Vitamin D and mortality in older men and women
Article first published online: 18 FEB 2009
© 2009 Blackwell Publishing Ltd
Volume 71, Issue 5, pages 666–672, November 2009
How to Cite
Pilz, S., Dobnig, H., Nijpels, G., Heine, R. J., Stehouwer, C. D. A., Snijder, M. B., Van Dam, R. M. and Dekker, J. M. (2009), Vitamin D and mortality in older men and women. Clinical Endocrinology, 71: 666–672. doi: 10.1111/j.1365-2265.2009.03548.x
- Issue published online: 5 OCT 2009
- Article first published online: 18 FEB 2009
- (Received 1 June 2008; returned for revision 3 November 2008; finally revised 9 December 2008; accepted 5 January 2009)
Objective Vitamin D deficiency is common among the elderly and may contribute to cardiovascular disease. The aim of our study was to elucidate whether low serum levels of 25-hydroxyvitamin D [25(OH)D] are associated with an increased risk of all-cause and cardiovascular mortality.
Design and patients The Hoorn Study is a prospective population-based study among older men and women.
Measurements Fasting serum 25(OH)D was determined in 614 study participants at the follow-up visit in 2000–2001, the baseline for the present analysis. To account for sex differences and seasonal variations of 25(OH)D levels we formed sex-specific quartiles, which were calculated from the 25(OH)D values of each season.
Results After a mean follow-up period of 6·2 years, 51 study participants died including 20 deaths due to cardiovascular causes. Unadjusted Cox proportional hazard ratios (HRs; with 95% confidence intervals) for all-cause and cardiovascular mortality in the first when compared with the upper three 25(OH)D quartiles were 2·24 (1·28–3·92; P = 0·005) and 4·78 (1·95–11·69; P = 0·001), respectively. After adjustment for age, sex, diabetes mellitus, smoking status, arterial hypertension, high-density lipoprotein-cholesterol, glomerular filtration rate and waist-to-hip ratio, the HRs remained significant for all-cause [1·97 (1·08–3·58; P = 0·027)] and for cardiovascular mortality [5·38 (2·02–14·34; P = 0·001)].
Conclusions Low 25(OH)D levels are associated with all-cause mortality and even more pronounced with cardiovascular mortality, but it remains unclear whether vitamin D deficiency is a cause or a consequence of a poor health status. Therefore, intervention studies are warranted to evaluate whether vitamin D supplementation reduces mortality and cardiovascular diseases.