scholarly journals Plasma 25-Hydroxyvitamin D Concentrations Are Inversely Associated with All-Cause Mortality among a Prospective Cohort of Chinese Adults Aged ≥80 Years

2019 ◽  
Vol 149 (6) ◽  
pp. 1056-1064 ◽  
Author(s):  
Chen Mao ◽  
Fu-Rong Li ◽  
Zhao-Xue Yin ◽  
Yue-Bin Lv ◽  
Jie-Si Luo ◽  
...  
Keyword(s):  
Vitamin D ◽  
Prospective Cohort ◽  
Sensitivity Analyses ◽  
Mortality Data ◽  
Inverse Association ◽  
Chinese Adults ◽  
Hydroxyvitamin D ◽  
All Cause Mortality ◽  
25 Hydroxyvitamin D

ABSTRACT Background High concentrations of plasma 25-hydroxyvitamin D [25(OH)D], a marker of circulating vitamin D, have been associated with a lower risk of mortality in epidemiologic studies of multiple populations, but the association for Chinese adults aged ≥80 y (oldest old) remains unclear. Objective We investigated the association between plasma [25(OH)D] concentration and all-cause mortality among Chinese adults aged ≥80 y. Design The present study is a prospective cohort study of 2185 Chinese older adults (median age: 93 y). Prospective all-cause mortality data were analyzed for survival in relation to plasma 25(OH)D using Cox proportional hazards regression models, with adjustments for potential sociodemographic and lifestyle confounders and biomarkers. The associations were measured with HR and 95% CIs. Results The median plasma 25(OH)D concentration was 34.4 nmol/L at baseline. Over the 5466 person-year follow-up period, 1100 deaths were identified. Men and women were analyzed together as no effect modification by sex was found. After adjusting for multiple potential confounders, the risk of all-cause mortality decreased as the plasma 25(OH)D concentration increased (P-trend <0.01). Compared with the lowest age-specific quartile of plasma 25(OH)D, the adjusted HRs for mortality for the second, third, and fourth age-specific quartiles were 0.72 (95% CI: 0.57, 0.90), 0.73 (95% CI: 0.58, 0.93), and 0.61 (95% CI: 0.47, 0.81), respectively. The observed associations were broadly consistent across age and other subgroups. Sensitivity analyses generated similar results after excluding participants who died within 2 y of follow-up or after further adjustment for ethnicity and chronic diseases. Conclusions A higher plasma 25-hydroxyvitamin D concentration was associated with a reduced risk of all-cause mortality among Chinese adults aged ≥80 y. This observed inverse association warrants further investigation in randomized controlled trials testing vitamin D supplementation in this age group.

scholarly journals The Risk of All-Cause Mortality Is Inversely Related to Serum 25(OH)D Levels

2012 ◽  
Vol 97 (8) ◽  
pp. 2792-2798 ◽  
Author(s):  
Walid Saliba ◽  
Ofra Barnett ◽  
Hedy S. Rennert ◽  
Gad Rennert
Keyword(s):  
Vitamin D ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Vital Status ◽  
Hydroxyvitamin D ◽  
All Cause Mortality ◽  
General Population Cohort ◽  
25 Hydroxyvitamin D ◽  
Vitamin D Supplements

Abstract Context and Objectives: Vitamin D plays a key role in maintaining bone health, but evidence for its nonskeletal effects is inconsistent. This study aims to examine the association between serum 25-hydroxyvitamin D [25(OH)D] levels and all-cause mortality in a large general population cohort. Design, Participants, and Setting: Using the computerized database of the largest health care provider in Israel, we identified a cohort of subjects 20 years old or older with serum 25(OH)D levels measured between January 2008 and December 2009. Vital status was ascertained through August 2011. Results: Median follow-up was 28.5 months (interquartile range 23.8–33.5 months); 7,247 of 182,152 participants (4.0%) died. Subjects who died had significantly lower serum 25(OH)D levels (mean 44.8 ± 24.2 nmol/liter) than those alive at the end of follow-up (51.0 ± 23.2 nmol/liter), P &lt; 0.001. After adjustment for age, gender, ethnicity, and seasonality, the hazard ratio (HR) for all-cause mortality was 2.02 [95% confidence interval (CI) 1.89–2.15] for the lowest serum 25(OH)D quartile (&lt;33.8 nmol/liter) compared with the highest. After further adjustment for comorbidity, use of vitamin D supplements and statins, smoking, socioeconomic status, and body mass index, the HR was 1.81 (95% CI 1.69–1.95). This remained, even after adjustment for serum low-density lipoprotein, high-density lipoprotein, calcium level (corrected for serum albumin levels), and glomerular filtration rate, 1.85 (95% CI 1.70–2.01). The fully adjusted HR associated with being in the second 25(OH)D quartile (33.8–49.4 nmol/liter) was 1.25 (95% CI 1.16–1.34). Conclusions: All-cause mortality is independently and inversely associated with serum 25(OH)D levels at levels less than 50 nmol/liter.

Abstract P173: Serum 25-hydroxyvitamin D and Mortality in Middle-aged Men and Women: Results from the MONICA/KORA Augsburg Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Barbara Thorand ◽  
Astrid Zierer ◽  
Andrea Schneider ◽  
Cornelia Huth ◽  
Christine S Autenrieth ◽  
...  
Keyword(s):  
Vitamin D ◽  
Large Scale ◽  
Inverse Association ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
Markers Of Inflammation ◽  
Vitamin D Levels ◽  
All Cause Mortality ◽  
25 Hydroxyvitamin D ◽  
Cvd Mortality

Background: Recent studies found an inverse association between vitamin D status and both morbidity and mortality from major chronic diseases such as cardiovascular diseases (CVD) and cancer. In contrast, some studies have suggested adverse health effects such as increased all-cause mortality at the high end of vitamin D levels. Therefore, the aim of the present study was to further elucidate the relationship between 25-hydroxyvitamin D (25[OH]D) and all-cause as well as CVD and non-CVD mortality. Methods: Our study population comprised 851 men and 774 women aged 35-74 years at baseline selected randomly, stratifying by sex and survey out of 9,531 subjects with available blood samples. All had participated in at least one of the three population-based MONICA/KORA Augsburg surveys between 1984-1995. Participants were followed-up for a mean of 16.8 ± 5.4 years. During this period 197 persons died from CVD (ICD9 390-459, 798) and 226 from non-cardiovascular causes. For three participants the cause of death was missing. 25[OH]D was measured in serum samples collected at baseline using an enzyme immunoassay from IDS, Frankfurt. Results: After adjustment for age, sex, survey, and season of blood sampling we observed a significant inverse association between serum 25[OH]D and all-cause mortality. The hazard ratio (HR) and 95% confidence interval (CI) comparing subjects with levels >75 nmol/l to those with levels ≤25 nmol/l was 0.59 (0.38-0.93); P trend =0.007 across the following four categories: ≤25 nmol/l; >25-≤50 nmol/l; >50-≤75 nmol/l; >75 nmol/l, assigning the median value within each category to the respective category. Further adjustment for BMI, education and lifestyle factors attenuated the association and it became non-significant (HR [95% CI]: 0.78 [0.48-1.27]; P trend =0.205). For CVD mortality, we also observed an inverse association which persisted after adjustment for the above mentioned confounders (HR [95% CI]: 0.49 [0.21-1.11]; P trend =0.012). After further multivariable adjustment including potential intermediate risk factors such as systolic blood pressure, total cholesterol/HDL-cholesterol, diabetes and markers of inflammation the association became non-significant (HR [95% CI]: 0.63 [0.26-1.51]; P trend =0.122). We did not observe any significant association between 25[OH]D and non-CVD mortality regardless of the degree of adjustment. However, there was a trend towards increased non-CVD mortality in women with 25[OH]D >75 nmol/l compared to those with concentrations ≤25 nmol/l (HR [95% CI]: 2.87 [0.99-8.33]; P trend =0.111 for the fully adjusted model). Conclusions: Our data indicate that vitamin D status is inversely related to CVD mortality. However, before large scale measures to improve vitamin D status should be initiated, further studies should evaluate potentially harmful effects of very high levels of 25[OH]D on other outcomes especially among women.

Vitamin D Level Stability in Dystrophinopathy Patients on Vitamin D Supplementation

2021 ◽  
pp. 1-7
Author(s):  
Naomi Vather-Wu ◽  
Matthew D. Krasowski ◽  
Katherine D. Mathews ◽  
Amal Shibli-Rahhal
Keyword(s):  
Vitamin D ◽  
Retrospective Cohort ◽  
Vitamin D Supplementation ◽  
Hydroxyvitamin D ◽  
Frequent Monitoring ◽  
25 Hydroxyvitamin D ◽  
The Mean ◽  
Stable Maintenance ◽  
Mean Time

Background: Expert guidelines recommend annual monitoring of 25-hydroxyvitamin D (25-OHD) and maintaining 25-OHD ≥30 ng/ml in patients with dystrophinopathies. Objective: We hypothesized that 25-OHD remains stable and requires less frequent monitoring in patients taking stable maintenance doses of vitamin D. Methods: We performed a retrospective cohort study, using the electronic health record to identify 26 patients with dystrophinopathies with a baseline 25-OHD ≥30 ng/mL and at least one additional 25-OHD measurement. These patients had received a stable dose of vitamin D for ≥3 months prior to their baseline 25-OHD measurement and throughout follow-up. The main outcome measured was the mean duration time the subjects spent with a 25-OHD ≥30 ng/mL. Results: Only 19% of patients dropped their 25-OHD to <  30 ng/ml, with a mean time to drop of 33 months and a median nadir 25-OHD of 28 ng/mL. Conclusions: These results suggest that measurement of 25-OHD every 2–2.5 years may be sufficient in patients with a baseline 25-OHD ≥30 ng/mL and who are on a stable maintenance dose of vitamin D. Other patients may require more frequent assessments.

scholarly journals Association of serum 25-hydroxyvitamin D concentrations with all-cause and cause-specific mortality among individuals with diabetes mellitus

2020 ◽  
Author(s):  
Zhenzhen Wan ◽  
Jingyu Guo ◽  
An Pan ◽  
Chen Chen ◽  
Liegang Liu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin D ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
25 Hydroxyvitamin D ◽  
Nationally Representative ◽  
Reduced Risk ◽  
Cvd Mortality

<b>Objective: </b>The evidence regarding vitamin D status and mortality among diabetes is scarce. This study aimed to examine the association of serum 25-hydroxyvitamin D [25(OH)D] concentrations with all-cause and cause-specific mortality among adults with <a>diabetes mellitus</a>. <p><b>Research Design and Methods: </b>This study included 6329 adults with diabetes from the Third National Health and Nutrition Examination Survey (NHANES III) and NHANES 2001-2014. Death outcomes were ascertained by linkage to National Death Index records through 31 December 2015. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence (CIs) for mortality from all causes, cardiovascular disease (CVD), and cancer.</p> <p><b>Results:</b> The weighted mean (95% CI) level of serum 25(OH)D was 57.7 (56.6, 58.8) nmol/L, and 46.6% had deficient vitamin D (<50 nmol/L [20 ng/mL]). <a>Higher </a>serum 25(OH)D levels were significantly associated with lower levels of glucose, insulin, HOMA-IR, HbA1c, blood lipids, and C-reactive protein at baseline (all <i>P</i><sub>trend</sub><0.05). During 55126 person-years of follow-up, 2056 deaths were documented, including 605 CVD deaths and 309 cancer deaths. <a>After multivariate adjustment, higher </a>serum 25(OH)D levels were significantly and linearly associated with lower all-cause and CVD mortality: there was a 31% reduced risk of all-cause mortality and a 38% reduced risk of CVD mortality per one unit increment in natural log-transformed 25(OH)D (both <i>P</i><0.001). Compared with participants with 25(OH)D <25 nmol/L, the multivariate-adjusted HRs and 95% CI for participants with 25(OH)D >75 nmol/L were 0.59 (0.43, 0.83) for all-cause mortality (<i>P</i><sub>trend</sub>=0.003), 0.50 (0.29, 0.86) for CVD mortality (<i>P</i><sub>trend</sub>=0.02), and 0.49 (0.23, 1.04) for cancer mortality (<i>P</i><sub>trend</sub>=0.12). </p> <p><b>Conclusions: </b>In a nationally representative sample of US adults with diabetes, higher serum 25(OH)D levels were significantly associated with lower all-cause and CVD mortality. These findings suggest that maintaining adequate vitamin D status may lower mortality risk in individuals with diabetes.</p>

scholarly journals Tumor Autonomous Effects of Vitamin D Deficiency Promote Breast Cancer Metastasis

Endocrinology ◽  
2016 ◽  
Vol 157 (4) ◽  
pp. 1341-1347 ◽  
Author(s):  
Jasmaine D. Williams ◽  
Abhishek Aggarwal ◽  
Srilatha Swami ◽  
Aruna V. Krishnan ◽  
Lijuan Ji ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Cancer Metastasis ◽  
Receptor Expression ◽  
Inverse Association ◽  
Primary Tumors ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Vitamin D Signaling

Abstract Patients with breast cancer (BCa) frequently have preexisting vitamin D deficiency (low serum 25-hydroxyvitamin D) when their cancer develops. A number of epidemiological studies show an inverse association between BCa risk and vitamin D status in humans, although some studies have failed to find an association. In addition, several studies have reported that BCa patients with vitamin D deficiency have a more aggressive molecular phenotype and worse prognostic indicators. However, it is unknown whether this association is mechanistically causative and, if so, whether it results from systemic or tumor autonomous effects of vitamin D signaling. We found that ablation of vitamin D receptor expression within BCa cells accelerates primary tumor growth and enables the development of metastases, demonstrating a tumor autonomous effect of vitamin D signaling to suppress BCa metastases. We show that vitamin D signaling inhibits the expression of the tumor progression gene Id1, and this pathway is abrogated in vitamin D deficiency in vivo in 2 murine models of BCa. These findings are relevant to humans, because we discovered that the mechanism of VDR regulation of Inhibitor of differentiation 1 (ID1) is conserved in human BCa cells, and there is a negative correlation between serum 25-hydroxyvitamin D levels and the level of ID1 in primary tumors from patients with BCa.

scholarly journals Vitamin D intake and risk of CVD and all-cause mortality: evidence from the Caerphilly Prospective Cohort Study

2017 ◽  
Vol 20 (15) ◽  
pp. 2744-2753 ◽  
Author(s):  
Jing Guo ◽  
John R Cockcroft ◽  
Peter C Elwood ◽  
Janet E Pickering ◽  
Julie A Lovegrove ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Vitamin D ◽  
Cohort Study ◽  
Diastolic Blood Pressure ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cvd Risk ◽  
Vitamin D Intake ◽  
All Cause Mortality

AbstractObjectiveProspective data on the associations between vitamin D intake and risk of CVD and all-cause mortality are limited and inconclusive. The aim of the present study was to investigate the associations between vitamin D intake and CVD risk and all-cause mortality in the Caerphilly Prospective Cohort Study.DesignThe associations of vitamin D intake with CVD risk markers were examined cross-sectionally at baseline and longitudinally at 5-year, 10-year and >20-year follow-ups. In addition, the predictive value of vitamin D intake for CVD events and all-cause mortality after >20 years of follow-up was examined. Logistic regression and general linear regression were used for data analysis.SettingParticipants in the UK.SubjectsMen (n452) who were free from CVD and type 2 diabetes at recruitment.ResultsHigher vitamin D intake was associated with increased HDL cholesterol (P=0·003) and pulse pressure (P=0·04) and decreased total cholesterol:HDL cholesterol (P=0·008) cross-sectionally at baseline, but the associations were lost during follow-up. Furthermore, higher vitamin D intake was associated with decreased concentration of plasma TAG at baseline (P=0·01) and at the 5-year (P=0·01), but not the 10-year examination. After >20 years of follow-up, vitamin D was not associated with stroke (n72), myocardial infarctions (n142), heart failure (n43) or all-cause mortality (n281), but was positively associated with increased diastolic blood pressure (P=0·03).ConclusionsThe study supports associations of higher vitamin D intake with lower fasting plasma TAG and higher diastolic blood pressure.

scholarly journals Serum 25-hydroxyvitamin D concentrations and cardiometabolic risk factors in adolescents and young adults

2016 ◽  
Vol 115 (11) ◽  
pp. 1994-2002 ◽  
Author(s):  
Lucinda J. Black ◽  
Sally Burrows ◽  
Robyn M. Lucas ◽  
Carina E. Marshall ◽  
Rae-Chi Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Vitamin D ◽  
Cardiometabolic Risk ◽  
Hdl Cholesterol ◽  
Cardiometabolic Risk Factors ◽  
Inverse Association ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Over Time

AbstractEvidence associating serum 25-hydroxyvitamin D (25(OH)D) concentrations and cardiometabolic risk factors is inconsistent and studies have largely been conducted in adult populations. We examined the prospective associations between serum 25(OH)D concentrations and cardiometabolic risk factors from adolescence to young adulthood in the West Australian Pregnancy Cohort (Raine) Study. Serum 25(OH)D concentrations, BMI, homoeostasis model assessment for insulin resistance (HOMA-IR), TAG, HDL-cholesterol and systolic blood pressure (SBP) were measured at the 17-year (n 1015) and 20-year (n 1117) follow-ups. Hierarchical linear mixed models with maximum likelihood estimation were used to investigate associations between serum 25(OH)D concentrations and cardiometabolic risk factors, accounting for potential confounders. In males and females, respectively, mean serum 25(OH)D concentrations were 73·6 (sd 28·2) and 75·4 (sd 25·9) nmol/l at 17 years and 70·0 (sd 24·2) and 74·3 (sd 26·2) nmol/l at 20 years. Deseasonalised serum 25(OH)D3 concentrations were inversely associated with BMI (coefficient −0·01; 95 % CI −0·03, −0·003; P=0·014). No change over time was detected in the association for males; for females, the inverse association was stronger at 20 years compared with 17 years. Serum 25(OH)D concentrations were inversely associated with log-HOMA-IR (coefficient −0·002; 95 % CI −0·003, −0·001; P<0·001) and positively associated with log-TAG in females (coefficient 0·002; 95 % CI 0·0008, 0·004; P=0·003). These associations did not vary over time. There were no significant associations between serum 25(OH)D concentrations and HDL-cholesterol or SBP. Clinical trials in those with insufficient vitamin D status may be warranted to determine any beneficial effect of vitamin D supplementation on insulin resistance, while monitoring for any deleterious effect on TAG.

scholarly journals Circulating 25-hydroxyvitamin D levels in relation to blood pressure parameters and hypertension in the Shanghai Women's and Men's Health Studies

2012 ◽  
Vol 108 (3) ◽  
pp. 449-458 ◽  
Author(s):  
Tsogzolmaa Dorjgochoo ◽  
Xiao Ou Shu ◽  
Yong-Bing Xiang ◽  
Gong Yang ◽  
Qiuyin Cai ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Antihypertensive Drugs ◽  
Urban China ◽  
Inverse Association ◽  
Cross Sectional ◽  
Who Criteria ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

Little is known about the association of circulating 25-hydroxyvitamin D (25(OH)D) and blood pressure (BP) parameters, including systolic and diastolic BP, pulse pressure (PP), mean arterial pressure (MAP) and hypertension in non-Western populations that have not yet been exposed to foods fortified with vitamins and seldom use vitamin D supplements. A cross-sectional analysis of plasma 25(OH)D levels in association with BP measures was performed for 1460 participants (1055 women and 405 men, aged 40–74 years) of two large cohort studies in Shanghai. Multivariable linear and logistic regressions were conducted. Overall, the prevalence of vitamin D deficiency was 55·8 % using National Health and Nutrition Examination Survey, USA criteria and 29·9 % using WHO criteria. The median plasma 25(OH)D level in the population was 38·0 nmol/l for men and 33·6 nmol/l for women (P < 0·01) among participants who were not on antihypertensive drugs. Among men, BP parameters (systolic BP, diastolic BP and MAP) were significantly and inversely associated with higher quintiles of 25(OH)D compared with the lowest quintile (Ptrend < 0·05 for all). Vitamin D non-deficient status (WHO criteria) was inversely associated with hypertension (ORadjusted = 0·29; 95 % CI 0·10, 0·82). An inverse association was also found between hypertension and the highest quintile of 25(OH)D (ORadjusted = 0·16; 95 % CI 0·04, 0·65 for ≥ 50·6 nmol/l; Ptrend = 0·02). Among women, no significant associations were found for BP parameters and hypertension. The present study shows that vitamin D deficiency is common among adults in urban China. Circulating 25(OH)D levels were inversely related to the levels of individual BP parameters and hypertension among middle-aged and elderly men but not among women. More research is needed to investigate the potential sex differential associations.

scholarly journals Low Plasma 25-Hydroxyvitamin D and Risk of Tobacco-Related Cancer

2013 ◽  
Vol 59 (5) ◽  
pp. 771-780 ◽  
Author(s):  
Shoaib Afzal ◽  
Stig E Bojesen ◽  
Børge G Nordestgaard
Keyword(s):  
Vitamin D ◽  
Tobacco Smoke ◽  
Population Based ◽  
Lower Plasma ◽  
Vitamin D Metabolism ◽  
Hydroxyvitamin D ◽  
Hazard Ratios ◽  
25 Hydroxyvitamin D ◽  
And Function

BACKGROUND Tobacco smoke chemicals may influence vitamin D metabolism and function, and conversely vitamin D may modify the carcinogenicity of tobacco smoke chemicals. We tested the hypothesis that lower plasma 25-hydroxyvitamin D [25(OH)D] is associated with a higher risk of tobacco-related cancer in the general population. METHODS A prospective population-based cohort of 9791 individuals from the Copenhagen City Heart Study who were free of cancer at baseline was followed from 1981–1983 until December 2008 with 100% complete follow-up. RESULTS During up to 28 years of follow-up, 1081 participants developed a tobacco-related cancer and 1506 developed other cancers. Decreasing 25(OH)D concentrations, subdivided by clinical categories or by seasonally adjusted percentile categories, were associated with increasing cumulative incidence of tobacco-related cancer (log-rank trend P = 2 × 10−6 and P = 5 × 10−9). Multivariable adjusted hazard ratios of tobacco-related cancer were 1.75 (95% CI, 1.33–2.30) for 25(OH)D &lt;5 vs ≥20 ng/mL, and 2.07 (1.63–2.62) for ≤5th vs &gt;66th percentile. Also, multivariable adjusted hazard ratios for a 50% reduction in 25(OH)D were 1.20 (1.13–1.28) for any tobacco-related cancer, 1.19 (95% CI, 1.09–1.31) for lung cancer, 1.44 (1.19–1.73) for head and neck cancer, 1.28 (1.06–1.54) for bladder cancer, 1.34 (1.04–1.73) for kidney cancer, and 0.95 (0.89–1.01) for other cancers. CONCLUSIONS Lower plasma 25(OH)D was associated with higher risk of tobacco-related cancers, but not with risk of other cancers.

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