25-hydroxyvitamin D levels and the risk of mortality in the general population.

Notes: 

78% increased risk of all-cause mortality in the lowest quartile. Also, too much Vitamin D raises risk. (50% reduced risk of breast cancer. Dr. Fuhrman recommends 35 - 45 range. 2000/Day RDI is 400.)

Title25-hydroxyvitamin D levels and the risk of mortality in the general population.
Publication TypeJournal Article
Year of Publication2008
AuthorsMelamed ML, Michos ED, Post W, Astor B
JournalArchives of internal medicine
Volume168
Issue15
Pagination1629-37
Date Published2008 Aug 11
ISSN1538-3679
KeywordsAdult, Age Factors, Body Mass Index, Cardiovascular Diseases, Cause of Death, Continental Population Groups, Diabetes Mellitus, Female, Health Surveys, Humans, Male, Middle Aged, Mortality, Motor Activity, Multivariate Analysis, Neoplasms, Seasons, Smoking, United States, Vitamin D, Vitamin D Deficiency, Vitamins
Abstract

BACKGROUND: In patients undergoing dialysis, therapy with calcitriol or paricalcitol or other vitamin D agents is associated with reduced mortality. Observational data suggests that low 25-hydroxyvitamin D levels (25[OH]D) are associated with diabetes mellitus, hypertension, and cancers. However, whether low serum 25(OH)D levels are associated with mortality in the general population is unknown.

METHODS: We tested the association of low 25(OH)D levels with all-cause, cancer, and cardiovascular disease (CVD) mortality in 13 331 nationally representative adults 20 years or older from the Third National Health and Nutrition Examination Survey (NHANES III) linked mortality files. Participant vitamin D levels were collected from 1988 through 1994, and individuals were passively followed for mortality through 2000.

RESULTS: In cross-sectional multivariate analyses, increasing age, female sex, nonwhite race/ethnicity, diabetes, current smoking, and higher body mass index were all independently associated with higher odds of 25(OH)D deficiency (lowest quartile of 25(OH)D level, <17.8 ng/mL [to convert to nanomoles per liter, multiply by 2.496]), while greater physical activity, vitamin D supplementation, and nonwinter season were inversely associated. During a median 8.7 years of follow-up, there were 1806 deaths, including 777 from CVD. In multivariate models (adjusted for baseline demographics, season, and traditional and novel CVD risk factors), compared with the highest quartile, being in the lowest quartile (25[OH]D levels <17.8 ng/mL) was associated with a 26% increased rate of all-cause mortality (mortality rate ratio, 1.26; 95% CI, 1.08-1.46) and a population attributable risk of 3.1%. The adjusted models of CVD and cancer mortality revealed a higher risk, which was not statistically significant.

CONCLUSION: The lowest quartile of 25(OH)D level (<17.8 ng/mL) is independently associated with all-cause mortality in the general population.

DOI10.1136/bmj.d3520
Alternate JournalArch. Intern. Med.
PubMed ID18695076
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