(26-11-11) Prospective association of vitamin D concentrations with mortality in postmenopausal women

: results from the Women's Health Initiative (WHI)1,2,3
1. Charles B Eaton,
2. Alicia Young,
3. Matthew A Allison,
4. Jennifer Robinson,
5. Lisa W Martin,
6. Lewis H Kuller,
7. Karen C Johnson,
8. J David Curb,
9. Linda Van Horn,
10. Anne McTiernan,
11. Simin Liu, and
12. JoAnn E Manson
+Author Affiliations
1. 1From the Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI (CBE); the Public Health Sciences Division, Epidemiology (AM), Fred Hutchinson Cancer Research Center (AY), Seattle, WA; the Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA (MAA); the Departments of Epidemiology and Medicine, Lipid Research Clinic, Prevention Intervention Center, University of Iowa, Iowa City, IA (JR); Division of Cardiology, George Washington University Medical Center, Washington, DC (LAM); the Department of Epidemiology, University Professor of Public Health, Pittsburgh, PA (LHK); the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN (KCJ); the Honolulu Heart Program, University of Hawaii, John A Burns School of Medicine, Kuakini Medical Center, Honolulu, HI (JDC); the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (LVH); the Center for Metabolic Disease Prevention, University of California Los Angeles, Program on Genomics and Nutrition, Department of Epidemiology, University of California Los Angeles, Los Angeles, CA (SL); and the Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (JEM).
+Author Notes
? ↵2 The Women's Health Initiative program is funded by the National Heart, Lung, and Blood Institute, NIH, US Department of Health and Human Services (contracts N01WH22110, 24152, 32100-2, 32105-6, 32108-9, 32111-13, 32115, 32118-32119, 32122, 42107-26, 42129-32, and 44221)
? ↵3 Address correspondence to CB Eaton, Center for Primary Care and Prevention, Alpert Medical School of Brown University, Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860. E-mail: [email protected].
Abstract
Background: Prospective epidemiologic data on the association between vitamin D and all-cause and cause-specific mortality are limited.
Objective: This study aimed to determine whether 25-hydroxyvitamin D [25(OH)D] concentrations were prospectively and independently associated with cardiovascular disease (CVD), cancer, and all-cause mortality in postmenopausal women.
Design: A substudy in 2429 postmenopausal women within the Women's Health Initiative (WHI) with measured baseline 25(OH)D concentrations were followed for 10 y for death from CVD, cancer, and all-cause mortality. Proportional hazards models were performed to evaluate quartiles of month-adjusted 25(OH)D concentrations, with adjustment for potential confounders. Sequential model building and analysis for multiplicative interaction were performed to evaluate the effects of central adiposity on the association of low 25(OH)D with all-cause mortality.
Results: Of the 2429 women, 224 deaths occurred, with 79 deaths from CVD and 62 deaths from cancer. Multivariate-adjusted HRs that compared quartiles 1 (lowest) to 4 (highest) of 25(OH)D for all-cause mortality (HR: 1.25; 95% CI: 0.80, 1.95), CVD mortality (HR: 1.27; 95% CI: 0.81, 1.99), and cancer mortality (HR: 1.39; 95% CI: 0.88, 2.19) were not significant. There was a potential interaction (P = 0.08) between abdominal obesity and low 25(OH)D concentrations that showed an increased risk of the lowest quartile of 25(OH)D concentrations (HR: 1.85; 95% CI: 1.00, 3.44) with increased mortality in women with a normal waist circumference but no increased risk in women with abdominal obesity (HR: 0.96; 95% CI: 0.52, 1.76).
Conclusion: Body fat distribution may play an important role in the modulation of the effect of low vitamin D concentrations on health. This trial was registered at clinicaltrials.gov as NCT 00000611.


Source: The american Journal of Clinical Nutrition - American Society for Nutrition

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