The Reverse J-Shaped Association Between Serum Total 25-Hydroxyvitamin D Concentration and All-Cause Mortality: The Impact of Assay Standardization
Durazo-Arvizu RA, Dawson-Hughes B, Kramer H, Cao G, Merkel J, Coates PM, Sempos CT
American journal of epidemiology · 47 citations
How it was studied
- Design
- Cohort study (classified by our AI screen)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Independent funding
- Government
- U.S. Department of Health and Human Services
- Government
- Office of Dietary Supplements
- Government
- U.S. Department of Agriculture
- Government
- National Institutes of Health
- Government
- Centers for Disease Control and Prevention
- University or hospital
- Loyola University Chicago Stritch School of Medicine
- Government
- National Heart, Lung, and Blood Institute
- Government
- National Institute of Diabetes and Digestive and Kidney Diseases
- Government
- NIDDK NIH HHS
- Government
- NHLBI NIH HHS
- Government
- US Department of Agriculture
- Government
- National Institutes of Health Office of Dietary Supplements
- Grants
- National Heart, Lung, and Blood Institute (R37-HL045508); National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK090360); National Institute of Diabetes and Digestive and Kidney Diseases (1R01DK90360-1A1); National Institutes of Health (5r37hl045508-17); U.S. Department of Agriculture (#58–1950-0-014); National Institutes of Health (1R01DK90360-1A1); National Institutes of Health (1R01DK90360)
Based on 12 listed funder(s).
Publication
- Published
- 2016-12-22 · Am J Epidemiol · vol. 185 · issue 8 · pp. 720–726
- Publisher
- Oxford University Press
- Cited
- 58 citations · more than 96% of similar papers · 4.8× the field average
- Impact
- Top 10% most cited in its field
- References
- 27 works
- Access
- Free to read
- Research areas
- Vitamin D Research Studies · Bone health and osteoporosis research · Healthcare cost, quality, practices
- Keywords
- Relative risk, Medicine, Confidence interval, National Health and Nutrition Examination Survey, Poisson regression, Vitamin D and neurology, Internal medicine, Gastroenterology, Population
- MeSH
- humans, vitamin d, nutrition surveys, mortality, data interpretation, statistical, risk, risk factors, female, male, statistics as topic, young adult
7 authors
From US
- Ramón Durazo-Arvizú · correspondingLoyola University Chicago
- Bess Dawson‐HughesLoyola University Chicago
- Holly KramerLoyola University Chicago
- Guichan CaoLoyola University Chicago
- Joyce M. MerkelLoyola University Chicago
- Paul M. CoatesLoyola University Chicago
Abstract
We evaluated the impact of standardizing the originally measured serum total 25-hydroxyvitamin D (25(OH)D) values from Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) on the association between 25(OH)D and rate of all-cause mortality. Values were standardized to the gold-standard laboratory method. Follow-up from 1990-2006 consisted of 15,099 participants aged at least 20 years at baseline, among whom there were 3,784 deaths. Relative risk of death was adjusted for age, sex, race/ethnicity, and season using Poisson regression. Results were obtained for eight 25(OH)D (nmol/L) categories: <20 nmol/L, 20-29 nmol/L, 30-39 nmol/L, 40-49 nmol/L, 50-59 nmol/L, 60-74 nmol/L, 75-99 nmol/L (reference), and ≥100 nmol/L. Assay standardization dramatically shifted original 25(OH)D values toward zero. Accordingly, risk ≥120 nmol/L could not be evaluated (i.e., n = 7 and ndeaths = 2). Relative risk (95% confidence interval (CI)) <40 nmol/L remained significant (30-39 nmol/L: relative risk (RR) = 1.4 (95% CI: 1.1, 1.6); 20-29 nmol/L: RR = 1.6 (95% CI: 1.3, 1.9), and <20 nmol/L: RR = 2.1 (95% CI: 1.6, 2.7). However, adjusted relative risk estimates for 25(OH)D levels ≥40 nmol/L were no longer significant (40-49 nmol/L: RR = 1.2 (95% CI: 0.99, 1.4); 50-59 nmol/L: RR = 1.2 (95% CI: 1.04, 1.4); 60-74 nmol/L: RR = 1.1 (95% CI: 0.94, 1.2); 75-99 nmol/L: RR = 1.0 (referent), and ≥100 nmol/L: RR = 1.1 (95% CI: 0.6, 2.1). In summary, after standardization, risk of death from all causes increased with decreasing 25(OH)D <40 nmol/L, while there was no association with values in categories between 40 nmol/L and 120 nmol/L.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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