Vitamin D And Risk Of All-Cause And Cause-Specific Mortality

Why this matters

• Findings suggest that thresholds of 45-60 nmol/L may represent a potential target to reduce the risk of premature death, which needs to be confirmed in future randomised controlled trials.

Study design

• This UK Biobank study included 365,530 participants with 25(OH)D measurements and no history of CVD, cancer or diabetes between 2006 and 2010.
• Primary outcome: all-cause and cause-specific mortality.
• Funding: National Natural Science Foundation of China and others.

Key results

• During a median follow-up of 8.9 (interquartile range, 8.3-9.5) years, 10,175 deaths were reported, including 1841 (18.1%) from CVD, 5737 (56.4%) from cancer and 2597 (25.5%) from other causes.
• Compared with participants with 25(OH)D <60 nmol/L, those with ≥60 nmol/L had a lower risk of:
  • all-cause mortality (HR, 0.83; 95% CI, 0.79-0.86);
  • CVD mortality (HR, 0.77; 95% CI, 0.68-0.86); and
  • other mortality (HR, 0.66; 95% CI, 0.60-0.73).
• Participants with 25(OH)D ≥45 nmol/L vs those with <45 nmol/L were at a lower risk of cancer mortality (HR, 0.89; 95% CI, 0.84-0.95).
• In the cancer-specific analysis, participants with 25(OH)D ≥45 nmol/L had a reduced risk of lung cancer mortality (HR, 0.82; 95% CI, 0.72-0.93) compared with those with <45 nmol/L.

Limitations

• Reverse causality cannot be excluded.

Fan X, Wang J, Song M, Giovannucci EL, Ma H, Jin G, Hu Z, Shen H, Hang D. Vitamin D status and risk of all-cause and cause-specific mortality in a large cohort: results from the UK Biobank. J Clin Endocrinol Metab. 2020 Jul 4 [Epub ahead of print]. doi: 10.1210/clinem/dgaa432. PMID: 32620963.