Association between vitamin D supplementation and mortality: systematic review and meta-analysis
Zhang Y, Fang F, Tang J, Jia L, Feng Y, Xu P, Faramand A
BMJ (Clinical research ed.) · 251 citations
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Independent funding
- University or hospital
- University of Pittsburgh
- Government
- National Natural Science Foundation of China
- University or hospital
- West China Hospital, Sichuan University
- Grants
- National Natural Science Foundation of China (81472361); National Natural Science Foundation of China (81100925)
Based on 3 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2019-08-12 · BMJ · vol. 366 · p. l4673
- Cited
- 369 citations · more than 99% of similar papers · 8.8× the field average
- Impact
- Top 10% most cited in its field
- References
- 94 works
- Access
- Open access (hybrid journal) · CC-BY-NC
- Research areas
- Vitamin D Research Studies · Vitamin C and Antioxidants Research · Vitamin K Research Studies
- Keywords
- Medicine, Meta-analysis, Placebo, Internal medicine, Confidence interval, Vitamin, Relative risk, Randomized controlled trial, Vitamin D and neurology, Subgroup analysis, Cause of death, Disease, Pathology
- MeSH
- humans, neoplasms, cholecalciferol, ergocalciferols, vitamin d, mortality, dietary supplements, randomized controlled trials as topic
7 authors
From CN, US
- Yu ZhangChengdu University
- Fang Fang · correspondingSichuan University; West China Hospital of Sichuan University
- Jingjing TangChinese University of Hong Kong, Shenzhen
- Lu Jia
- Yuning FengChengdu University
- Ping XuSichuan University; Sichuan Provincial Library
Abstract
Objective
To investigate whether vitamin D supplementation is associated with lower mortality in adults.
Design
Systematic review and meta-analysis of randomised controlled trials.
Data sources
Medline, Embase, and the Cochrane Central Register from their inception to 26 December 2018.
Eligibility criteria for selecting studies
Randomised controlled trials comparing vitamin D supplementation with a placebo or no treatment for mortality were included. Independent data extraction was conducted and study quality assessed. A meta-analysis was carried out by using fixed effects and random effects models to calculate risk ratio of death in the group receiving vitamin D supplementation and the control group.
Main outcome measures
All cause mortality.
Results
52 trials with a total of 75 454 participants were identified. Vitamin D supplementation was not associated with all cause mortality (risk ratio 0.98, 95% confidence interval 0.95 to 1.02, I2=0%), cardiovascular mortality (0.98, 0.88 to 1.08, 0%), or non-cancer, non-cardiovascular mortality (1.05, 0.93 to 1.18, 0%). Vitamin D supplementation statistically significantly reduced the risk of cancer death (0.84, 0.74 to 0.95, 0%). In subgroup analyses, all cause mortality was significantly lower in trials with vitamin D3 supplementation than in trials with vitamin D2 supplementation (P for interaction=0.04); neither vitamin D3 nor vitamin D2 was associated with a statistically significant reduction in all cause mortality.
Conclusions
Vitamin D supplementation alone was not associated with all cause mortality in adults compared with placebo or no treatment. Vitamin D supplementation reduced the risk of cancer death by 16%. Additional large clinical studies are needed to determine whether vitamin D3 supplementation is associated with lower all cause mortality.
Study registration
PROSPERO registration number CRD42018117823.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY-NC).
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