Association between fat-soluble vitamins and self-reported health status: a cross-sectional analysis of the MARK-AGE cohort
Br J Nutr. 2021 Nov 19;1-28. doi: 10.1017/S0007114521004633
Caroline S Stokes 1 2, Daniela Weber 1 3, Stefan Wagenpfeil 4, Wolfgang Stuetz 5, María Moreno-Villanueva 6 7, Martijn E T Dollé 8, Eugène Jansen 8, Efstathios S Gonos 9, Jürgen Bernhardt 10, Beatrix Grubeck-Loebenstein 11, Simone Fiegl 12, Ewa Sikora 13, Olivier Toussaint 14, Florence Debacq-Chainiaux 14, Miriam Capri 15 16, Antti Hervonen 17, P Eline Slagboom 18, Nicolle Breusing 19, Jan Frank 5, Alexander Bürkle 6, Claudio Franceschi 20, Tilman Grune 1 3 21 22 23 24
Self-rated health (SRH) is associated with higher risk of death. Since low plasma levels of fat-soluble vitamins are related to mortality, we aimed to assess whether plasma concentrations of vitamins A, D and E were associated with SRH in the MARK-AGE study. We included 3158 participants (52% female) aged between 35-75 years. Cross-sectional data were collected via questionnaires. An enzyme immunoassay quantified 25-hydroxyvitamin D and HPLC determined α-tocopherol and retinol plasma concentrations. The median 25-hydroxyvitamin D and retinol concentrations differed significantly (P<0.001) between SRH categories, and were lower in the combined fair/poor category versus the excellent, very good, good categories (25-hydroxvitamin D: 40.8 vs. 51.9, 49.3, 46.7 nmol/l, respectively; retinol: 1.67 vs. 1.75, 1.74, 1.70 µmol/l, respectively). Both vitamin D and retinol status were independently associated with fair/poor SRH in multiple regression analyses: adjusted ORs (95% CI) for the vitamin D insufficiency, deficiency, severe deficiency categories were 1.33 (1.06-1.68), 1.50 (1.17-1.93), and 1.83 (1.34-2.50) respectively; P=0.015, P=0.001, P<0.001, and for the second/third/fourth retinol quartiles: 1.44 (1.18-1.75), 1.57 (1.28-1.93), 1.49 (1.20-1.84); all P<0.001. No significant associations were reported for α-tocopherol quartiles. Lower vitamin A and D status emerged as independent markers for fair/poor SRH. Further insights into the long-term implications of these modifiable nutrients on health status are warranted.