1Centre for Epidemiology and Biostatistics,Melbourne School of Population and Global Health,The University of Melbourne,Level 3,207 Bouverie Street,Melbourne,Victoria 3010,Australia.
3Farr Institute of Health Informatics Research,London,UK.
Public Health Nutr. 2017 Jul;20(10):1775-1784. doi: 10.1017/S1368980016000501. Epub 2016 Mar 29.
To investigate relationships between mortality and circulating 25-hydroxyvitamin D (25(OH)D), 25-hydroxycholecalciferol (25(OH)D3) and 25-hydroxyergocalciferol (25(OH)D2).
Case-cohort study within the Melbourne Collaborative Cohort Study (MCCS). We measured 25(OH)D2 and 25(OH)D3 in archived dried blood spots by LC-MS/MS. Cox regression was used to estimate mortality hazard ratios (HR), with adjustment for confounders.
General community.
The MCCS included 29 206 participants, who at recruitment in 1990-1994 were aged 40-69 years, had dried blood spots collected and no history of cancer. For the present study we selected participants who died by 31 December 2007 (n 2410) and a random sample (sub-cohort, n 2996).
The HR per 25 nmol/l increment in concentration of 25(OH)D and 25(OH)D3 were 0·86 (95 % CI 0·78, 0·96; P=0·007) and 0·85 (95 % CI 0·77, 0·95; P=0·003), respectively. Of 5108 participants, sixty-three (1·2 %) had detectable 25(OH)D2; their mean 25(OH)D concentration was 11·9 (95 % CI 7·3, 16·6) nmol/l higher (P<0·001). The HR for detectable 25(OH)D2 was 1·80 (95 % CI 1·09, 2·97; P=0·023); for those with detectable 25(OH)D2, the HR per 25 nmol/l increment in 25(OH)D was 1·06 (95 % CI 0·87, 1·29; P interaction=0·02). HR were similar for participants who reported being in good, very good or excellent health four years after recruitment.
Total 25(OH)D and 25(OH)D3 concentrations were inversely associated with mortality. The finding that the inverse association for 25(OH)D was restricted to those with no detectable 25(OH)D2 requires confirmation in populations with higher exposure to ergocalciferol.
研究死亡率与循环 25-羟维生素 D（25（OH）D）、25-羟胆钙化醇（25（OH）D3）和 25-羟麦角钙化醇（25（OH）D2）之间的关系。
墨尔本协作队列研究（MCCS）中的病例-队列研究。我们通过 LC-MS/MS 测量了存档的干血斑中的 25（OH）D2 和 25（OH）D3。使用 Cox 回归估计死亡率风险比（HR），并进行了混杂因素的调整。
普通社区。
MCCS 纳入了 29206 名参与者，他们在 1990-1994 年招募时年龄为 40-69 岁，采集了干血斑且无癌症病史。为了本研究，我们选择了截至 2007 年 12 月 31 日死亡的参与者（n=2410）和一个随机样本（子队列，n=2996）。
浓度每增加 25nmol/L，25（OH）D 和 25（OH）D3 的 HR 分别为 0.86（95%CI 0.78,0.96；P=0.007）和 0.85（95%CI 0.77,0.95；P=0.003）。在 5108 名参与者中，有 63 名（1.2%）可检测到 25（OH）D2；他们的平均 25（OH）D 浓度高 11.9（95%CI 7.3,16.6）nmol/L（P<0.001）。可检测到 25（OH）D2 的 HR 为 1.80（95%CI 1.09,2.97；P=0.023）；对于可检测到 25（OH）D2 的参与者，25（OH）D 每增加 25nmol/L，HR 为 1.06（95%CI 0.87,1.29；P 交互=0.02）。在招募后四年报告身体状况良好、非常好或极佳的参与者中，HR 相似。
总 25（OH）D 和 25（OH）D3 浓度与死亡率呈负相关。25（OH）D 的负相关仅限于那些无法检测到 25（OH）D2 的人群，这一发现需要在暴露于麦角钙化醇更高的人群中得到证实。
