Inverse association between circulating vitamin D and mortality--dependent on sex and cause of death?

Nutr Metab Cardiovasc Dis. 2013 Oct;23(10):960-6. doi: 10.1016/j.numecd.2013.05.005. Epub 2013 Oct 3.

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.

Keywords: MONICA; Mortality; Switzerland; Vitamin D.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 25-Hydroxyvitamin D 2 / blood*
  • Adult
  • Aged
  • Aging*
  • Calcifediol / blood*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / mortality
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Mortality
  • Neoplasms / epidemiology
  • Neoplasms / etiology
  • Neoplasms / mortality
  • Proportional Hazards Models
  • Risk Factors
  • Sex Characteristics
  • Switzerland / epidemiology
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / epidemiology
  • Vitamin D Deficiency / physiopathology*

Substances

  • 25-Hydroxyvitamin D 2
  • Calcifediol