Low vitamin D and increased mortality

Lower levels of vitamin D, higher rates of death

Association of Serum 25-Hydroxyvitamin D Concentrations With All-Cause and Cause-Specific Mortality Among Adult Patients With Existing Cardiovascular Disease

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8496747/

Observational study, non-interventional

Background

Vitamin D, lower levels, common in patients with cardiovascular disease (CVD)

Study of patients with existing CVD

Prospectively examine the associations of serum 25-hydroxyvitamin D [25(OH)D] concentrations with,

All-cause mortality and,

cause-specific mortality

Methods

N = 37,079 patients with CVD from the UK

Biobank study

From a prospective cohort of half a million, aged 40–69 years

https://www.ukbiobank.ac.uk

CVD

Coronary heart disease

Atrial fibrillation

Heart failure

Stroke

Results

Among 37,079 patients with CVD at baseline, 57.5% were vitamin D deficient

Deficient, 25[OH]D less than 50 nmol/L (less than 20ng/ml)

Median follow-up of 11.7 years

Deaths that occurred = 6,319 total

2,161 deaths from CVD

2,230 deaths from cancer

623 deaths from respiratory disease

1,305 other-cause deaths

Non-linear inverse associations

For all-cause mortality

Cancer mortality

Respiratory disease mortality

Other-cause mortality

That is deaths went up as vitamin D levels went down

(P-non-linearity less than 0.01)

Approximately linear inverse associations for CVD

That is deaths went up as vitamin D levels went down

(P-non-linearity = 0.074)

Among CVD patients with vitamin D deficiency

For every 10 nmol/L increment in serum 25(OH)D concentrations,

There was an associated 12% reduced risk for all-cause mortality

There was an associated 9% reduced risk for CVD mortality.

In patients with vitamin D deficiency

Per 10 nmol/L increase in serum 25(OH)D levels,

was associated with a lower risk of mortality from (aHR]; 95% CI)

All-cause 0.88

CVD 0.91

Cancer 0.90

Respiratory diseases 0.81

Other causes 0.81

Multivariable Cox regression models

Age, sex, alcohol, BMI, GFR, education, ethnicity, household income, smoking status, healthy diet score, diabetes (and meds), HbA1c, duration of CVD, blood pressure (and meds), lipid profile (and meds), triglycerides, cholesterol

Conclusion

Among patients with existing CVD,

increasing levels in serum 25(OH)D,

were independently associated with a decreased risk of all-cause and cause-specific mortality

These findings suggest that elevated serum 25(OH)D concentration benefits CVD patients with vitamin D deficiency.

Therefore

Patients with vitamin D deficiency may benefit more from an increase in serum levels,

than those with CVD and serum 25(OH)D levels of less than 50 nmol/L (less than 20ng/ml)

Our findings provided novel clues
awaiting further validation in clinical trials.