Inverse association between circulating vitamin D and mortality – Dependent on sex and cause of death?

• Published in: Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2013-10, Vol.23 (10), p.960-966
• Main Authors: Rohrmann, S, Braun, J, Bopp, M, Faeh, D
• Format: Article
• Language: English
• Subjects: 25-Hydroxyvitamin D 2 - blood; Adult; adults; Aged; Aging; blood pressure; Calcifediol - blood; Cardiovascular; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - mortality; chronic diseases; Cohort Studies; death; diet; Female; Follow-Up Studies; Humans; Longitudinal Studies; Male; men; Middle Aged; MONICA; Mortality; nationalities and ethnic groups; Neoplasms - epidemiology; Neoplasms - etiology; Neoplasms - mortality; Proportional Hazards Models; Risk Factors; Sex Characteristics; Switzerland; Switzerland - epidemiology; Vitamin D; vitamin D deficiency; Vitamin D Deficiency - blood; Vitamin D Deficiency - epidemiology; Vitamin D Deficiency - physiopathology; vitamin status; women
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2013.05.005

Abstract Background and aims In various populations, vitamin D deficiency is associated with chronic diseases and mortality. We examined the association between concentration of circulating 25-hydroxyvitamin D [25(OH)D], a marker of vitamin D status, and all-cause as well as cause-specific mortality. Methods and Results The study included 3404 participants of the general adult Swiss population, who were recruited between November 1988 and June 1989 and followed-up until the end of 2008. Circulating 25(OH)D was measured by protein-bound assay. Cox proportional hazards regression was used to examine the association between 25(OH)D concentration and all-cause and cause-specific mortality adjusting for sex, age, season, diet, nationality, blood pressure, and smoking status. Per 10 ng/mL increase in 25(OH)D concentration, all-cause mortality decreased by 20% (HR = 0.83; 95% CI 0.74–0.92). 25(OH)D concentration was inversely associated with cardiovascular mortality in women (HR = 0.68, 95% CI 0.46–1.00 per 10 ng/mL increase), but not in men (HR = 0.97; 95% CI 0.77–1.23). In contrast, 25(OH)D concentration was inversely associated with cancer mortality in men (HR = 0.72, 95% CI 0.57–0.91 per 10 ng/mL increase), but not in women (HR = 1.14, 95% CI 0.93–1.39). Multivariate adjustment only slightly modified the 25(OH)D-mortality association. Conclusion 25(OH)D was similarly inversely related to all-cause mortality in men and women. However, we observed opposite effects in women and men with respect to cardiovascular and cancer mortality.