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 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 Association of Serum 25-Hydroxyvitamin D Concentrations with All-Cause and Cause-Specific Mortality Among Adult Patients with Existing Cardiovascular Disease

2021 ◽  
Author(s):  
Lei Dai ◽  
Man Liu ◽  
Liangkai Chen
Keyword(s):  
Cardiovascular Disease ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Respiratory Disease ◽  
Adult Patients ◽  
Hydroxyvitamin D ◽  
Specific Mortality ◽  
25 Hydroxyvitamin D ◽  
Reduced Risk ◽  
Cvd Mortality

Abstract Background:Vitamin D insufficiency and deficiency are common in patients with cardiovascular disease (CVD). We aimed to prospectively examine the associations of serum 25-hydroxyvitamin D [25(OH)D] concentrations with all-cause and cause-specific mortality among adult patients with existing CVD.Methods:We included 37,080 patients with CVD from the UK Biobank study, a prospective cohort of half a million participants aged 40–69 years. We defined patients with CVD as those who suffered coronary heart disease, atrial fibrillation, heart failure, or stroke. The associations of serum 25(OH)D concentration with all-cause and cause-specific mortality were examined by using multivariable Cox regression models and competing risk analyses.Results:Among 37,080 patients with CVD at baseline, 57.5% were subjected to vitamin D deficiency (i.e., 25[OH]D <50 nmol/L). During a median follow-up of 8.9 years, 3920 total deaths occurred, including 1411 deaths from CVD, 1497 deaths from cancer, 368 deaths from respiratory disease, and 644 other-cause deaths. We observed non-linear inverse associations for all-cause, cancer, respiratory disease, and other-cause mortality (P-nonlinearity <0.001) and approximately linear inverse associations for CVD mortality (P-nonlinearity = 0.069). Among CVD patients with vitamin D deficiency, per 10 nmol/L increment in serum 25(OH)D concentrations was associated with an 11% reduced risk for all-cause mortality and 10% reduced risk for CVD mortality.Conclusion:Among patients with existing CVD, increasing levels in serum 25(OH)D were independently associated with a decreased risk of all-cause and cause-specific mortality. These findings suggest that elevated serum 25(OH)D concentration benefits CVD patients with vitamin D deficiency.

scholarly journals Association of Serum 25-Hydroxyvitamin D Concentrations With All-Cause and Cause-Specific Mortality Among Adult Patients With Existing Cardiovascular Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Lei Dai ◽  
Man Liu ◽  
Liangkai Chen
Keyword(s):  
Cardiovascular Disease ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Respiratory Disease ◽  
Adult Patients ◽  
Hydroxyvitamin D ◽  
Specific Mortality ◽  
25 Hydroxyvitamin D ◽  
Reduced Risk ◽  
Cvd Mortality

Background: Vitamin D insufficiency and deficiency are common in patients with cardiovascular disease (CVD). We aimed to prospectively examine the associations of serum 25-hydroxyvitamin D [25(OH)D] concentrations with all-cause and cause-specific mortality among adult patients with existing CVD.Methods: We included 37,079 patients with CVD from the UK Biobank study, a prospective cohort of half a million participants aged 40–69 years. We defined patients with CVD as those who suffered coronary heart disease, atrial fibrillation, heart failure, or stroke. The associations of serum 25(OH)D concentration with all-cause and cause-specific mortality were examined by using multivariable Cox regression models and competing risk analyses.Results: Among 37,079 patients with CVD at baseline, 57.5% were subjected to vitamin D deficiency (i.e., 25[OH]D &lt;50 nmol/L). During a median follow-up of 11.7 years, 6,319 total deaths occurred, including 2,161 deaths from CVD, 2,230 deaths from cancer, 623 deaths from respiratory disease, and 1,305 other-cause deaths. We observed non-linear inverse associations for all-cause, cancer, respiratory disease, and other-cause mortality (P-non-linearity &lt;0.01) and approximately linear inverse associations for CVD mortality (P-non-linearity = 0.074). Among CVD patients with vitamin D deficiency, per 10 nmol/L increment in serum 25(OH)D concentrations was associated with an 12% reduced risk for all-cause mortality and 9% reduced risk for CVD mortality.Conclusion: Among patients with existing CVD, increasing levels in serum 25(OH)D were independently associated with a decreased risk of all-cause and cause-specific mortality. These findings suggest that elevated serum 25(OH)D concentration benefits CVD patients with vitamin D deficiency.

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.

scholarly journals Weight and skin colour as predictors of vitamin D status: results of an epidemiological investigation using nationally representative data

2016 ◽  
Vol 20 (10) ◽  
pp. 1857-1864 ◽  
Author(s):  
Sonali Rajan ◽  
Tom Weishaar ◽  
Bryan Keller
Keyword(s):  
Vitamin D ◽  
Body Weight ◽  
Skin Colour ◽  
Vitamin D Status ◽  
Epidemiological Investigation ◽  
Dietary Recommendations ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Nationally Representative ◽  
The Impact

AbstractObjectiveCurrent US dietary recommendations for vitamin D vary by age. Recent research suggests that body weight and skin colour are also major determinants of vitamin D status. The objective of the present epidemiological investigation was to clarify the role of age as a predictor of vitamin D status, while accounting for body weight and skin colour, among a nationally representative sample.DesignWe calculated the mean serum 25-hydroxyvitamin D levels for the US population by age and weight, as well as by weight and race/ethnicity group. Multiple regression analyses were utilized to evaluate age and weight as predictors of vitamin D status: serum 25-hydroxyvitamin D levels with age alone, age and body weight, and age, body weight and their two-way interaction were modelled for the entire sample and each age subgroup. Graphical data were developed using B-spline non-linear regression.SettingNational Health and Nutrition Examination Survey (31 934 unweighted cases).SubjectsIndividuals aged 1 year and older.ResultsThere were highly significant differences in mean vitamin D status among US residents by weight and skin colour, with those having darker skin colour or higher body weight having worse vitamin D status. Although a significant factor, the impact of age on vitamin D status was notably less than the impact of body weight.ConclusionsVitamin D status varied predominantly by body weight and skin colour. Recommendations by nutritionists for diet and supplementation needs should take this into account if vitamin D-related health disparities are to be meaningfully reduced across the USA.

scholarly journals Vitamin D Status Is Negatively Correlated with Insulin Resistance in Chinese Type 2 Diabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Jie Zhang ◽  
Jianhong Ye ◽  
Gang Guo ◽  
Zhenhao Lan ◽  
Xing Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Type 2 Diabetes Mellitus ◽  
Chinese Patients ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

Objectives. Vitamin D deficiency plays a role in insulin resistance and the pathogenesis of type 2 diabetes mellitus. Little information is available about the association between vitamin D status and insulin resistance in the Chinese population. Currently, vitamin D status is evaluated by the concentrations of serum 25-hydroxyvitamin D [25(OH)D]. This study explores the relationship between insulin resistance and serum 25-hydroxyvitamin D concentrations in Chinese patients with type 2 diabetes mellitus.Subjects and Methods. This study included 117 patients with type 2 diabetes. The following variables were measured: 25-hydroxyvitamin D [25(OH)D], glycosylated hemoglobin A1c (HbA1c), fasting blood glucose (FBS), fasting blood insulin (FINS), fasting blood C-peptide, serum creatinine (SCr), glomerular filtration rate (eGFR), body mass index (BMI), and homeostatic model estimates of insulin resistance (HOMA-IR).Results. The cases were divided into three groups: Group 1 (G1) with 25(OH)D ≤ 20 ng/mL [≤50 nmol/L], Group 2 (G2) with 25(OH)D values from 20 ng/mL [50 nmol/L] to 30 ng/mL [75 nmol/L], and Group 3 (G3) with 25(OH)D ≥ 30 ng/mL [≥75 nmol/L], with 52.6%, 26.3%, and 21.1% of subjects in Groups 1–3, respectively. There was a negative correlation between 25(OH)D and HOMA-IR (β= −0.314,p=0.001) adjusted by age, BMI, and eGFR.Conclusion. Better vitamin D status may be protective of glucose homeostasis since 25(OH)D was negatively associated with insulin resistance in Chinese patients with type 2 diabetes.

scholarly journals Comparison of Vitamin D and 25-Hydroxyvitamin D Concentrations in Human Breast Milk between 1989 and 2016–2017

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 573
Author(s):  
Naoko Tsugawa ◽  
Mayu Nishino ◽  
Akiko Kuwabara ◽  
Honami Ogasawara ◽  
Maya Kamao ◽  
...  
Keyword(s):  
Vitamin D ◽  
Breast Milk ◽  
Sun Exposure ◽  
Stepwise Multiple Regression ◽  
Human Breast Milk ◽  
Vitamin D Status ◽  
Human Breast ◽  
Hydroxyvitamin D ◽  
Lactating Mothers ◽  
25 Hydroxyvitamin D

Background: Breast milk is considered the optimal source of nutrition during infancy. Although the vitamin D concentration in human breast milk is generally considered poor for infants, vitamin D in breast milk is an important source for exclusively breastfed infants. Increases in vitamin D insufficiency and deficiency in lactating mothers may reduce vitamin D concentrations in breast milk. This study aimed to compare vitamin D and 25-hydroxyvitamin D (25OHD) concentrations in breast milk collected in 1989 and 2016–2017 and simultaneously analyze them with liquid chromatography-tandem mass spectrometry (LC-MS/MS); the association between the lifestyle of recent lactating mothers (2016–2017) and vitamin D status in human breast milk was also evaluated. Method: Lactating mothers were recruited from three regions of Japan in 1989 (n = 72) and 2016–2017 (n = 90), and milk from 3–4 months was collected in summer and winter. The samples were strictly sealed and stored at −80℃ until measurement. Breast milk vitamin D and 25OHD concentrations were analyzed by LC-MS/MS. Vitamin D intake, sun exposure, and sunscreen use of the lactating mothers in 2016–2017 were assessed. Results: Both vitamin D and 25OHD concentrations in breast milk were higher in the summer regardless of the survey year. Significantly lower vitamin D and 25OHD concentrations were observed in 2016–2017 compared with 1989 in summer, but no survey year difference was observed in winter. The stepwise multiple regression analyses identified season, daily outdoor activity, and suntan in the last 12 months as independent factors associated with vitamin D3 concentrations. Conclusion: The results suggest that low vitamin D status in recent lactating mothers may have decreased vitamin D and 25OHD concentrations in breast milk compared with the 1980s. These results are helpful for developing public health strategies to improve vitamin D status in lactating mothers and infants.

scholarly journals COVID-19 Disease Severity and Death in Relation to Vitamin D Status among SARS-CoV-2-Positive UAE Residents

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1714
Author(s):  
Habiba AlSafar ◽  
William B. Grant ◽  
Rafiq Hijazi ◽  
Maimunah Uddin ◽  
Nawal Alkaabi ◽  
...  
Keyword(s):  
Vitamin D ◽  
United Arab Emirates ◽  
Blood Levels ◽  
Vitamin D Status ◽  
Hospital Visit ◽  
Serum Samples ◽  
Hydroxyvitamin D ◽  
Increased Risk ◽  
Multiethnic Population ◽  
25 Hydroxyvitamin D

Insufficient blood levels of the neurohormone vitamin D are associated with increased risk of COVID-19 severity and mortality. Despite the global rollout of vaccinations and promising preliminary results, the focus remains on additional preventive measures to manage COVID-19. Results conflict on vitamin D’s plausible role in preventing and treating COVID-19. We examined the relation between vitamin D status and COVID-19 severity and mortality among the multiethnic population of the United Arab Emirates. Our observational study used data for 522 participants who tested positive for SARS-CoV-2 at one of the main hospitals in Abu Dhabi and Dubai. Only 464 of those patients were included for data analysis. Demographic and clinical data were retrospectively analyzed. Serum samples immediately drawn at the first hospital visit were used to measure serum 25-hydroxyvitamin D [25(OH)D] concentrations through automated electrochemiluminescence. Levels < 12 ng/mL were significantly associated with higher risk of severe COVID-19 infection and of death. Age was the only other independent risk factor, whereas comorbidities and smoking did not contribute to the outcomes upon adjustment. Sex of patients was not an important predictor for severity or death. Our study is the first conducted in the UAE to measure 25(OH)D levels in SARS-CoV-2-positive patients and confirm the association of levels < 12 ng/mL with COVID-19 severity and mortality.

scholarly journals Vitamin D Status and Seasonal Variation among Danish Children and Adults: A Descriptive Study

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1801 ◽  
Author(s):  
Louise Hansen ◽  
Anne Tjønneland ◽  
Brian Køster ◽  
Christine Brot ◽  
Rikke Andersen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Seasonal Variation ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
Supplement Use ◽  
Wide Range ◽  
Adults And Children ◽  
25 Hydroxyvitamin D ◽  
Vitamin D Supplement ◽  
Very High

The aim of the present study was to describe vitamin D status and seasonal variation in the general Danish population. In this study, 3092 persons aged 2 to 69 years (2565 adults, 527 children) had blood drawn twice (spring and autumn) between 2012 and 2014. A sub-sample of participants had blood samples taken monthly over a year. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were measured by liquid chromatography mass spectrometry, and information on supplement use was assessed from questionnaires. Seasonal variations in 25(OH)D concentrations were evaluated graphically and descriptively, and status according to age, sex, and supplement use was described. It was found that 86% of both adults and children were vitamin D-sufficient in either spring and or/autumn; however, many had a spring concentration below 50 nmol/L. A wide range of 25(OH)D concentrations were found in spring and autumn, with very low and very high values in both seasons. Among adults, women in general had higher median 25(OH)D concentrations than men. Furthermore, vitamin D supplement use was substantial and affected the median concentrations markedly, more so during spring than autumn. Seasonal variation was thus found to be substantial, and bi-seasonal measurements are vital in order to capture the sizable fluctuations in vitamin D status in this Nordic population.

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