Interdisciplinary Program in Precision Public Health, Graduate School, Korea University, Seoul 02841, Korea.
Department of Food and Nutrition, Chonnam National University, Gwangju 61186, Korea.
Nutrients. 2022 Apr 28;14(9):1849. doi: 10.3390/nu14091849.
Background Recent randomized controlled trials (RCTs) have shown no effect of vitamin D supplementation on cardiovascular disease, cancer events and mortality or all-cause mortality in Western populations. However, there has been a lack of research on populations with low vitamin D status, including Asians. In addition, there have been indications that an individual’s sex or hypertension status may affect the relationship between vitamin D status and mortality. In this study, we retrospectively assessed the association between vitamin D status and all-cause, cardiovascular, and cancer mortality in Koreans using a national database, and stratified participants according to sex and hypertension status. Methods Participants in the Korean Health and Nutrition Examination Survey 2008−2014, who consented to their data being synthesized with mortality data (up to December 2019), were included (n = 22,742; mean follow-up: 8.9 years). Participants’ level of serum 25-hydroxyvitamin D (25(OH)D) was measured by radioimmunoassay and categorized as <12, 12−19.9, and ≥20 ng/mL. A Cox proportional hazard model was used to assess the risk of mortality. Results In the total sample, risk of all-cause, cancer, and cardiovascular mortality was greater in adults with a serum 25(OH)D level below 12 and 12−19.9 ng/mL than those with ≥20 ng/mL. Men and adults with hypertension, who had low vitamin D status, had a higher risk of cancer and cardiovascular mortality, but not women or adults without hypertension. Similar results were observed when various cutoffs for 25(OH)D were employed, or extrinsic deaths were excluded. Conclusions Vitamin D status below 20 ng/mL is associated with a higher risk of mortality in Korean adults, especially in men and those with hypertension, on the basis of data from a nationally representative sample. Further RCTs on Asian adults with low vitamin D status are warranted.
最近的随机对照试验（RCT）表明，维生素 D 补充剂对西方人群的心血管疾病、癌症事件和死亡率或全因死亡率没有影响。然而，对于维生素 D 水平较低的人群，包括亚洲人，研究还很缺乏。此外，有迹象表明，个体的性别或高血压状况可能会影响维生素 D 状态与死亡率之间的关系。在这项研究中，我们使用国家数据库回顾性评估了维生素 D 状态与韩国人全因、心血管和癌症死亡率之间的关系，并根据性别和高血压状况对参与者进行分层。
纳入同意将其数据与死亡率数据（截至 2019 年 12 月）合并的 2008-2014 年韩国健康与营养调查参与者（n = 22742；平均随访时间：8.9 年）。采用放射免疫法检测参与者血清 25-羟维生素 D（25(OH)D）水平，并分为<12、12-19.9 和≥20ng/mL。采用 Cox 比例风险模型评估死亡率风险。
在总样本中，血清 25(OH)D 水平<12 和 12-19.9ng/mL 的成年人全因、癌症和心血管死亡率风险高于≥20ng/mL 者。维生素 D 状态较低的男性和高血压成年人癌症和心血管死亡率风险较高，但女性和无高血压成年人并非如此。当使用不同的 25(OH)D 切点或排除外源性死亡时，观察到了相似的结果。
在韩国成年人中，基于具有代表性的全国性样本数据，血清 25(OH)D 水平<20ng/mL 与死亡率风险升高相关，尤其是男性和高血压成年人。有必要对维生素 D 水平较低的亚洲成年人进行进一步的 RCT 研究。
