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Prospective study of serum 25-hydroxyvitamin D level, cardiovascular disease mortality, and all-cause mortality in older U.S. adults.
J Am Geriatr Soc. 2009 Sep; 57(9):1595-603.JA

Abstract

OBJECTIVES

To evaluate the association between serum 25-hydroxyvitamin D (25(OH)D) levels and mortality in a representative U.S. sample of older adults.

DESIGN

Prospective cohort from the Third National Health and Nutrition Examination Survey (NHANES III) and linked mortality files.

SETTING

Noninstitutionalized U.S. civilian population.

PARTICIPANTS

Three thousand four hundred eight NHANES III participants aged 65 and older enrolled from 1988 to 1994 and followed for mortality through 2000.

MEASUREMENTS

Primary exposure was serum 25(OH)D level at enrollment. Primary and secondary outcomes were all-cause and cardiovascular disease (CVD) mortality, respectively.

RESULTS

During the median 7.3 years of follow-up, there were 1,493 (44%) deaths, including 767 CVD-related deaths. Median 25(OH)D level was 66 nmol/L. Adjusting for demographics, season, and cardiovascular risk factors, baseline 25(OH)D levels were inversely associated with all-cause mortality risk (adjusted hazard ratio (HR)=0.95, 95% confidence interval (CI)=0.92-0.98, per 10 nmol/L 25[OH]D). Compared with subjects with 25(OH)D levels of 100 nmol/L or higher, the adjusted HR for subjects with levels less than 25.0 nmol/L was 1.83 (95% CI=1.14-2.94) and for levels of 25.0 to 49.9 nmol/L was 1.47 (95% CI=1.09-1.97). The association appeared stronger for CVD mortality (adjusted HR=2.36, 95% CI=1.17-4.75, for subjects with 25[OH]D levels<25.0 nmol/L vs those > or =100.0 nmol/L) than for non-CVD mortality (adjusted HR=1.42, 95% CI=0.73-2.79, for subjects with 25[OH]D levels<25.0 nmol/L vs those > or =100.0 nmol/L).

CONCLUSION

In noninstitutionalized older adults, a group at high risk for all-cause mortality, serum 25(OH)D levels had an independent, inverse association with CVD and all-cause mortality. Randomized controlled trials of vitamin D supplementation in older adults are warranted to determine whether this association is causal and reversible.

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Authors+Show Affiliations

Ginde AA
Department of Emergency Medicine, School of Medicine, University of Colorado Denver, 12401 E. 17th Avenue, B-215, Aurora, CO 80045. adit.ginde@ucdenver.edu
Scragg R
No affiliation info available
Schwartz RS
No affiliation info available
Camargo CA
No affiliation info available

MeSH

AgedCardiovascular DiseasesCause of DeathCohort StudiesComorbidityFemaleFollow-Up StudiesHumansMaleNutrition SurveysProportional Hazards ModelsProspective StudiesRisk FactorsUnited StatesVitamin DVitamin D Deficiency

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19549021

Citation

Ginde, Adit A., et al. "Prospective Study of Serum 25-hydroxyvitamin D Level, Cardiovascular Disease Mortality, and All-cause Mortality in Older U.S. Adults." Journal of the American Geriatrics Society, vol. 57, no. 9, 2009, pp. 1595-603.
Ginde AA, Scragg R, Schwartz RS, et al. Prospective study of serum 25-hydroxyvitamin D level, cardiovascular disease mortality, and all-cause mortality in older U.S. adults. J Am Geriatr Soc. 2009;57(9):1595-603.
Ginde, A. A., Scragg, R., Schwartz, R. S., & Camargo, C. A. (2009). Prospective study of serum 25-hydroxyvitamin D level, cardiovascular disease mortality, and all-cause mortality in older U.S. adults. Journal of the American Geriatrics Society, 57(9), 1595-603. https://doi.org/10.1111/j.1532-5415.2009.02359.x
Ginde AA, et al. Prospective Study of Serum 25-hydroxyvitamin D Level, Cardiovascular Disease Mortality, and All-cause Mortality in Older U.S. Adults. J Am Geriatr Soc. 2009;57(9):1595-603. PubMed PMID: 19549021.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective study of serum 25-hydroxyvitamin D level, cardiovascular disease mortality, and all-cause mortality in older U.S. adults. AU - Ginde,Adit A, AU - Scragg,Robert, AU - Schwartz,Robert S, AU - Camargo,Carlos A,Jr Y1 - 2009/06/22/ PY - 2009/6/25/entrez PY - 2009/6/25/pubmed PY - 2009/12/16/medline SP - 1595 EP - 603 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 57 IS - 9 N2 - OBJECTIVES: To evaluate the association between serum 25-hydroxyvitamin D (25(OH)D) levels and mortality in a representative U.S. sample of older adults. DESIGN: Prospective cohort from the Third National Health and Nutrition Examination Survey (NHANES III) and linked mortality files. SETTING: Noninstitutionalized U.S. civilian population. PARTICIPANTS: Three thousand four hundred eight NHANES III participants aged 65 and older enrolled from 1988 to 1994 and followed for mortality through 2000. MEASUREMENTS: Primary exposure was serum 25(OH)D level at enrollment. Primary and secondary outcomes were all-cause and cardiovascular disease (CVD) mortality, respectively. RESULTS: During the median 7.3 years of follow-up, there were 1,493 (44%) deaths, including 767 CVD-related deaths. Median 25(OH)D level was 66 nmol/L. Adjusting for demographics, season, and cardiovascular risk factors, baseline 25(OH)D levels were inversely associated with all-cause mortality risk (adjusted hazard ratio (HR)=0.95, 95% confidence interval (CI)=0.92-0.98, per 10 nmol/L 25[OH]D). Compared with subjects with 25(OH)D levels of 100 nmol/L or higher, the adjusted HR for subjects with levels less than 25.0 nmol/L was 1.83 (95% CI=1.14-2.94) and for levels of 25.0 to 49.9 nmol/L was 1.47 (95% CI=1.09-1.97). The association appeared stronger for CVD mortality (adjusted HR=2.36, 95% CI=1.17-4.75, for subjects with 25[OH]D levels<25.0 nmol/L vs those > or =100.0 nmol/L) than for non-CVD mortality (adjusted HR=1.42, 95% CI=0.73-2.79, for subjects with 25[OH]D levels<25.0 nmol/L vs those > or =100.0 nmol/L). CONCLUSION: In noninstitutionalized older adults, a group at high risk for all-cause mortality, serum 25(OH)D levels had an independent, inverse association with CVD and all-cause mortality. Randomized controlled trials of vitamin D supplementation in older adults are warranted to determine whether this association is causal and reversible. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/19549021/Prospective_study_of_serum_25_hydroxyvitamin_D_level_cardiovascular_disease_mortality_and_all_cause_mortality_in_older_U_S__adults_ L2 - https://doi.org/10.1111/j.1532-5415.2009.02359.x DB - PRIME DP - Unbound Medicine ER -