Vitamin D deficiency and mortality risk in the general population: a meta-analysis of prospective cohort studies
Top Cited Papers
- 1 January 2012
- journal article
- research article
- Published by Elsevier BV in The American Journal of Clinical Nutrition
- Vol. 95 (1), 91-100
- https://doi.org/10.3945/ajcn.111.014779
Abstract
Background: Low vitamin D status may increase mortality risk. Objective: We used nonparametric (“highest compared with lowest” categories) and parametric (>2 categories) statistical models to evaluate associations of 25-hydroxyvitamin D [25(OH)D] serum concentrations and mortality in observational studies among general populations. Design: We searched PubMed, EMBASE, Web of Science, and reference lists for relevant articles. We included studies that contained data on relative risks (RRs) for mortality for different 25(OH)D concentrations, which included a corresponding measure of uncertainty, and this yielded 14 prospective cohort studies that involved 5562 deaths out of 62,548 individuals. We applied log-transformed RRs and CIs, adjusted for the maximal number of confounding variables. In the parametric model, which is based on 11 studies and 59,231 individuals, we used the lowest quantile as the reference category. Results: For “highest compared with lowest” categories of 25(OH)D, the estimated summary RR of mortality was 0.71 (95% CI: 0.50, 0.91). In the parametric model, the estimated summary RRs (95% CI) of mortality were 0.86 (0.82, 0.91), 0.77 (0.70, 0.84), and 0.69 (0.60, 0.78) for individuals with an increase of 12.5, 25, and 50 nmol 25(OH)D serum values/L, respectively, from a median reference category of ∼27.5 nmol/L. There was, however, no significant decrease in mortality when an increase of ∼87.5 nmol/L above the reference category occurred. Conclusion: Data suggest a nonlinear decrease in mortality risk as circulating 25(OH)D increases, with optimal concentrations ∼75–87.5 nmol/L.This publication has 67 references indexed in Scilit:
- Meta‐analysis of observational studies of serum 25‐hydroxyvitamin D levels and colorectal, breast and prostate cancer and colorectal adenomaInternational Journal of Cancer, 2011
- Common genetic determinants of vitamin D insufficiency: a genome-wide association studyThe Lancet, 2010
- Relationship of 25-hydroxyvitamin D with all-cause and cardiovascular disease mortality in older community-dwelling adultsEuropean Journal of Clinical Nutrition, 2009
- Low serum 25-hydroxyvitamin D concentrations are associated with greater all-cause mortality in older community-dwelling womenNutrition Research, 2009
- Demographic Differences and Trends of Vitamin D Insufficiency in the US Population, 1988-2004JAMA Internal Medicine, 2009
- 25-Hydroxyvitamin D Levels and the Risk of Mortality in the General PopulationArchives of Internal Medicine, 2008
- Vitamin D Supplementation and Total MortalityA Meta-analysis of Randomized Controlled TrialsArchives of Internal Medicine, 2007
- Vitamin D DeficiencyThe New England Journal of Medicine, 2007
- Quantifying heterogeneity in a meta-analysisStatistics in Medicine, 2002
- Advanced methods in meta‐analysis: multivariate approach and meta‐regressionStatistics in Medicine, 2002