Low Vitamin D Status and Suicide: A Case-Control Study of Active Duty Military Service Members

Considering that epidemiological studies show that suicide rates in many countries are highest in the spring when vitamin D status is lowest, and that low vitamin D status can affect brain function, we sought to evaluate if a low level of 25-hydroxyvitamin D [25(OH)D] could be a predisposing factor...

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Published inPloS one Vol. 8; no. 1; p. e51543
Main Authors Umhau, John C., George, David T., Heaney, Robert P., Lewis, Michael D., Ursano, Robert J., Heilig, Markus, Hibbeln, Joseph R., Schwandt, Melanie L.
Format Journal Article
LanguageEnglish
Published United States Public Library of Science 04.01.2013
Public Library of Science (PLoS)
Subjects
25-Hydroxyvitamin D
Active control
Adult
Age Factors
Alcoholism
Analysis
Armed forces
Astronomical Sciences
Biology
Brain
Brain research
Case studies
Case-Control Studies
Epidemiology
Female
Health sciences
Humans
Low level
Male
Medicine
Mental depression
Mental health
Military
Military deployment
Military Personnel
Military psychology
Neurosciences
Odds Ratio
Population
Preventive medicine
Principal components analysis
Psychiatry
Risk Factors
Risk management
Risk reduction
Seasons
Sex Factors
Sex ratio
Social and Behavioral Sciences
Suicide
Suicides & suicide attempts
Supplements
Surveillance
Vitamin D
Vitamin D - analogs & derivatives
Vitamin D - blood
Vitamin deficiency
Vitamins - blood
United States > US
Maryland
Online AccessGet full text

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Abstract Considering that epidemiological studies show that suicide rates in many countries are highest in the spring when vitamin D status is lowest, and that low vitamin D status can affect brain function, we sought to evaluate if a low level of 25-hydroxyvitamin D [25(OH)D] could be a predisposing factor for suicide. We conducted a prospective, nested, case-control study using serum samples stored in the Department of Defense Serum Repository. Participants were previously deployed active duty US military personnel (2002-2008) who had a recent archived serum sample available for analysis. Vitamin D status was estimated by measuring 25(OH) D levels in serum samples drawn within 24 months of the suicide. Each verified suicide case (n = 495) was matched to a control (n = 495) by rank, age and sex. We calculated odds ratio of suicide associated with categorical levels (octiles) of 25(OH) D, adjusted by season of serum collection. More than 30% of all subjects had 25(OH)D values below 20 ng/mL. Although mean serum 25(OH)D concentrations did not differ between suicide cases and controls, risk estimates indicated that subjects in the lowest octile of season-adjusted 25(OH)D (<15.5 ng/mL) had the highest risk of suicide, with subjects in the subsequent higher octiles showing approximately the same level of decreased risk (combined odds ratio compared to lowest octile = 0.49; 95% C.I.: 0.315-0.768). Low vitamin D status is common in active duty service members. The lowest 25(OH)D levels are associated with an increased risk for suicide. Future studies could determine if additional sunlight exposure and vitamin D supplementation might reduce suicide by increasing 25(OH) D levels.
AbstractList Objective Considering that epidemiological studies show that suicide rates in many countries are highest in the spring when vitamin D status is lowest, and that low vitamin D status can affect brain function, we sought to evaluate if a low level of 25-hydroxyvitamin D [25(OH)D] could be a predisposing factor for suicide. Method We conducted a prospective, nested, case-control study using serum samples stored in the Department of Defense Serum Repository. Participants were previously deployed active duty US military personnel (2002-2008) who had a recent archived serum sample available for analysis. Vitamin D status was estimated by measuring 25(OH) D levels in serum samples drawn within 24 months of the suicide. Each verified suicide case (n = 495) was matched to a control (n = 495) by rank, age and sex. We calculated odds ratio of suicide associated with categorical levels (octiles) of 25(OH) D, adjusted by season of serum collection. Findings More than 30% of all subjects had 25(OH)D values below 20 ng/mL. Although mean serum 25(OH)D concentrations did not differ between suicide cases and controls, risk estimates indicated that subjects in the lowest octile of season-adjusted 25(OH)D (<15.5 ng/mL) had the highest risk of suicide, with subjects in the subsequent higher octiles showing approximately the same level of decreased risk (combined odds ratio compared to lowest octile = 0.49; 95% C.I.: 0.315-0.768). Conclusions Low vitamin D status is common in active duty service members. The lowest 25(OH)D levels are associated with an increased risk for suicide. Future studies could determine if additional sunlight exposure and vitamin D supplementation might reduce suicide by increasing 25(OH) D levels.
Objective Considering that epidemiological studies show that suicide rates in many countries are highest in the spring when vitamin D status is lowest, and that low vitamin D status can affect brain function, we sought to evaluate if a low level of 25-hydroxyvitamin D [25(OH)D] could be a predisposing factor for suicide. Method We conducted a prospective, nested, case-control study using serum samples stored in the Department of Defense Serum Repository. Participants were previously deployed active duty US military personnel (2002–2008) who had a recent archived serum sample available for analysis. Vitamin D status was estimated by measuring 25(OH) D levels in serum samples drawn within 24 months of the suicide. Each verified suicide case (n = 495) was matched to a control (n = 495) by rank, age and sex. We calculated odds ratio of suicide associated with categorical levels (octiles) of 25(OH) D, adjusted by season of serum collection. Findings More than 30% of all subjects had 25(OH)D values below 20 ng/mL. Although mean serum 25(OH)D concentrations did not differ between suicide cases and controls, risk estimates indicated that subjects in the lowest octile of season-adjusted 25(OH)D (<15.5 ng/mL) had the highest risk of suicide, with subjects in the subsequent higher octiles showing approximately the same level of decreased risk (combined odds ratio compared to lowest octile  = 0.49; 95% C.I.: 0.315–0.768). Conclusions Low vitamin D status is common in active duty service members. The lowest 25(OH)D levels are associated with an increased risk for suicide. Future studies could determine if additional sunlight exposure and vitamin D supplementation might reduce suicide by increasing 25(OH) D levels.
Considering that epidemiological studies show that suicide rates in many countries are highest in the spring when vitamin D status is lowest, and that low vitamin D status can affect brain function, we sought to evaluate if a low level of 25-hydroxyvitamin D [25(OH)D] could be a predisposing factor for suicide.We conducted a prospective, nested, case-control study using serum samples stored in the Department of Defense Serum Repository. Participants were previously deployed active duty US military personnel (2002-2008) who had a recent archived serum sample available for analysis. Vitamin D status was estimated by measuring 25(OH) D levels in serum samples drawn within 24 months of the suicide. Each verified suicide case (n = 495) was matched to a control (n = 495) by rank, age and sex. We calculated odds ratio of suicide associated with categorical levels (octiles) of 25(OH) D, adjusted by season of serum collection.More than 30% of all subjects had 25(OH)D values below 20 ng/mL. Although mean serum 25(OH)D concentrations did not differ between suicide cases and controls, risk estimates indicated that subjects in the lowest octile of season-adjusted 25(OH)D (<15.5 ng/mL) had the highest risk of suicide, with subjects in the subsequent higher octiles showing approximately the same level of decreased risk (combined odds ratio compared to lowest octile = 0.49; 95% C.I.: 0.315-0.768).Low vitamin D status is common in active duty service members. The lowest 25(OH)D levels are associated with an increased risk for suicide. Future studies could determine if additional sunlight exposure and vitamin D supplementation might reduce suicide by increasing 25(OH) D levels.
Considering that epidemiological studies show that suicide rates in many countries are highest in the spring when vitamin D status is lowest, and that low vitamin D status can affect brain function, we sought to evaluate if a low level of 25-hydroxyvitamin D [25(OH)D] could be a predisposing factor for suicide. We conducted a prospective, nested, case-control study using serum samples stored in the Department of Defense Serum Repository. Participants were previously deployed active duty US military personnel (2002-2008) who had a recent archived serum sample available for analysis. Vitamin D status was estimated by measuring 25(OH) D levels in serum samples drawn within 24 months of the suicide. Each verified suicide case (n = 495) was matched to a control (n = 495) by rank, age and sex. We calculated odds ratio of suicide associated with categorical levels (octiles) of 25(OH) D, adjusted by season of serum collection. More than 30% of all subjects had 25(OH)D values below 20 ng/mL. Although mean serum 25(OH)D concentrations did not differ between suicide cases and controls, risk estimates indicated that subjects in the lowest octile of season-adjusted 25(OH)D (<15.5 ng/mL) had the highest risk of suicide, with subjects in the subsequent higher octiles showing approximately the same level of decreased risk (combined odds ratio compared to lowest octile = 0.49; 95% C.I.: 0.315-0.768). Low vitamin D status is common in active duty service members. The lowest 25(OH)D levels are associated with an increased risk for suicide. Future studies could determine if additional sunlight exposure and vitamin D supplementation might reduce suicide by increasing 25(OH) D levels.
Considering that epidemiological studies show that suicide rates in many countries are highest in the spring when vitamin D status is lowest, and that low vitamin D status can affect brain function, we sought to evaluate if a low level of 25-hydroxyvitamin D [25(OH)D] could be a predisposing factor for suicide.OBJECTIVEConsidering that epidemiological studies show that suicide rates in many countries are highest in the spring when vitamin D status is lowest, and that low vitamin D status can affect brain function, we sought to evaluate if a low level of 25-hydroxyvitamin D [25(OH)D] could be a predisposing factor for suicide.We conducted a prospective, nested, case-control study using serum samples stored in the Department of Defense Serum Repository. Participants were previously deployed active duty US military personnel (2002-2008) who had a recent archived serum sample available for analysis. Vitamin D status was estimated by measuring 25(OH) D levels in serum samples drawn within 24 months of the suicide. Each verified suicide case (n = 495) was matched to a control (n = 495) by rank, age and sex. We calculated odds ratio of suicide associated with categorical levels (octiles) of 25(OH) D, adjusted by season of serum collection.METHODWe conducted a prospective, nested, case-control study using serum samples stored in the Department of Defense Serum Repository. Participants were previously deployed active duty US military personnel (2002-2008) who had a recent archived serum sample available for analysis. Vitamin D status was estimated by measuring 25(OH) D levels in serum samples drawn within 24 months of the suicide. Each verified suicide case (n = 495) was matched to a control (n = 495) by rank, age and sex. We calculated odds ratio of suicide associated with categorical levels (octiles) of 25(OH) D, adjusted by season of serum collection.More than 30% of all subjects had 25(OH)D values below 20 ng/mL. Although mean serum 25(OH)D concentrations did not differ between suicide cases and controls, risk estimates indicated that subjects in the lowest octile of season-adjusted 25(OH)D (<15.5 ng/mL) had the highest risk of suicide, with subjects in the subsequent higher octiles showing approximately the same level of decreased risk (combined odds ratio compared to lowest octile = 0.49; 95% C.I.: 0.315-0.768).FINDINGSMore than 30% of all subjects had 25(OH)D values below 20 ng/mL. Although mean serum 25(OH)D concentrations did not differ between suicide cases and controls, risk estimates indicated that subjects in the lowest octile of season-adjusted 25(OH)D (<15.5 ng/mL) had the highest risk of suicide, with subjects in the subsequent higher octiles showing approximately the same level of decreased risk (combined odds ratio compared to lowest octile = 0.49; 95% C.I.: 0.315-0.768).Low vitamin D status is common in active duty service members. The lowest 25(OH)D levels are associated with an increased risk for suicide. Future studies could determine if additional sunlight exposure and vitamin D supplementation might reduce suicide by increasing 25(OH) D levels.CONCLUSIONSLow vitamin D status is common in active duty service members. The lowest 25(OH)D levels are associated with an increased risk for suicide. Future studies could determine if additional sunlight exposure and vitamin D supplementation might reduce suicide by increasing 25(OH) D levels.
Audience Academic
Author Heilig, Markus
Heaney, Robert P.
Umhau, John C.
Schwandt, Melanie L.
Lewis, Michael D.
Ursano, Robert J.
George, David T.
Hibbeln, Joseph R.
AuthorAffiliation 1 National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, United States of America
2 Osteoporosis Research Center, Creighton University Medical Center, Omaha, Nebraska, United States of America
3 Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
4 Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
Chiba University Center for Forensic Mental Health, Japan
AuthorAffiliation_xml – name: 4 Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
– name: 1 National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, United States of America
– name: 2 Osteoporosis Research Center, Creighton University Medical Center, Omaha, Nebraska, United States of America
– name: 3 Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
– name: Chiba University Center for Forensic Mental Health, Japan
Author_xml – sequence: 1
  givenname: John C.
  surname: Umhau
  fullname: Umhau, John C.
– sequence: 2
  givenname: David T.
  surname: George
  fullname: George, David T.
– sequence: 3
  givenname: Robert P.
  surname: Heaney
  fullname: Heaney, Robert P.
– sequence: 4
  givenname: Michael D.
  surname: Lewis
  fullname: Lewis, Michael D.
– sequence: 5
  givenname: Robert J.
  surname: Ursano
  fullname: Ursano, Robert J.
– sequence: 6
  givenname: Markus
  surname: Heilig
  fullname: Heilig, Markus
– sequence: 7
  givenname: Joseph R.
  surname: Hibbeln
  fullname: Hibbeln, Joseph R.
– sequence: 8
  givenname: Melanie L.
  surname: Schwandt
  fullname: Schwandt, Melanie L.
BackLink https://www.ncbi.nlm.nih.gov/pubmed/23308099$$D View this record in MEDLINE/PubMed
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Competing Interests: The authors have declared that no competing interests exist.
Conceived and designed the experiments: JCU JRH MDL. Performed the experiments: JCU JRH MDL. Analyzed the data: JCU RPH MLS DTG RJU MH. Wrote the paper: JCU MLS. Critically revised manuscript for important intellectual content: DTG RPH MDL RJU MH JRH MLS.
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Snippet Considering that epidemiological studies show that suicide rates in many countries are highest in the spring when vitamin D status is lowest, and that low...
Objective Considering that epidemiological studies show that suicide rates in many countries are highest in the spring when vitamin D status is lowest, and...
Objective Considering that epidemiological studies show that suicide rates in many countries are highest in the spring when vitamin D status is lowest, and...
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SubjectTerms 25-Hydroxyvitamin D
Active control
Adult
Age Factors
Alcoholism
Analysis
Armed forces
Astronomical Sciences
Biology
Brain
Brain research
Case studies
Case-Control Studies
Epidemiology
Female
Health sciences
Humans
Low level
Male
Medicine
Mental depression
Mental health
Military
Military deployment
Military Personnel
Military psychology
Neurosciences
Odds Ratio
Population
Preventive medicine
Principal components analysis
Psychiatry
Risk Factors
Risk management
Risk reduction
Seasons
Sex Factors
Sex ratio
Social and Behavioral Sciences
Suicide
Suicides & suicide attempts
Supplements
Surveillance
Vitamin D
Vitamin D - analogs & derivatives
Vitamin D - blood
Vitamin deficiency
Vitamins - blood
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Title Low Vitamin D Status and Suicide: A Case-Control Study of Active Duty Military Service Members
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