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Association of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D and parathyroid hormone with mortality among middle-aged and older European men.
Age Ageing. 2014 Jul; 43(4):528-35.AA

Abstract

BACKGROUND

vitamin D deficiency has been associated with an increased risk of mortality, but whether this relationship is causal or linked to co-existent comorbidity and adverse life factors remains uncertain. Our objective was to determine whether endogenous 25-hydroxyvitamin D (25(OH)D), 1,25-dihydroxyvitamin D (1,25(OH)2D) and parathyroid hormone (PTH) levels predicted all-cause, cardiovascular and cancer mortality independently of health and lifestyle factors.

SETTING

: prospective cohort analysis within the European Male Ageing Study.

PARTICIPANTS

: 2,816 community-dwelling men aged 40-79 years at baseline.

METHODS

: Cox regression was used to examine the association of all-cause mortality with 25(OH)D, 1,25(OH)2D and PTH; cardiovascular and cancer mortality were modelled using competing-risks regression. Results were expressed as hazard ratios (HR) and 95% confidence intervals (CIs) for Cox models; sub-hazard ratios (SHR) and 95% CIs for competing-risks models.

RESULTS

: a total of 187 men died during a median of 4.3 years of follow-up. Serum levels of 25(OH)D (per 1 SD decrease: HR = 1.45; 95% CI = 1.16, 1.81) and 1,25(OH)2D (per 1 SD decrease: HR = 1.20; 95% CI = 1.00, 1.44) were associated with an increased risk of all-cause mortality after adjusting for age, centre, smoking, self-reported morbidities, physical activity and functional performance. Only levels of 25(OH)D <25 nmol/l predicted cancer mortality (SHR = 3.33; 95% CI = 1.38, 8.04).

CONCLUSION

: lower 25(OH)D and 1,25(OH)2D levels independently predicted all-cause mortality in middle-aged and older European men. Associations with cancer mortality were only observed among men with very low levels of 25(OH)D. These associations were only partially explained by the range of adverse health and lifestyle factors measured here.

Authors+Show Affiliations

Cathie Marsh Centre for Census and Survey Research, School of Social Sciences, The University of Manchester, Manchester, UK.Andrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium.Geriatric Medicine, Katholieke Universiteit Leuven, Leuven, Belgium.Arthritis Research UK Centre for Epidemiology, Institute of Inflammation and Repair, The University of Manchester, Manchester, UK.Clinical & Cognitive Neurosciences, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK.Arthritis Research UK Centre for Epidemiology, Institute of Inflammation and Repair, The University of Manchester, Manchester, UK.Andrology Research Unit, Centre for Endocrinology and Diabetes, Institute of Human Development, The University of Manchester, Manchester, UK.Geriatric Medicine, Katholieke Universiteit Leuven, Leuven, Belgium.Molecular Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium.Department of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary.Department of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain.Andrology Research Unit, Centre for Endocrinology and Diabetes, Institute of Human Development, The University of Manchester, Manchester, UK.Endocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy.Reproductive Medicine Centre, Malmö University Hospital, University of Lund, Malmö, Sweden.Department of Endocrinology, Royal Free and University College Hospital Medical School, Royal Free Hospital, London, UK.Department of Reproductive Biology, Imperial College London, London, UK.Department of Andrology and Reproductive Endocrinology, Medical University of Łódź, Łódź, Poland.Division of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, UK.Andrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia.Andrology Research Unit, Centre for Endocrinology and Diabetes, Institute of Human Development, The University of Manchester, Manchester, UK.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

24375224

Citation

Lee, David M., et al. "Association of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D and Parathyroid Hormone With Mortality Among Middle-aged and Older European Men." Age and Ageing, vol. 43, no. 4, 2014, pp. 528-35.
Lee DM, Vanderschueren D, Boonen S, et al. Association of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D and parathyroid hormone with mortality among middle-aged and older European men. Age Ageing. 2014;43(4):528-35.
Lee, D. M., Vanderschueren, D., Boonen, S., O'Neill, T. W., Pendleton, N., Pye, S. R., Ravindrarajah, R., Gielen, E., Claessens, F., Bartfai, G., Casanueva, F. F., Finn, J. D., Forti, G., Giwercman, A., Han, T. S., Huhtaniemi, I. T., Kula, K., Lean, M. E., Punab, M., & Wu, F. C. (2014). Association of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D and parathyroid hormone with mortality among middle-aged and older European men. Age and Ageing, 43(4), 528-35. https://doi.org/10.1093/ageing/aft206
Lee DM, et al. Association of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D and Parathyroid Hormone With Mortality Among Middle-aged and Older European Men. Age Ageing. 2014;43(4):528-35. PubMed PMID: 24375224.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D and parathyroid hormone with mortality among middle-aged and older European men. AU - Lee,David M, AU - Vanderschueren,Dirk, AU - Boonen,Steven, AU - O'Neill,Terence W, AU - Pendleton,Neil, AU - Pye,Stephen R, AU - Ravindrarajah,Rathi, AU - Gielen,Evelien, AU - Claessens,Frank, AU - Bartfai,György, AU - Casanueva,Felipe F, AU - Finn,Joseph D, AU - Forti,Gianni, AU - Giwercman,Aleksander, AU - Han,Thang S, AU - Huhtaniemi,Ilpo T, AU - Kula,Krzysztof, AU - Lean,Michael E J, AU - Punab,Margus, AU - Wu,Frederick C W, AU - ,, Y1 - 2013/12/26/ PY - 2013/12/31/entrez PY - 2014/1/1/pubmed PY - 2015/3/31/medline KW - 1,25-dihydroxyvitamin D KW - 25-hydroxyvitamin D KW - mortality KW - older people KW - parathyroid hormone KW - population based SP - 528 EP - 35 JF - Age and ageing JO - Age Ageing VL - 43 IS - 4 N2 - BACKGROUND: vitamin D deficiency has been associated with an increased risk of mortality, but whether this relationship is causal or linked to co-existent comorbidity and adverse life factors remains uncertain. Our objective was to determine whether endogenous 25-hydroxyvitamin D (25(OH)D), 1,25-dihydroxyvitamin D (1,25(OH)2D) and parathyroid hormone (PTH) levels predicted all-cause, cardiovascular and cancer mortality independently of health and lifestyle factors. SETTING: : prospective cohort analysis within the European Male Ageing Study. PARTICIPANTS: : 2,816 community-dwelling men aged 40-79 years at baseline. METHODS: : Cox regression was used to examine the association of all-cause mortality with 25(OH)D, 1,25(OH)2D and PTH; cardiovascular and cancer mortality were modelled using competing-risks regression. Results were expressed as hazard ratios (HR) and 95% confidence intervals (CIs) for Cox models; sub-hazard ratios (SHR) and 95% CIs for competing-risks models. RESULTS: : a total of 187 men died during a median of 4.3 years of follow-up. Serum levels of 25(OH)D (per 1 SD decrease: HR = 1.45; 95% CI = 1.16, 1.81) and 1,25(OH)2D (per 1 SD decrease: HR = 1.20; 95% CI = 1.00, 1.44) were associated with an increased risk of all-cause mortality after adjusting for age, centre, smoking, self-reported morbidities, physical activity and functional performance. Only levels of 25(OH)D <25 nmol/l predicted cancer mortality (SHR = 3.33; 95% CI = 1.38, 8.04). CONCLUSION: : lower 25(OH)D and 1,25(OH)2D levels independently predicted all-cause mortality in middle-aged and older European men. Associations with cancer mortality were only observed among men with very low levels of 25(OH)D. These associations were only partially explained by the range of adverse health and lifestyle factors measured here. SN - 1468-2834 UR - https://www.unboundmedicine.com/medline/citation/24375224/Association_of_25_hydroxyvitamin_D_125_dihydroxyvitamin_D_and_parathyroid_hormone_with_mortality_among_middle_aged_and_older_European_men_ L2 - https://academic.oup.com/ageing/article-lookup/doi/10.1093/ageing/aft206 DB - PRIME DP - Unbound Medicine ER -