The role of vitamin D supplementation in the risk of developing pneumonia:
three independent case–control studies
Thorax doi:10.1136/thoraxjnl-2013-203623
Hilde H F Remmelts1,2,3,
Simone M C Spoorenberg1,
Jan Jelrik Oosterheert2,
Willem Jan W Bos1,
Mark C H de Groot4,
Ewoudt M W van de Garde4,5
1 Department of Internal Medicine, St Antonius Hospital, Nieuwegein, The Netherlands
2 Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands
3 Department of Internal Medicine, Gelderse Vallei Hospital, Ede, The Netherlands
4 Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, University of Utrecht, Utrecht, The Netherlands
5 Department of Clinical Pharmacy, St Antonius Hospital, Nieuwegein, The Netherlands
Correspondence to Hilde H F Remmelts, Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Heidelberglaan 100, PO Box 85500, Utrecht 3508 GA, The Netherlands; h.h.f.remmelts-3@umcutrecht.nl
Background Vitamin D plays a role in host defence against infection. Vitamin D deficiency has been associated with an increased risk of respiratory tract infections in children and adults. This study aimed to examine whether vitamin D supplementation is associated with a lower pneumonia risk in adults.
Methods Three independent case–control studies were performed including a total of 33 726 cases with pneumonia in different settings with respect to hospitalisation status and a total of 105 243 controls. Cases and controls were matched by year of birth, gender and index date. The major outcome measure was exposure to vitamin D supplementation at the time of pneumonia diagnosis. Conditional logistic regression was used to compute ORs for the association between vitamin D supplementation and occurrence of pneumonia.
Results Vitamin D supplementation was not associated with a lower risk of pneumonia. In studies 1 and 2, adjustment for confounding resulted in non-significant ORs of 1.814 (95% CI 0.865 to 3.803) and 1.007 (95% CI 0.888 to 1.142), respectively. In study 3, after adjustment for confounding, the risk of pneumonia remained significantly higher among vitamin D users (OR 1.496, 95% CI 1.208 to 1.853). Additional analyses showed significant modification of the association through co-use of corticosteroids and drugs that affect bone mineralisation. For patients using these drugs, ORs below one were found combined with higher ORs for patients not using these drugs.
Conclusions This study showed no preventive association between vitamin D supplementation and the risk of pneumonia in adults.
Abstract fails to mention how much vitamin D was taken in observational studies. We assume small doses - perhaps 400 IU
See also VitaminDWiki
- Pneumonia 2.6X more likely if low vitamin D – April 2013
- Recurrence of child pneumonia delayed by 100000 IU of vitamin D – RCT Oct 2010
- Pneumonia and low vitamin D - many studies
- Any supplementation with vitamin D reduced chance of Any supplementation with vitamin D reduced chance of pneunomia by 50 percent – Oct 2013by 50 percent – Oct 2013