Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan.
Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
Eur J Epidemiol. 2023 Mar;38(3):291-300. doi: 10.1007/s10654-023-00968-8. Epub 2023 Jan 31.
While higher circulating 25-hydroxyvitamin D concentrations have been reported to be associated with decreased risk of all-cause mortality, evidence on dietary vitamin D intake is limited and inconsistent. We investigated whether vitamin D intake is associated with all-cause and cause-specific mortality among Japanese adults. Participants were 42,992 men and 50,693 women who responded to the second survey of the Japan Public Health Center-based Prospective Study (1995-1998) and who were followed up for mortality through 2018. Dietary intake was ascertained using a validated food frequency questionnaire. Hazard ratios of deaths from the second survey to December 2018 were estimated using Cox proportional hazard regression analysis. During follow-up, we identified 22,630 deaths. Overall, the third and fourth quintiles, but not the highest quintile, of vitamin D intake were each associated with a significantly lower risk of all-cause mortality. In subgroups characterized by low sunlight exposure, risk of all-cause mortality decreased linearly with increasing vitamin D intake. The multivariable-adjusted hazard ratios (95% confidence intervals) of all-cause mortality for the highest versus lowest quintile of vitamin D intake were 0.87 (0.79-0.95) in women and 0.88 (0.79-0.97) in residents of higher latitude areas. Lower risk was also observed for all-cause mortality in participants with hypertension and for heart disease mortality in those with higher calcium intake. Higher vitamin D intake was associated with decreased risk of ischemic stroke and pneumonia mortality. Higher dietary vitamin D was associated with a lower risk of mortality among individuals with low sunlight exposure or hypertension. Individuals with potentially low vitamin D may benefit from increasing dietary vitamin D intake for the prevention of premature death.
虽然较高的循环 25-羟维生素 D 浓度与全因死亡率降低相关，但有关饮食维生素 D 摄入量的证据有限且不一致。我们研究了维生素 D 摄入量与日本成年人全因和死因特异性死亡率的关系。参与者为 42992 名男性和 50693 名女性，他们参加了基于日本公共卫生中心的前瞻性研究（1995-1998 年）的第二次调查，并通过 2018 年的死亡率进行了随访。饮食摄入量通过验证的食物频率问卷确定。使用 Cox 比例风险回归分析估计第二次调查至 2018 年 12 月的死亡风险比。在随访期间，我们确定了 22630 例死亡。总体而言，维生素 D 摄入量的第三和第四五分位数，但不是最高五分位数，与全因死亡率的风险显著降低相关。在低阳光暴露特征的亚组中，全因死亡率随着维生素 D 摄入量的增加呈线性下降。最高五分位与最低五分位相比，女性的全因死亡率的多变量调整风险比（95%置信区间）为 0.87（0.79-0.95），高纬度地区居民为 0.88（0.79-0.97）。在高血压患者中，全因死亡率也观察到较低的风险，在钙摄入量较高的人群中，死于心脏病的风险也较低。缺血性卒中和肺炎死亡率也降低。较高的膳食维生素 D 与低阳光暴露或高血压个体的死亡率降低相关。维生素 D 可能摄入不足的个体可能受益于增加膳食维生素 D 摄入以预防过早死亡。
