Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland 20892, USA. e-mail:
Am J Epidemiol. 2012 Dec 1;176(11):1043-50. doi: 10.1093/aje/kws285. Epub 2012 Nov 8.
Prospective epidemiologic data on the association between vitamin D and mortality are limited, particularly in Asian populations. Among subjects in Linxian, China, the authors aimed to test whether baseline serum 25-hydroxyvitamin D (25(OH)D) concentrations in a prospective cohort were associated with all-cause mortality and cause-specific mortality rates over 24 years of follow-up (1986-2010). Serum 25(OH)D concentrations were measured in 1,101 subjects using an immunoassay. Hazard ratios and 95% confidence intervals were calculated using Cox regression models that were adjusted for age, sex, tobacco smoking, alcohol drinking, and hypertension. The 25th, 50th, and 75th percentile concentrations of 25(OH)D were 19.6, 31.9, and 48.4 nmol/L, respectively. During follow-up, 793 subjects died, including 279 who died of cerebrovascular accident, 217 who died of cancer, and 200 cardiovascular disease deaths. All-cause mortality was not associated with 25(OH)D concentrations using continuous models (for every 15 nmol/L, hazard ratio = 1.01, 95% confidence interval: 0.97, 1.05) or quartile models (fourth vs. first quartiles, hazard ratio = 1.06, 95% confidence interval: 0.87, 1.30; P for trend = 0.731). The authors also found no association with the cause-specific mortality outcomes. Results were similar for men and women. This study showed that prediagnostic serum 25(OH)D concentrations were not associated with all-cause or cause-specific mortality rates in this Chinese population who had low levels of vitamin D.
前瞻性流行病学数据表明,维生素 D 与死亡率之间存在关联,但这种关联在亚洲人群中尤其有限。在中国林县的研究对象中,作者旨在检验前瞻性队列中基线血清 25-羟维生素 D(25(OH)D)浓度是否与 24 年随访期间(1986-2010 年)的全因死亡率和死因特异性死亡率相关。使用免疫测定法测量了 1101 名受试者的血清 25(OH)D 浓度。使用 Cox 回归模型计算风险比和 95%置信区间,该模型调整了年龄、性别、吸烟、饮酒和高血压因素。25(OH)D 的第 25、50 和 75 百分位数浓度分别为 19.6、31.9 和 48.4nmol/L。在随访期间,793 名受试者死亡,其中 279 名死于脑血管意外,217 名死于癌症,200 名死于心血管疾病。使用连续模型(每增加 15nmol/L,风险比=1.01,95%置信区间:0.97,1.05)或四分位模型(第四分位与第一分位相比,风险比=1.06,95%置信区间:0.87,1.30;P 趋势=0.731),25(OH)D 浓度与全因死亡率均无相关性。与特定死因死亡率也无关联。男性和女性的结果相似。这项研究表明,在维生素 D 水平较低的中国人群中,诊断前血清 25(OH)D 浓度与全因或死因特异性死亡率无关。