Low Mortality if more than 20 ng of Vitamin D (UK Biobank) – Oct 2020


Vitamin D Status and Risk of All-Cause and Cause-Specific Mortality in a Large Cohort: Results From the UK Biobank

J Clin Endocrinol Metab . 2020 Oct 1;105(10):dgaa432. doi: 10.1210/clinem/dgaa432.
Xikang Fan 1 , Jiayu Wang 1 , Mingyang Song 2 3 4 , Edward L Giovannucci 2 3 5 , Hongxia Ma 1 6 7 , Guangfu Jin 1 6 7 , Zhibin Hu 1 6 7 , Hongbing Shen 1 7 , Dong Hang 1 7

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Context: Although an inverse association between vitamin D status and mortality has been reported in observational studies, the precise association shape and optimal vitamin D status remain undetermined.

Objective: To investigate the association between vitamin D status and risk of all-cause and cause-specific mortality and estimate optimal serum 25-hydroxyvitamin D [25(OH)D] concentrations.

Design: Prospective cohort study.

Setting: UK Biobank.

Participants: 365,530 participants who had serum 25(OH)D measurements and no history of cardiovascular disease (CVD), cancer, or diabetes at baseline (2006-2010).

Main outcome measures: All-cause and cause-specific mortality.

Results: During a median follow-up of 8.9 (interquartile range: 8.3-9.5) years, 10,175 deaths occurred, including 1,841 (18.1%) due to CVD and 5,737 (56.4%) due to cancer. The multivariate analyses revealed nonlinear inverse associations, with a decrease in mortality risk appearing to level off at 60 nmol/L of 25(OH)D for all-cause and CVD deaths and at 45 nmol/L for cancer deaths.
Compared to participants with 25(OH)D concentrations below the cutoffs, those with higher concentrations had a

  • 17% lower risk for all-cause mortality (hazard ratio [HR]: 0.83, 95% confidence interval [CI]: 0.79-0.86), (24 ng)
  • 23% lower risk for CVD mortality (HR: 0.77, 95% CI: 0.68-0.86), (24 ng)
  • 11% lower risk for cancer mortality (HR: 0.89, 95% CI: 0.84-0.95).(18 ng)

Conclusions: Higher 25(OH)D concentrations are nonlinearly associated with lower risk of all-cause, CVD, and cancer mortality. The thresholds of 45 to 60 nmol/L might represent an intervention target to reduce the overall risk of premature death, which needs further confirmation in large clinical trials.
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