Serum 25-hydroxyvitamin D Concentration and Risk for Major Clinical Disease Events in a Community-based Population of Older Adults: a Cohort Study

Overview

Journal Ann Intern Med

Specialty General Medicine

Date 2012 May 2

PMID 22547472

Citations 55

Authors

Ian H de Boer

Gregory Levin

Cassianne Robinson-Cohen

Mary L Biggs

Andy N Hoofnagle

David S Siscovick

Bryan Kestenbaum

Affiliations

Soon will be listed here.

Abstract

Background: Circulating concentrations of 25-hydroxyvitamin D [25-(OH)D] are used to define vitamin D deficiency. Current clinical 25-(OH)D targets based on associations with intermediate markers of bone metabolism may not reflect optimal levels for other chronic diseases and do not account for known seasonal variation in 25-(OH)D concentration.

Objective: To evaluate the relationship of 25-(OH)D concentration with the incidence of major clinical disease events that are pathophysiologically relevant to vitamin D.

Design: Cohort study.

Setting: The Cardiovascular Health Study conducted in 4 U.S. communities. Data from 1992 to 2006 were included in this analysis.

Participants: 1621 white older adults.

Measurements: Serum 25-(OH)D concentration (using a high-performance liquid chromatography-tandem mass spectrometry assay that conforms to National Institute of Standards and Technology reference standards) and associations with time to a composite outcome of incident hip fracture, myocardial infarction, cancer, or death.

Results: Over a median 11-year follow-up, the composite outcome occurred in 1018 participants (63%). Defining events included 137 hip fractures, 186 myocardial infarctions, 335 incidences of cancer, and 360 deaths. The association of low 25-(OH)D concentration with risk for the composite outcome varied by season (P = 0.057). A concentration lower than a season-specific Z score of -0.54 best discriminated risk for the composite outcome and was associated with a 24% higher risk in adjusted analyses (95% CI, 9% to 42%). Corresponding season-specific 25-(OH)D concentrations were 43, 50, 61, and 55 nmol/L (17, 20, 24, and 22 ng/mL) in winter, spring, summer, and autumn, respectively.

Limitation: The observational study was restricted to white participants.

Conclusion: Threshold concentrations of 25-(OH)D associated with increased risk for relevant clinical disease events center near 50 nmol/L (20 ng/mL). Season-specific targets for 25-(OH)D concentration may be more appropriate than static targets when evaluating health risk.

Primary Funding Source: National Institutes of Health.

Citing Articles

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Association of 25-hydroxyvitamin D with risk of overall and colorectal cancer among Japanese using a Mendelian randomization approach.

Katagiri R, Goto A, Nakano S, Nakatochi M, Koyanagi Y, Iwagami M Sci Rep. 2023; 13(1):2384.

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Relationship between serum vitamin D and hip fracture in the elderly: a systematic review and meta-analysis.

Ghahfarrokhi S, Mohammadian-Hafshejani A, Sherwin C, Heidari-Soureshjani S J Bone Miner Metab. 2022; 40(4):541-553.

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Associations Between 25-Hydroxyvitamin D, Kidney Function, and Insulin Resistance Among Adults in the United States of America.

Geng J, Qiu Y, Li Y, Li J, Liao R, Du H Front Nutr. 2022; 8:716878.

PMID: 35242790 PMC: 8885514. DOI: 10.3389/fnut.2021.716878.

Non-Musculoskeletal Benefits of Vitamin D beyond the Musculoskeletal System.

Zhang S, Miller D, Li W Int J Mol Sci. 2021; 22(4).

PMID: 33669918 PMC: 7924658. DOI: 10.3390/ijms22042128.

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