Granic A, Aspray T, Hill T, Davies K, Collerton J, Martin-Ruiz C, von Zglinicki T, Kirkwood T B L, Mathers J C, Jagger C
Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK.
J Intern Med. 2015 Apr;277(4):456-67. doi: 10.1111/joim.12273. Epub 2014 Jun 20.
To investigate the associations between low and high concentrations of baseline serum 25-hydroxyvitamin D [25(OH)D] and all-cause mortality in very old (≥85 years) men and women over 6 years.
DESIGN, SETTING AND SUBJECTS: Prospective mortality data from 775 participants in the Newcastle 85+ Study were analysed for survival in relation to 25(OH)D (season-specific quartiles and predefined cut-off values) and sex using Cox proportional hazards models. The models were fitted to the entire and restricted (nonusers of vitamin D-containing supplements and medication) cohorts.
For the entire cohort, mortality was higher in both the lowest and highest 25(OH)D season-specific quartiles [SQ1: hazard ratio (HR) 1.31, 95% confidence interval (CI) 1.01-1.69, P = 0.04; SQ4: HR 1.44, 95% CI 1.12-1.85, P = 0.004] compared with the combined middle quartiles (SQ2 + SQ3), after adjustment for sociodemographic factors. The increased risk for the highest quartile remained significant after further adjustment for lifestyle variables (SQ4: HR 1.37, 95% CI 1.06-1.77, P = 0.02) and was seen only in women in sex-specific analyses. Similarly, in sensitivity analyses with predefined 25(OH)D cut-off values, the highest 25(OH)D concentration (≥75 nmol L(-1) ) was associated with a 2.4-fold increased risk of mortality in women (restricted cohort) after adjusting for all covariates.
Low and high season-specific 25(OH)D quartiles were associated with increased risks of mortality over 6 years in the very old; this effect was particularly noticeable in women, including those who reported taking vitamin D-containing supplements/medication.
调查6年期间，极低浓度和极高浓度的基线血清25-羟基维生素D[25(OH)D]与85岁及以上老年男性和女性全因死亡率之间的关联。
设计、地点和研究对象：对纽卡斯尔85岁及以上研究中775名参与者的前瞻性死亡率数据进行分析，使用Cox比例风险模型研究25(OH)D（按季节划分的四分位数和预定义临界值）与性别对生存率的影响。模型适用于整个队列以及受限队列（未使用含维生素D补充剂和药物的人群）。
在整个队列中，经社会人口学因素调整后，与中间两个四分位数（SQ2+SQ3）合并组相比，最低和最高25(OH)D季节特异性四分位数组的死亡率均更高[SQ1：风险比(HR)1.31，95%置信区间(CI)1.01-1.69，P=0.04；SQ4：HR 1.44，95%CI 1.12-1.85，P=0.004]。在进一步调整生活方式变量后，最高四分位数组的风险增加仍然显著（SQ4：HR 1.37，95%CI 1.06-1.77，P=0.02），且在性别特异性分析中仅见于女性。同样，在使用预定义25(OH)D临界值的敏感性分析中，在调整所有协变量后，最高25(OH)D浓度（≥75 nmol L-1）与女性（受限队列）死亡率增加2.4倍相关。
极低和极高季节特异性25(OH)D四分位数与老年人群6年期间死亡率风险增加相关；这种效应在女性中尤为明显，包括那些报告服用含维生素D补充剂/药物的女性。
