Department of Veterans Affairs, Center of Excellence for Suicide Prevention, Canandaigua, New York, United States of America.
Wegmans School of Pharmacy, St John Fisher College, Rochester, New York, United States of America.
PLoS One. 2023 Feb 1;18(2):e0279166. doi: 10.1371/journal.pone.0279166. eCollection 2023.
The purpose of this study is to determine the associations between Vitamin D supplementation, 25(OH) blood serum levels, suicide attempts, and intentional self-harm in a population of veterans in the Department of Veterans Affairs (VA).
A retrospective cohort study of US Veterans supplemented with Vitamin D. Veterans with any Vitamin D3 (cholecalciferol) or Vitamin D2 (ergocalciferol) fill between 2010 and 2018 were matched 1:1 to untreated control veterans having similar demographics and medical histories. Cox proportional hazards regression was used to estimate the time from the first Vitamin D3 (cholecalciferol) or Vitamin D2 (ergocalciferol) prescription fill to the first suicide attempt or intentional self-harm. Analyses were repeated in stratified samples to measure associations by race (Black or White), gender (male or female), blood levels (0-19 ng/ml, 20-39 ng/ml, and 40+ ng/ml), and average daily dosage.
Vitamin D3 and D2 supplementation were associated with a 45% and 48% lower risk of suicide attempt and self-harm ((D2 Hazard Ratio (HR) = 0.512, [95% CI, 0.457, 0.574]; D3 HR = 0.552, [95% CI, 0.511, 0.597])). Supplemented black veterans and veterans with 0-19 ng/ml vitamin D serum levels were at ~64% lower risk relative to controls (Black Veteran HR: 0.362 [95% CI: 0.298,0.440]; 0-19 ng/ml HR: 0.359 [95% CI: 0.215,0.598]). Supplementation with higher vitamin D dosages was associated with greater risk reductions than lower dosages (Log Average Dosage HR: 0.837 [95% CI: 0.779,0.900]).
Vitamin D supplementation was associated with a reduced risk of suicide attempt and self-harm in Veterans, especially in veterans with low blood serum levels and Black veterans.
本研究旨在确定维生素 D 补充剂、25(OH) 血清水平、自杀企图和故意自残在退伍军人事务部 (VA) 退伍军人中的关联。
这是一项对接受维生素 D 补充的美国退伍军人的回顾性队列研究。在 2010 年至 2018 年期间，任何服用维生素 D3（胆钙化醇）或维生素 D2（麦角钙化醇）的退伍军人与接受相似人口统计学和病史的未接受维生素 D 治疗的对照退伍军人进行 1:1 匹配。使用 Cox 比例风险回归来估计从第一次维生素 D3（胆钙化醇）或维生素 D2（麦角钙化醇）处方到第一次自杀企图或故意自残的时间。在分层样本中重复分析，以衡量按种族（黑人或白人）、性别（男性或女性）、血液水平（0-19ng/ml、20-39ng/ml 和 40+ng/ml）和平均日剂量测量关联。
维生素 D3 和 D2 补充与自杀企图和自残的风险降低 45%和 48%相关（D2 风险比（HR）=0.512，[95%CI，0.457，0.574]；D3 HR=0.552，[95%CI，0.511，0.597]））。与对照组相比，黑人退伍军人和维生素 D 血清水平为 0-19ng/ml 的退伍军人的风险降低了约 64%（黑人退伍军人 HR：0.362 [95%CI：0.298，0.440]；0-19ng/ml HR：0.359 [95%CI：0.215，0.598]）。较高剂量的补充与较低剂量的补充相比，风险降低更大（Log 平均剂量 HR：0.837 [95%CI：0.779，0.900]）。
维生素 D 补充与退伍军人自杀企图和自残风险降低相关，尤其是在血液血清水平较低和黑人退伍军人中。
