Vitamin D and mortality: Individual participant data meta-analysis of standardized 25-hydroxyvitamin D in 26916 individuals from a European consortium

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dc.contributor.authorGaksch, Martin
dc.contributor.authorJorde, Rolf
dc.contributor.authorGrimnes, Guri
dc.contributor.authorJoakimsen, Ragnar
dc.contributor.authorSchirmer, Henrik
dc.contributor.authorWilsgaard, Tom
dc.contributor.authorMathiesen, Ellisiv B.
dc.contributor.authorNjølstad, Inger
dc.contributor.authorLøchen, Maja-Lisa
dc.contributor.authorMärz, Winfried
dc.contributor.authorKleber, Marcus E.
dc.contributor.authorTomaschitz, Andreas
dc.contributor.authorGrübler, Martin
dc.contributor.authorEiriksdottir, Gudny
dc.contributor.authorGudmundsson, Elias F.
dc.contributor.authorHarris, Tamara B.
dc.contributor.authorCotch, Mary F.
dc.contributor.authorAspelund, Thor
dc.contributor.authorGudnason, Vilmundur
dc.contributor.authorRutters, Femke
dc.contributor.authorBeulens, Joline W. J.
dc.contributor.authorvan ‘t Riet, Esther
dc.contributor.authorNijpels, Giel
dc.contributor.authorDekker, Jacqueline M.
dc.contributor.authorGrove-Laugesen, Diana
dc.contributor.authorRejnmark, Lars
dc.contributor.authorBusch, Markus A.
dc.contributor.authorMensink, Gert B. M.
dc.contributor.authorScheidt-Nave, Christa
dc.contributor.authorThamm, Michael
dc.contributor.authorSwart, Karin M. A.
dc.contributor.authorBrouwer, Ingeborg A.
dc.contributor.authorLips, Paul
dc.contributor.authorvan Schoor, Natasja M.
dc.contributor.authorSempos, Christopher T.
dc.contributor.authorDurazo-Arvizu, Ramón A.
dc.contributor.authorŠkrabáková, Zuzana
dc.contributor.authorDowling, Kirsten G.
dc.contributor.authorCashman, Kevin D.
dc.contributor.authorKiely, Mairead E.
dc.contributor.authorPilz, Stefan
dc.contributor.funderSeventh Framework Programmeen
dc.date.accessioned2017-03-10T11:48:59Z
dc.date.available2017-03-10T11:48:59Z
dc.date.issued2017-02-16
dc.date.updated2017-03-09T13:34:24Z
dc.description.abstractBackground: Vitamin D deficiency may be a risk factor for mortality but previous meta-analyses lacked standardization of laboratory methods for 25-hydroxyvitamin D (25[OH]D) concentrations and used aggregate data instead of individual participant data (IPD). We therefore performed an IPD meta-analysis on the association between standardized serum 25(OH)D and mortality. Methods: In a European consortium of eight prospective studies, including seven general population cohorts, we used the Vitamin D Standardization Program (VDSP) protocols to standardize 25(OH)D data. Meta-analyses using a one step procedure on IPD were performed to study associations of 25(OH)D with all-cause mortality as the primary outcome, and with cardiovascular and cancer mortality as secondary outcomes. This meta-analysis is registered at ClinicalTrials.gov, number NCT02438488. Findings: We analysed 26916 study participants (median age 61.6 years, 58% females) with a median 25(OH)D concentration of 53.8 nmol/L. During a median follow-up time of 10.5 years, 6802 persons died. Compared to participants with 25(OH)D concentrations of 75 to 99.99 nmol/L, the adjusted hazard ratios (with 95% confidence interval) for mortality in the 25(OH)D groups with 40 to 49.99, 30 to 39.99, and <30 nmol/L were 1.15 (1.00–1.29), 1.33 (1.16–1.51), and 1.67 (1.44–1.89), respectively. We observed similar results for cardiovascular mortality, but there was no significant linear association between 25(OH)D and cancer mortality. There was also no significantly increased mortality risk at high 25(OH)D levels up to 125 nmol/L. Interpretation: In the first IPD meta-analysis using standardized measurements of 25(OH)D we observed an association between low 25(OH)D and increased risk of all-cause mortality. It is of public health interest to evaluate whether treatment of vitamin D deficiency prevents premature deaths.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleide0170791
dc.identifier.citationGaksch, M., Jorde, R., Grimnes, G., Joakimsen, R., Schirmer, H., Wilsgaard, T., et al (2017) ‘Vitamin D and mortality: Individual participant data meta-analysis of standardized 25-hydroxyvitamin D in 26916 individuals from a European consortium’, PloS ONE, 12(2), e0170791 (15 pp). doi:10.1371/journal.pone.0170791en
dc.identifier.doi10.1371/journal.pone.0170791
dc.identifier.endpage15en
dc.identifier.issn1932-6203
dc.identifier.issued2en
dc.identifier.journaltitlePlos ONEen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/3765
dc.identifier.volume12en
dc.language.isoenen
dc.publisherPublic Library of Scienceen
dc.relation.projectinfo:eu-repo/grantAgreement/EC/FP7::SP1::KBBE/613977/EU/Food-based solutions for Optimal vitamin D Nutrition and health through the life cycle/ODINen
dc.rightsThis is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.en
dc.rights.urihttps://creativecommons.org/publicdomain/zero/1.0/en
dc.subjectVitamin D deficiencyen
dc.subjectMortalityen
dc.subjectPublic healthen
dc.titleVitamin D and mortality: Individual participant data meta-analysis of standardized 25-hydroxyvitamin D in 26916 individuals from a European consortiumen
dc.typeArticle (peer-reviewed)en
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