Association of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D and parathyroid hormone with mortality among middle-aged and older European men

• Published in: Age and ageing Vol. 43; no. 4; pp. 528 - 535
• Main Authors: Lee, David M, Vanderschueren, Dirk, Boonen, Steven, O'Neill, Terence W, Pendleton, Neil, Pye, Stephen R, Ravindrarajah, Rathi, Gielen, Evelien, Claessens, Frank, Bartfai, György, Casanueva, Felipe F, Finn, Joseph D, Forti, Gianni, Giwercman, Aleksander, Han, Thang S, Huhtaniemi, Ilpo T, Kula, Krzysztof, Lean, Michael E J, Punab, Margus, Wu, Frederick C W
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.07.2014; Oxford Publishing Limited (England)
• Subjects: 25-dihydroxyvitamin D; 25-hydroxyvitamin D; Adult; Aged; Aging - blood; Alfacalcidol; Analysis; Biomarkers - blood; Calcifediol; Cardiovascular Diseases - mortality; Care and treatment; Clinical Medicine; Cohort Studies; Elderly; Europe; Follow-Up Studies; Hormones; Humans; Klinisk medicin; Life Style; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Mens health; Middle age; Middle Aged; Mortality; Neoplasms - mortality; Obstetrics, Gynecology and Reproductive Medicine; older people; Parathyroid hormone; Parathyroid Hormone - blood; Parathyroid hormones; population based; Prospective Studies; Regression Analysis; Reproduktionsmedicin och gynekologi; Risk Factors; Surveys and Questionnaires; Survival Rate; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin deficiency; Europe; mortality; parathyroid hormone; older people; 25-hydroxyvitamin D; 1,25-dihydroxyvitamin D; population based
• ISSN: 0002-0729; 1468-2834; 1468-2834
• DOI: 10.1093/ageing/aft206

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. : prospective cohort analysis within the European Male Ageing Study. : 2,816 community-dwelling men aged 40-79 years at baseline. : 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. : 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). : 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.