicine C (W.S.), Ha'emek Medical Center, Afula 18101, Israel; and Department of Epidemiology and Disease Prevention (G.R.), Office of the Chief Physician, Clalit Health Services Headquarters, Tel Aviv 62098, Israel.
Context and Objectives:Vitamin D plays a key role in maintaining bone health, but evidence for its nonskeletal effects is inconsistent. This study aims to examine the association between serum 25-hydroxyvitamin D [25(OH)D] levels and all-cause mortality in a large general population cohort.
Design, Participants, and Setting:Using the computerized database of the largest health care provider in Israel, we identified a cohort of subjects 20 years old or older with serum 25(OH)D levels measured between January 2008 and December 2009. Vital status was ascertained through August 2011.
Results: Median follow-up was 28.5 months (interquartile range 23.8-33.5 months); 7,247 of 182,152 participants (4.0%) died. Subjects who died had significantly lower serum 25(OH)D levels (mean 44.8 ± 24.2 nmol/liter) than those alive at the end of follow-up (51.0 ± 23.2 nmol/liter), P < 0.001. After adjustment for age, gender, ethnicity, and seasonality, the hazard ratio (HR) for all-cause mortality was 2.02 [95% confidence interval (CI) 1.89-2.15] for the lowest serum 25(OH)D quartile (<33.8 nmol/liter) compared with the highest.
After further adjustment for comorbidity, use of vitamin D supplements and statins, smoking, socioeconomic status, and body mass index, the HR was 1.81 (95% CI 1.69-1.95). This remained, even after adjustment for serum low-density lipoprotein, high-density lipoprotein, calcium level (corrected for serum albumin levels), and glomerular filtration rate, 1.85 (95% CI 1.70-2.01).
The fully adjusted HR associated with being in the second 25(OH)D quartile (33.8-49.4 nmol/liter) was 1.25 (95% CI 1.16-1.34).
Conclusions:All-cause mortality is independently and inversely associated with serum 25(OH)D levels at levels less than 50 nmol/liter.
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- who died = 18 ng
- who lived = 20.4 ng
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Short url = http://is.gd/lowddeathDeath rate 2X higher at age 60 if low vitamin D - 180,000 in Israel May 2012
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