Vitamin D Deficiency Linked to Increased Mortality

There is a strong association between 25-hydroxyvitamin D (25[OH]D) deficiency (<50 nmol/L) and increased mortality, particularly for diabetes-related deaths, according to a study presented at the annual meeting of the European Association for the Study of Diabetes, held from Sept. 16 to 20 in Barcelona, Spain.

Rodrig Marculescu, M.D., from the Medical University of Vienna, and colleagues linked data from all 78,581 patients (mean age, 51.0 years; men, 31.5 percent) who had a 25(OH)D measurement at the General Hospital of Vienna between 1991 and 2011 to the Austrian national register of deaths.

During 20 years of follow-up (median, 10.5 years), 11,877 deaths were reported. The researchers found that patients with 25(OH)D ≤10 nmol/L had a twofold to threefold increased risk for death (<45 years old: hazard ratio [HR], 2.7 [95 percent confidence interval (CI), 2.1 to 3.4]; 45 to <60 years old: HR, 2.9 [95 percent CI, 2.6 to 3.4]; 60 to <75 years old: HR, 2.0 [95 percent CI, 1.8 to 2.3]). Patients with 25(OH)D ≥90 nmol/L had up to a 40 percent reduction in all-cause mortality (<45 years old: HR, 0.7 [95 percent CI, 0.6 to 0.9]; 45 to <60 years old: HR, 0.6 [95 percent CI, 0.5 to 0.7]; 60 to <75 years old: HR, 0.7 [95 percent CI, 0.7 to 0.8]). No association was noted between 25(OH)D levels in patients ≥75 years (10 nmol/L: HR, 1.1 [95 percent CI, 1.0 to 1.2]; 90 nmol/L: HR, 1.0 [95 percent CI, 0.9 to 1.0]). There was a modest relationship between 25(OH)D and either cancer or cardiovascular disease-related mortality, but a stronger association for diabetes-related death (HR, 4.4; 95 percent CI, 3.1 to 6.3).

"Our findings strengthen the rationale for widespread vitamin D supplementation to prevent premature mortality, emphasize the need for it early in life, and mitigate concerns about a possible negative effect at higher levels," the authors write.

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