Strong Link Between Vitamin D Deficiency and Vastly Increased Risk of Premature Death

 


Vitamin D deficiency is strongly linked to increased mortality, particularly in younger and middle-aged people, and is particularly associated with diabetes-related deaths, according to new research presented at the 2019 Annual Meeting of the European Association for the Study of Diabetes (E-A S D) in Barcelona, Spain (September 16–20, 2019). 


At the Medical University of Vienna in Austria, Dr Rodrigo and his colleagues carried out the research. It looked at the effects of low blood levels of 25-hydroxy vitamin D (25D), also known as vitamin D, on overall and cause-specific mortality in a large study cohort that included people of all ages and was made up of people who took little vitamin D as they got older. 




Numerous studies and clinical trials support the hypothesis that vitamin D deficiency has a link to mortality.  Vitamin D deficiency is a risk factor for early death that is easily corrected and widespread. However, the majority of this research has focused on older populations, and the authors believe that the prevalence of vitamin D among the elderly may have affected many of the largest-scale studies. They also say: "There has not yet been a comprehensive report on the association between vitamin D and the risk of death and cause-specific mortality". 


The records of all 78,581 patients who had a vitamin D (25D) measurement taken at the Department of Laboratory Medicine, General Hospital of Vienna, between 1991 and 2011 were matched with the Austrian national register of deaths. The average age of the patients was 51 years, and 31 percent of them were male. Patients were followed for up to 20 years whenever possible, with a median follow-up of 10 years. The first three years of mortality following the vitamin D measurement were excluded from the analysis. 


The authors set their low and high levels for risk calculation at 10 N MOL/L and 90 N MOL/L, respectively, using a blood vitamin D level of 50 N MOL/L, a commonly used cut-off value for vitamin D deficiency, as their reference value


The study found that patients with vitamin D levels of 10 N MOL/L or less had a 2-3 fold increased risk of death, with a 3-fold increased risk in patients between the ages of 45 and 60. There was a 30–40% reduction in all-cause mortality associated with levels of 90 N MOL/L or higher, with the largest effect occurring in the 45–60-year-old age group (a 40% risk reduction). 


In patients over the age of 75, there were no statistically significant associations between vitamin D levels and mortality. In terms of cause-specific mortality, the authors were surprised to discover that the strongest associations of vitamin D were with causes of death other than cancer and cardiovascular disease. For these causes of death, differences between age groups were even more pronounced, with patients between the ages of 45 and 60 experiencing the greatest effect. 


The authors say this further diminishes concerns about a possible negative effect of vitamin D in the higher concentration range, as has been shown in some previous studies reporting “inverse J-shaped” risk associations (meaning risk decreased to a certain level of vitamin D and then started increasing again at higher levels). Further subdivision of these non-cardiovascular, non-cancer causes of death revealed the greatest effect of vitamin D on diabetes, with a 4.4 times higher risk of death from the disease in the vitamin D deficient group


This association is strongest in younger and middle-aged groups for causes of death other than cancer and cardiovascular disease, particularly diabetes

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