(26-09-14) Serum 25-hydroxyvitamin D, mortality, and incident cardiovascular disease, respiratory disease, cancers, and fractures:

Serum 25-hydroxyvitamin D, mortality, and incident cardiovascular disease, respiratory disease, cancers, and fractures: a 13-y prospective population study1–4


AJCN. First published ahead of print September 17, 2014 as doi: 10.3945/ajcn.114.086413

Kay-Tee Khaw, Robert Luben, and Nicholas Wareham

ABSTRACT
Background: Vitamin D is associated with many health conditions,
but optimal blood concentrations are still uncertain.
Objectives: We examined the prospective relation between serum
25-hydroxyvitamin D [25(OH)D] concentrations [which comprised
25(OH)D3 and 25(OH)D2] and subsequent mortality by the cause
and incident diseases in a prospective population study.
Design: Serum vitamin D concentrations were measured in 14,641
men and women aged 42–82 y in 1997–2000 who were living in
Norfolk, United Kingdom, and were followed up to 2012. Participants
were categorized into 5 groups according to baseline serum
concentrations of total 25(OH)D ,30, 30 to ,50, 50 to ,70, 70 to
,90, and $90 nmol/L.

Results: The mean serum total 25(OH)D was 56.6 nmol/L, which
consisted predominantly of 25(OH)D3 (mean: 56.2 nmol/L; 99% of
total). The age-, sex-, and month-adjusted HRs (95% CIs) for allcause
mortality (2776 deaths) for men and women by increasing
vitamin D category were 1, 0.84 (0.74, 0.94), 0.72 (0.63, 0.81), 0.71
(0.62, 0.82), and 0.66 (0.55, 0.79) (P-trend , 0.0001). When analyzed
as a continuous variable and with additional adjustment for body mass
index, smoking, social class, education, physical activity, alcohol intake,
plasma vitamin C, history of cardiovascular disease, diabetes, or
cancer, HRs for a 20-nmol/L increase in 25(OH)D were 0.92 (0.88,
0.96) (P , 0.001) for total mortality, 0.96 (0.93, 0.99) (P = 0.014)
(4469 events) for cardiovascular disease, 0.89 (0.85, 0.93) (P ,
0.0001) (2132 events) for respiratory disease, 0.89 (0.81, 0.98) (P =
0.012) (563 events) for fractures, and 1.02 (0.99, 1.06) (P = 0.21)
(3121 events) for incident total cancers.

Conclusions: Plasma 25(OH)D concentrations predict subsequent
lower 13-y total mortality and incident cardiovascular disease, respiratory
disease, and fractures but not total incident cancers. For
mortality, lowest risks were in subjects with concentrations .90
nmol/L, and there was no evidence of increased mortality at high
concentrations, suggesting that a moderate increase in population
mean concentrations may have potential health benefit, but ,1% of
the population had concentrations .120 nmol/L. Am J

Source: Clin Nutr doi: 10.3945/ajcn.114.086413.

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