Zittermann Armin, von Helden Raimund, Grant William, Kipshoven Christoph, Ringe Johann D
Department of Cardio-Thoracic Surgery; Heart Center North Rhine-Westfalia; Ruhr University Bochum; Bad Oeynhausen, Germany.
Dermatoendocrinol. 2009 Nov;1(6):300-6. doi: 10.4161/derm.1.6.10970.
Inadequate vitamin D status is a worldwide problem. Evidence is accumulating that individuals with low vitamin D status have excess mortality rates. We calculated to which extent annual mortality rates can be reduced in the German population by optimizing vitamin D status.
Mean serum concentrations of 25-hydroxyvitamin D in the DEVID study cohort were 41 nmol/l (SD: 22 nmol/l). More than 90% of individuals had 25-hydroxyvitamin D concentrations below the threshold that was associated with lowest mortality risk in the two aforementioned trials (75 nmol/l). According to conservative estimations, at least 2.2% of all deaths or 18,300 lives annually can be saved by achieving 25(OH)D concentrations of at least 75 nmol/l in the entire adult German population. Available data provide evidence for an exponential increase in total mortality with deficient 25-hydroxyvitamin D concentrations.
Our calculations are based on (1) an annual mortality rate of 1.34% in the adult German population as provided by the Statistical Yearbook, (2) the actual vitamin D status in German adults with a high mortality risk as assessed in 1,343 individuals from 264 general practitioners in different German regions (DEVID study), and (3) data from two very large prospective cohorts (Dobnig et al. 2008; Melamed et al. 2008) about the excess mortality in individuals with inadequate vitamin D status.
Improving vitamin D status in a population with inadequate vitamin D status might be an effective strategy to reduce annual mortality rates.
维生素D水平不足是一个全球性问题。越来越多的证据表明，维生素D水平低的个体死亡率过高。我们计算了通过优化维生素D水平，德国人群的年死亡率可降低的程度。
DEVID研究队列中25-羟基维生素D的平均血清浓度为41 nmol/l（标准差：22 nmol/l）。超过90%的个体25-羟基维生素D浓度低于上述两项试验中与最低死亡风险相关的阈值（75 nmol/l）。根据保守估计，在整个德国成年人群中使25(OH)D浓度至少达到75 nmol/l，每年可挽救所有死亡人数的至少2.2%或18,300人的生命。现有数据证明，随着25-羟基维生素D浓度不足，总死亡率呈指数上升。
我们的计算基于：（1）《统计年鉴》提供的德国成年人群1.34%的年死亡率；（2）对来自德国不同地区264名全科医生的1,343名个体进行评估得出的德国高死亡风险成年人的实际维生素D状况（DEVID研究）；（3）两个非常大型的前瞻性队列（Dobnig等人，2008年；Melamed等人，2008年）关于维生素D水平不足个体的额外死亡率的数据。
在维生素D水平不足的人群中改善维生素D状况可能是降低年死亡率的有效策略。
