TY - JOUR
T1 - Vitamin D and mortality
T2 - meta-analysis of individual participant data from a large consortium of cohort studies from Europe and the United States
AU - Schöttker, Ben
AU - Jorde, Rolf
AU - Peasey, Anne
AU - Thorand, Barbara
AU - Jansen, Eugène H J M
AU - Groot, Lisette de
AU - Streppel, Martinette
AU - Gardiner, Julian
AU - Ordóñez-Mena, José Manuèl
AU - Perna, Laura
AU - Wilsgaard, Tom
AU - Rathmann, Wolfgang
AU - Feskens, Edith
AU - Kampman, Ellen
AU - Siganos, Galatios
AU - Njølstad, Inger
AU - Mathiesen, Ellisiv Bøgeberg
AU - Kubínová, Růžena
AU - Pająk, Andrzej
AU - Topor-Madry, Roman
AU - Tamosiunas, Abdonas
AU - Hughes, Maria
AU - Kee, Frank
AU - Bobak, Martin
AU - Trichopoulou, Antonia
AU - Boffetta, Paolo
AU - Brenner, Hermann
AU - Consortium on Health and Ageing: Network of Cohorts in Europe and the United States
N1 - © Schöttker et al 2014.
PY - 2014/6/17
Y1 - 2014/6/17
N2 - OBJECTIVE: To investigate the association between serum 25-hydroxyvitamin D concentrations (25(OH)D) and mortality in a large consortium of cohort studies paying particular attention to potential age, sex, season, and country differences.DESIGN: Meta-analysis of individual participant data of eight prospective cohort studies from Europe and the US.SETTING: General population.PARTICIPANTS: 26,018 men and women aged 50-79 years.MAIN OUTCOME MEASURES: All-cause, cardiovascular, and cancer mortality.RESULTS: 25(OH)D concentrations varied strongly by season (higher in summer), country (higher in US and northern Europe) and sex (higher in men), but no consistent trend with age was observed. During follow-up, 6695 study participants died, among whom 2624 died of cardiovascular diseases and 2227 died of cancer. For each cohort and analysis, 25(OH)D quintiles were defined with cohort and subgroup specific cut-off values. Comparing bottom versus top quintiles resulted in a pooled risk ratio of 1.57 (95% CI 1.36 to 1.81) for all-cause mortality. Risk ratios for cardiovascular mortality were similar in magnitude to that for all-cause mortality in subjects both with and without a history of cardiovascular disease at baseline. With respect to cancer mortality, an association was only observed among subjects with a history of cancer (risk ratio, 1.70 (1.00 to 2.88)). Analyses using all quintiles suggest curvilinear, inverse, dose-response curves for the aforementioned relationships. No strong age, sex, season, or country specific differences were detected. Heterogeneity was low in most meta-analyses.CONCLUSIONS: Despite levels of 25(OH)D strongly varying with country, sex, and season, the association between 25(OH)D level and all-cause and cause-specific mortality was remarkably consistent. Results from a long term randomised controlled trial addressing longevity are being awaited before vitamin D supplementation can be recommended in most individuals with low 25(OH)D levels.
AB - OBJECTIVE: To investigate the association between serum 25-hydroxyvitamin D concentrations (25(OH)D) and mortality in a large consortium of cohort studies paying particular attention to potential age, sex, season, and country differences.DESIGN: Meta-analysis of individual participant data of eight prospective cohort studies from Europe and the US.SETTING: General population.PARTICIPANTS: 26,018 men and women aged 50-79 years.MAIN OUTCOME MEASURES: All-cause, cardiovascular, and cancer mortality.RESULTS: 25(OH)D concentrations varied strongly by season (higher in summer), country (higher in US and northern Europe) and sex (higher in men), but no consistent trend with age was observed. During follow-up, 6695 study participants died, among whom 2624 died of cardiovascular diseases and 2227 died of cancer. For each cohort and analysis, 25(OH)D quintiles were defined with cohort and subgroup specific cut-off values. Comparing bottom versus top quintiles resulted in a pooled risk ratio of 1.57 (95% CI 1.36 to 1.81) for all-cause mortality. Risk ratios for cardiovascular mortality were similar in magnitude to that for all-cause mortality in subjects both with and without a history of cardiovascular disease at baseline. With respect to cancer mortality, an association was only observed among subjects with a history of cancer (risk ratio, 1.70 (1.00 to 2.88)). Analyses using all quintiles suggest curvilinear, inverse, dose-response curves for the aforementioned relationships. No strong age, sex, season, or country specific differences were detected. Heterogeneity was low in most meta-analyses.CONCLUSIONS: Despite levels of 25(OH)D strongly varying with country, sex, and season, the association between 25(OH)D level and all-cause and cause-specific mortality was remarkably consistent. Results from a long term randomised controlled trial addressing longevity are being awaited before vitamin D supplementation can be recommended in most individuals with low 25(OH)D levels.
KW - Age Factors
KW - Aged
KW - Cardiovascular Diseases
KW - Cohort Studies
KW - Europe
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Neoplasms
KW - Seasons
KW - Sex Factors
KW - United States
KW - Vitamin D
KW - Vitamin D Deficiency
KW - Journal Article
KW - Meta-Analysis
KW - Research Support, N.I.H., Extramural
KW - Research Support, Non-U.S. Gov't
U2 - https://doi.org/10.1136/bmj.g3656
DO - https://doi.org/10.1136/bmj.g3656
M3 - Article
C2 - 24938302
SN - 2044-5415
VL - 348
SP - g3656
JO - BMJ quality & safety
JF - BMJ quality & safety
ER -