BMJ (Clinical research ed.) · 2014
Vitamin D and mortality: meta-analysis of individual participant data from a large consortium of cohort studies from Europe and the United States.
СтатьяМетаанализПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Schöttker Ben, Jorde Rolf, Peasey Anne, Thorand Barbara, Jansen Eugène H J M, Groot Lisette de, Streppel Martinette, Gardiner Julian, Ordóñez-Mena José Manuèl, Perna Laura, Wilsgaard Tom, Rathmann Wolfgang, Feskens Edith, Kampman Ellen, Siganos Galatios, Njølstad Inger, Mathiesen Ellisiv Bøgeberg, Kubínová Růžena, Pająk Andrzej, Topor-Madry Roman, Tamosiunas Abdonas, Hughes Maria, Kee Frank, Bobak Martin, Trichopoulou Antonia, Boffetta Paolo, Brenner Hermann, Consortium on Health and Ageing: Network of Cohorts in Europe and the United States
Аннотация
OBJECTIVE: To investigate the association between serum 25-hydroxyvitamin D concentrations (25(OH)D) and mortality in a large consortium of cohort studies paying particular attention to potential age, sex, season, and country differences.
DESIGN: Meta-analysis of individual participant data of eight prospective cohort studies from Europe and the US.
SETTING: General population.
PARTICIPANTS: 26,018 men and women aged 50-79 years.
MAIN OUTCOME MEASURES: All-cause, cardiovascular, and cancer mortality.
RESULTS: 25(OH)D concentrations varied strongly by season (higher in summer), country (higher in US and northern Europe) and sex (higher in men), but no consistent trend with age was observed. During follow-up, 6695 study participants died, among whom 2624 died of cardiovascular diseases and 2227 died of cancer. For each cohort and analysis, 25(OH)D quintiles were defined with cohort and subgroup specific cut-off values. Comparing bottom versus top quintiles resulted in a pooled risk ratio of 1.57 (95% CI 1.36 to 1.81) for all-cause mortality. Risk ratios for cardiovascular mortality were similar in magnitude to that for all-cause mortality in subjects both with and without a history of cardiovascular disease at baseline. With respect to cancer mortality, an association was only observed among subjects with a history of cancer (risk ratio, 1.70 (1.00 to 2.88)). Analyses using all quintiles suggest curvilinear, inverse, dose-response curves for the aforementioned relationships. No strong age, sex, season, or country specific differences were detected. Heterogeneity was low in most meta-analyses.
CONCLUSIONS: Despite levels of 25(OH)D strongly varying with country, sex, and season, the association between 25(OH)D level and all-cause and cause-specific mortality was remarkably consistent. Results from a long term randomised controlled trial addressing longevity are being awaited before vitamin D supplementation can be recommended in most individuals with low 25(OH)D levels.
DESIGN: Meta-analysis of individual participant data of eight prospective cohort studies from Europe and the US.
SETTING: General population.
PARTICIPANTS: 26,018 men and women aged 50-79 years.
MAIN OUTCOME MEASURES: All-cause, cardiovascular, and cancer mortality.
RESULTS: 25(OH)D concentrations varied strongly by season (higher in summer), country (higher in US and northern Europe) and sex (higher in men), but no consistent trend with age was observed. During follow-up, 6695 study participants died, among whom 2624 died of cardiovascular diseases and 2227 died of cancer. For each cohort and analysis, 25(OH)D quintiles were defined with cohort and subgroup specific cut-off values. Comparing bottom versus top quintiles resulted in a pooled risk ratio of 1.57 (95% CI 1.36 to 1.81) for all-cause mortality. Risk ratios for cardiovascular mortality were similar in magnitude to that for all-cause mortality in subjects both with and without a history of cardiovascular disease at baseline. With respect to cancer mortality, an association was only observed among subjects with a history of cancer (risk ratio, 1.70 (1.00 to 2.88)). Analyses using all quintiles suggest curvilinear, inverse, dose-response curves for the aforementioned relationships. No strong age, sex, season, or country specific differences were detected. Heterogeneity was low in most meta-analyses.
CONCLUSIONS: Despite levels of 25(OH)D strongly varying with country, sex, and season, the association between 25(OH)D level and all-cause and cause-specific mortality was remarkably consistent. Results from a long term randomised controlled trial addressing longevity are being awaited before vitamin D supplementation can be recommended in most individuals with low 25(OH)D levels.